Nicolás E Barceló1, Alma Lopez2, Lingqi Tang1, Maria Gabriela Aguilera Nunez1, Felica Jones3, Jeanne Miranda1, Bowen Chung4, Armen Arevian1, Curley Bonds5, Adriana Izquierdo6, Elizabeth Dixon7, Kenneth Wells8. 1. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA. 2. David Geffen School of Medicine at UCLA, Los Angeles CA. 3. Healthy African American Families Phase II, Los Angeles, CA. 4. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA; Los Angeles County Department of Mental Health, Los Angeles CA. 5. Los Angeles County Department of Mental Health, Los Angeles, CA. 6. Department of Medicine, David Geffen School of Medicine at UCLA; VA Greater Los Angeles Healthcare System, Los Angeles, CA. 7. UCLA School of Nursing, Los Angeles, CA. 8. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA; Department of Health Policy and Management, Fielding School of Public Health; RAND Health Program; Greater Los Angeles Veteran Affairs Health Care System, Los Angeles CA.
Abstract
Objective: Racial/ethnic minorities experience disparities in depression1 and there is a paucity of evidence-based interventions to improve depression care access and outcomes. Community Partners in Care (CPIC) is a community-partnered study of depression care quality improvement (QI) in under-resourced, urban communities: Community Engagement and Planning (CEP) for multi-sector coalitions, and Resources for Services (RS) for program technical assistance.2 CEP demonstrated benefits for the overall CPIC study population; effects for Black and Latino sub-populations are unknown. Methods: This sub-analysis examines outcomes for 409 Latino and 488 Black (non-Latino) adults recruited from 90 programs who completed baseline or 6-month follow-up. Regression analyses were used to estimate CEP vs RS intervention effects on primary (Mental Health Related Quality of Life [MHRQL], Patient Health Questionnaire-9 [PHQ-9]) and community-prioritized (mental wellness, physical activity, risk for homelessness) outcomes at 6-months. Results: Baseline characteristics did not differ significantly by intervention in either group. In the adjusted analysis for Black adults, CEP resulted in decreased odds of poor MHRQL (OR: .62, 95% CI=.41-.94, P=.028) with a trend for reducing homelessness risk (OR: .60, .35-1.05, P=.69). For Latino adults, CEP resulted in greater probability of mental wellness (OR: 1.81, 1.05-3.13, P=.034) and a trend for increased physical activity (OR: 1.52, .93-2.49, P=.091). Conclusions: Exploratory analyses of CEP for depression quality improvement suggests significant 6-month benefits in mental health outcomes for Black and Latino participants and trends for improvement in community-prioritized outcomes for both groups. Findings may inform research in multi-sector coalitions to promote equity in depression care.
Objective: Racial/ethnic minorities experience disparities in depression1 and there is a paucity of evidence-based interventions to improve depression care access and outcomes. Community Partners in Care (CPIC) is a community-partnered study of depression care quality improvement (QI) in under-resourced, urban communities: Community Engagement and Planning (CEP) for multi-sector coalitions, and Resources for Services (RS) for program technical assistance.2 CEP demonstrated benefits for the overall CPIC study population; effects for Black and Latino sub-populations are unknown. Methods: This sub-analysis examines outcomes for 409 Latino and 488 Black (non-Latino) adults recruited from 90 programs who completed baseline or 6-month follow-up. Regression analyses were used to estimate CEP vs RS intervention effects on primary (Mental Health Related Quality of Life [MHRQL], Patient Health Questionnaire-9 [PHQ-9]) and community-prioritized (mental wellness, physical activity, risk for homelessness) outcomes at 6-months. Results: Baseline characteristics did not differ significantly by intervention in either group. In the adjusted analysis for Black adults, CEP resulted in decreased odds of poor MHRQL (OR: .62, 95% CI=.41-.94, P=.028) with a trend for reducing homelessness risk (OR: .60, .35-1.05, P=.69). For Latino adults, CEP resulted in greater probability of mental wellness (OR: 1.81, 1.05-3.13, P=.034) and a trend for increased physical activity (OR: 1.52, .93-2.49, P=.091). Conclusions: Exploratory analyses of CEP for depression quality improvement suggests significant 6-month benefits in mental health outcomes for Black and Latino participants and trends for improvement in community-prioritized outcomes for both groups. Findings may inform research in multi-sector coalitions to promote equity in depression care.
Entities:
Keywords:
Community-Based Participatory Research; Depression; Disparity; Equity; Minority Groups
Authors: Stephen B Thomas; Sandra Crouse Quinn; James Butler; Craig S Fryer; Mary A Garza Journal: Annu Rev Public Health Date: 2011 Impact factor: 21.981
Authors: Ira Lesser; Aurora Rosales; Sidney Zisook; Carlos Gonzalez; Deborah Flores; Madhukar Trivedi; Andres Sciolla; James Luther; Stephen Wisniewski; Jonathan Alpert; Ian Cook; A John Rush; Marcy Epstein Journal: Psychiatr Serv Date: 2008-11 Impact factor: 3.084