Pratik Mehta1, Anthony Brown2, Bowen Chung1,3, Felica Jones2, Lingqi Tang1,3, James Gilmore4, Jeanne Miranda1,3, Kenneth Wells1,3,5. 1. Department of Psychiatry and Biobehavioral Sciences, UCLA Medical Center, Los Angeles, Calif. 2. Healthy African American Families, Los Angeles, Calif. 3. Center for Health Services and Society, UCLA Semel Institute, Los Angeles, Calif. 4. Behavioral Health Services, Inc., Los Angeles, Calif. 5. Department of Health Services and Society, UCLA Medical Center, Los Angeles, Calif.
Abstract
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 OUTCOME MEASURES: 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 multi-sector 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.
RCT Entities:
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 OUTCOME MEASURES: 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 multi-sector 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.
Entities:
Keywords:
Collaborative Care; Community-based Participatory Research; Depression; Mental Health
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