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Final Research Report Comparing Long-Term Outcomes of Two Collaborative Care Approaches for People with Depression Kenneth Wells, MD1,2,3,4,5 ; Loretta Jones, MA6,7, ; Michael Ong, MD2 ; Wayne Aoki, PhD8 ;Thomas Belin, PhD3 ; Elizabeth Bromley, MD1,2,5 ; Bowen Chung, MD 1,2,4,9 ; Elizabeth Dixon, PhD MSN/MPH, RN 10 ; Megan Dwight Johnson, MD 11 ; Felica Jones 6 ; Paul Koegel, PhD 4 ;Dmitry Khodyakov, PhD4 ; Craig Landry, PhD1,2 ; Elizabeth Lizaola, MPH 1,2 ; Norma Mtume, MHS, MA, MFT 12 ; Victoria Ngo, PhD4 ; Judith Perlman, MS4 ; Esmeralda Pulido, MPH13 ; Vivian Sauer, MSW14; Cathy Sherbourne, PhD 4 ; Aziza Lucas Wright 4,6,15;Lingqi Tang, PhD1,2; Yolanda Whittington, MSW 9 ; Pluscedia Williams 6,7 ;Lily Zhang, MS1,2 ; Marvin Southard, DSW18 ;Jeanne Miranda, PhD 1,2 ; Sheryl Kataoka, MD, MSHS 1,2 ; Roya Ijadi-Maghsoodi, MD, MSHPM 2,5 ; Chantal Figueroa, PhD 15; Enrico Castillo, MD, MSHPM 9,16; Heather Patel, MPH 16 ;Mienah Zulfacar Sharif 16; S. Megan Helle 16 ;Krystal Griffith, MPH 1,2; Farbod Kadkhoda, MA 1,2; Priscilla Shorter 17; Rosalinda Cardenas 1,2;Joseph Mango, MFA 1,2 ; Erika Orellana 1,2 1David Geffen School of Medicine, University of California, Los Angeles 2Semel Institute, University of California, Los Angeles 3Fielding School of Public Health, University of California, Los Angeles, CA 4RAND Health Program/ The RAND Corporation, Santa Monica, CA 5Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA 6Healthy African American Families Phase II, Los Angeles, CA 7Charles R Drew University of Medicine and Science, Los Angeles, CA 8Los Angeles Christian Health Centers, Los Angeles, CA 9Los Angeles County Department of Mental Health Services, Los Angeles, CA 10University of California, Los Angeles School of Nursing, Los Angeles, CA 11Kaiser Permanente/Southern California Permanente Medical Group 12 Shields for Families, Inc.,Los Angeles, CA 13 University of Washington Medical Center, Seattle, WA 14 Jewish Family Services of Los Angeles, Los Angeles, CA 15 Colorado College, Colorado Springs, CO 16 University of California, Los Angeles, CA 17 NYU Langone Medical Center, New York, NY 18 University of Southern California, Los Angeles, CA Original Project Title: Long-Term Outcomes of Community Engagement to Address Depression Outcomes Disparities PCORI ID: 1845 HSRProj ID: 20142268 ClinicalTrials.gov ID: NCT01699789 _______________________________ To cite this document, please use: Wells K, Jones L, Ong M, et al. 2018. Comparing Long- Term Outcomes of Two Collaborative Care Approaches for People with Depression. Washington, DC: Patient-Centered Outcomes Research Institute (PCORI). https:// doi.org/10.25302/11.2018.CER.1845 Table of Contents Abstract ................................................................................................................................ 1 Background ........................................................................................................................... 3 Alternative Sectors and Community Partners in Care ................................................................ 4 Participation of Patients and Other Stakeholders in the Design and Conduct of Research and Dissemination of Findings ...................................................................................................... 8 Methods ............................................................................................................................. 10 Overview of Design ................................................................................................................... 10 Main Extension Study Design .................................................................................................... 11 Main Extension Study Sampling ................................................................................................ 12 Interventions: Choice of Comparators ...................................................................................... 15 Main Extension Study Outcomes .............................................................................................. 18 Data Collection and Sources ...................................................................................................... 20 Analytic and Statistical Approaches: Partnered Analysis .......................................................... 21 Methods for Aim 4 Supplemental Policy Interviews ................................................................. 25 Results ................................................................................................................................ 27 Discussion ........................................................................................................................... 52 Decisional Context ..................................................................................................................... 52 Results in Context ...................................................................................................................... 54 Implementation of Results ........................................................................................................ 56 Generalizability .......................................................................................................................... 57 Subpopulations .......................................................................................................................... 57 Limitations ................................................................................................................................. 58 Future Research ........................................................................................................................ 59 Conclusions ......................................................................................................................... 60 References .......................................................................................................................... 62 Acknowledgments ............................................................................................................... 68 Related Publications ............................................................................................................ 70 Appendices ......................................................................................................................... 71 Description of Main Study Design ........................................................................................... I-71 Estimate of Use of Programs for Depression Services for Programs in Unassigned Intervention (Contamination) and Assigned Intervention During the Main Study (Baseline to 12 Months) .............................................................................................................................................. ..II-78 Community Partners in Care Collaborative Care Resources ................................................. III-80 Community Engagement and Planning ................................................................................. IV-86 Qualitative Interview Guides .................................................................................................. V-87 Client 3-year Qualitative Interviewer Guide ....................................................................... V-88 Staff Qualitative Interviews Guide ...................................................................................... V-95 HNI Stakeholder Interviews Questionnaire ...................................................................... V-103 Policy and Funder Stakeholders Interviews Questionnaire ............................................. V-104 Appendix References ....................................................................................................... VI-105 Abstract Background: Depression is a leading cause of morbidity with disparities in care. Depression collaborative care—a team-based approach supporting care management, patient activation, and evidence-based treatments—is effective relative to usual care but often unavailable in underresourced communities. Community Partners in Care (CPIC) randomized 95 programs in health care and community-based (eg, social services, faith-based) service sectors in 2 communities, into Resources for Services (RS) for individual program technical assistance versus Community Engagement and Planning (CEP) for multisector coalition support for depression collaborative care. For depressed clients, CEP relative to RS reduced having poor mental health–related quality of life (MHRQL) and behavioral health hospitalization over 6 to 12 months. Longer-term outcomes are unknown. Aims: This extension study of CPIC aims to do the following: 1. Compare CEP and RS effects at 3-year follow-up 2 years after intervention support, on primary (depression and MHRQL), community-prioritized outcomes of physical health– related quality of life (PHRQL) and behavioral health hospitalization, and outpatient services use (secondary). 2. Compare effects of CEP and RS at 6, 12, and 36 months for CPIC participants enrolled in health care or community-based service sectors. 3. Describe outcome priorities for African American and Latino depressed clients, and as perceived by providers. 4. Describe views of stakeholders planning the Los Angeles County Health Neighborhood Initiative (HNI) informed by CPIC and national stakeholders briefed on CPIC and HNI. We hypothesized that CEP relative to RS would improve long-term mental and physical health and reduce hospitalization nights,
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