Community Partners in Care: 6- and 12-month Outcomes of Community Engagement versus Technical Assistance to Implement Depression Collaborative Care among Depressed Older Adults

Objective: Community Partners in Care, a community-partnered, cluster-randomized trial with depressed clients from 95 Los Angeles health and community programs, examined the added value of a community coalition approach (Community Engagement and Planning [CEP]) versus individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care in underserved communities. This exploratory subanalysis examines 6- and 12-month outcomes among CPIC participants aged >50 years.Design: Community-partnered, cluster-randomized trial conducted between April 2010 and March 2012.Setting: Hollywood-Metropolitan (HM) and South Los Angeles (SLA) Service Planning Areas (SPAs), Los Angeles, CaliforniaParticipants: 394 participants aged >50 years with depressive symptoms (8-item Patient Health Questionnaire score ≥ 10).Intervention: A community-partnered multi-sector coalition approach (Community Engagement and Planning [CEP]) vs individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care.Main Outcome Measures: Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), community-prioritized outcomes including mental wellness, homelessness risk and physical activity, and services utilization.Results: At 6 months, CEP was more effective than RS at improving MHRQL and mental wellness among participants aged >50 years; no differences were found in the effects of CEP vs RS on other outcomes. No significant outcome differences between CEP and RS were found at 12 months.Conclusions: A multisector community coalition approach may offer additional benefits over individual program technical assistance to improve outcomes among depressed adults aged >50 years living in underserved communities. Ethn Dis.2018;28(Suppl 2):339-348; doi:10.18865/ed.28.S2.339.

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Community Partners in Care: 6-Month Outcomes of Two Quality Improvement Depression Care Interventions in Male Participants

Ethnicity & Disease ◽

10.18865/ed.27.3.223 ◽

2017 ◽

Vol 27 (3) ◽

pp. 223 ◽

Cited By ~ 4

Author(s):

Pratik Mehta ◽

Anthony Brown ◽

Bowen Chung ◽

Felica Jones ◽

Lingqi Tang ◽

...

Keyword(s):

Mental Health ◽

Los Angeles ◽

Technical Assistance ◽

Cluster Randomized Trial ◽

Future Research ◽

Community Partners ◽

South Los Angeles ◽

Male Clients ◽

Minority Men ◽

Mental Wellness

Objective: Limited data exist on approaches to improve depression services for men in under-resourced communities. This article explores this issue using a sub-analysis of male participants in Community Partners in Care (CPIC). Design: Community partnered, cluster, randomized trial. Setting: Hollywood-Metropolitan and South Los Angeles, California. Participants: 423 adult male clients with modified depression (PHQ-8 score≥10). Interventions: Depression collaborative care implementation using community engagement and planning (CEP) across programs compared with the more-traditional individual program, technical assistance (Resources for Services, RS). Main Outcomes Measured: Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), mental wellness, services utilization and settings. Results: At screening, levels of probable depression were moderate to high (17.5%- 47.1%) among men across services sectors. Intervention effects on primary outcomes (PHQ-8 score and MHRQL) did not differ. Men in CEP compared with RS had improved mental wellness (OR 1.85, 95% CI 1.00–3.42) and reduced hospitalizations (OR .40, 95% CI .16–.98), with fewer mental health specialty medication visits (IRR 0.33, 95% CI .15–.69), and a trend toward greater faith-based depression visits (IRR 2.89, 95% CI .99–8.45). Conclusions: Exploratory sub-analyses suggest that high rates of mainly minority men in under-resourced communities have high prevalence of depression. A multisector coalition approach may hold promise for improving community-prioritized outcomes, such as mental wellness and reduced hospitalizations for men, meriting further development of this approach for future research and program design.Ethn Dis. 2017;27(3):223-232; doi:10.18865/ed.27.3.223

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