The authors of the study acknowledge that based on previous studies, when patients of ethnic minority groups are given patient-centered communication and care, their patient adherence and satisfaction improve. The authors used this background to create a cluster randomized trial involving African American patients suffering from depression. The purpose of the BRIDGE study was to determine whether patient-centered and culturally appropriate collaborative care had a positive effect on depression symptoms and rates of depression in African American patients (Cooper et al., 2013).The study involved interventions for clinicians and patients. Clinician interventions included continuing education in the form of articles, study updates, and communication training videos, all on depression. These tools were provided to both the standard and the patient-centered clinician groups. Patient interventions involved one on one telephone appointments with either a Caucasian social worker, for the standard group, or an African American social worker, for the patient-centered group. The patient-centered group was also given culturally targeted information on depression. Surveys throughout the study assessed depression severity and mental health functioning at 6, 12, and 18 months in both groups (Cooper et al., 2013).Describe and critique the research questions and study designThe research question in this study is whether patient-centered and culturally tailored care given to African American patients suffering from depression would lead to a “greater reduction in their depression symptoms, higher rates of depression remission, and greater improvements in mental health functioning…” than the standard group (Cooper et al., 2013). Depression can be a difficult disease to study because of the many ways that patients deal with their mental health. By relying on patients to self-report on their disease, the data can become extremely subjective.The study design was a cluster randomized trial. Instead of randomly assigning interventions to each participant, interventions were randomly assigned to “clusters” of participants based on the clinician. Clinicians were randomly assigned to either the patient-centered group or the standard group, despite the fact that many of the clinicians worked at the same clinics (Cooper et al., 2013). Randomization is important in making sure that clinicians are not able to choose how they will provide care to their patients. The majority of clinicians contributed some of their patients to this study, which could create a bias if the patients already have a relationship with their clinician. The interventions occurred over a 12-month period, which we believe is an adequate amount of time to accurately determine if the interventions have had an effect on depression severity (Cooper et al., 2013).Sample and SettingThe population of interest in this study was adequately described and the eligibility requirements for participants were clearly stated. It is however left unclear exactly how the participants were chosen other than 10 patients were selected from each randomized clinician. The study used a cluster sampling plan which can lead to higher sampling biases and a higher sampling error. Eligibility requirements of clinicians were stated and the recruitment method was explained. Recruitment for the clinicians involved an invitation to participate in the study, this method leads to a response bias as only individuals who are willing or interested will respond. Researchers saw a higher amount of participation from clinicians whose entire clinic was participating rather than a singular clinician at a specific site. The settings for the intervention were defined and eligibility requirements were detailed regarding the clinics. A stratified random design was used to determine the study sites and used for clinician delegation (to either standard collaborative care or patient-centered collaborative care). The researchers do not indicate that saturation was achieved and did not specify how they made the decision to stop collecting data (Cooper et al., 2013).