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Long-term outcomes of community engagement to address depression outcomes disparities
Investigator (PI): Wells, Kenneth B
Performing Organization (PO): (Current): University of California, Los Angeles, UCLA Health, David Geffen School of Medicine, Jane & Terry Semel Institute for Neuroscience & Human Behavior, Center for Health Services and Society / (310) 794-3725
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2013
Final Year: 2018
Record Source/Award ID: PCORI/1845
Funding: Total Award Amount: $2,342,615
Award Type: Grant
Award Information: PCORI: More information and project results (when completed)
Abstract: This study extends an existing study in Los Angeles that is partnered between academic and community and client stakeholders. The study has the long-term goal of learning collaboratively how to eliminate disparities in outcomes for persons with depression by improving information and services in inner-city communities of color, using two Los Angeles communities as examples. Much is known about how to treat depression, but there are gaps in access, quality, and outcomes of care that raise the burden of illness from depression in minority communities-and little is known about how to address these gaps. This study builds on an existing project, Community Partners in Care, in which different kinds of community-based agencies were assigned at random to having technical assistance as an individual agency to use toolkits to improve depression services and outcomes, or to work together across agencies to tailor the use of the toolkits to the strengths of the community and to collaborate as a network to improve depression outcomes. That study is just finishing and final results show that, at six-month follow-up, the community engagement and network activation approach, compared to technical assistance, improved clients' mental health and physical functioning and reduced risk factors for homelessness. These findings suggest that clients might benefit over a longer period of time. In addition, to build stronger collaborative systems for the future, it would be important to know how clients prioritize among such diverse outcomes and how providers and clients would work better together to address clients' priorities. The proposed study asks for funding to support data collection to compare three-year outcomes of clients under the two conditions--community engagement and technical assistance--particularly in their health outcomes, risk for homelessness, and employment outcomes, which are high priorities of clients and community stakeholders. The interventions could affect long-term outcomes directly or indirectly through earlier effects on health and social factors. We will study both pathways. We also propose to collect and analyze rich narrative information to understand what outcomes are important to depressed clients and how they make decisions about getting help to address them. Similarly, we want to collect data to understand whether and how providers address depressed clients' priorities for outcomes and services and to host community discussions across stakeholders on how to design programs through collaboration to better address clients' priorities. The research effort is "partnered" or done collaboratively with community members and clients.
MeSH Terms:
  • Community Mental Health Services /*organization & administration
  • Depression /epidemiology
  • /*ethnology /*therapy
  • Follow-Up Studies
  • Health Status Disparities
  • * Healthcare Disparities
  • Homeless Persons
  • Humans
  • Los Angeles
  • * Outcome Assessment, Health Care
  • Risk
  • Unemployment
Country: United States
State: California
Zip Code: 90024
UI: 20142268
CTgovId: NCT01699789
Project Status: Completed
Record History: ('2018: Project extended to 2018. 2017: Project extended to 2017.',)