Depression is a common chronic condition—second to hypertension—and is estimated to be the leading cause of morbidity and disability worldwide. It is common across all age and cultural groups; but, under-resourced communities, especially communities of color, have less access to care and evidence-based treatments.
Community Partners in Care (CPIC) compared the effectiveness of diverse safety net providers working together using a participatory network approach, and a technical assistance approach, to implement quality improvement (QI) for clients’ mental health-related quality of life (HRQL) and services use. Community Partners In Care was designed and is being implemented in the CPPR model by a community-academic Council from Los Angeles.
Through CPIC, diverse safety net providers working together to a technical assistance model were compared through a rigorous randomized trial involving over 1000 depressed clients drawn from 93 healthcare and community-based programs. The clients were primarily African American and Latino, the majority met federal poverty criteria and had multiple chronic medical conditions, nearly half were uninsured and at high risk for being homeless and many had substance abuse problems.
From 93 randomized programs, 4,440 clients were screened and 1,322 clients were identified as depressed by the 8-item Patient Health Questionnaire (PHQ-8). 1,246 clients enrolled and 1,018 clients completed baseline or 6-month follow-up.
Results showed that diverse safety net providers working together was more effective than technical assistance at improving mental health-related quality of life (HRQL), increasing physical activity and reducing homelessness risk factors, rate of behavioral health hospitalization and medication visits among specialty care users (i.e. psychiatrists, mental health providers) while increasing depression visits among users of primary care/public health for depression and users of faith-based and park programs (each p<0.05).
In contrast to 6-month results, the findings did not show consistent effects on safety net providers working together to reduce the likelihood of poor client MHRQL and behavioral health hospitalizations at 12-months. Still given under-resourced communities’ needs, diverse safety net providers working together favorable profile, and the absence of evidence-based alternatives, community engagement remains a viable strategy for policymakers and community to consider.
Analysis of 3-year follow up findings is still under way
Population of focus: African American, Latinx
Links to resource:
- Learn more about the Community Partners in Care collaborative research project of community and academic partners working together.
- Read more about the Community Partners in Care collaborative research project.