Chung Bowen, Ngo Victoria K, Ong Michael K, Pulido Esmeralda, Jones Felica, Gilmore James, Stoker-Mtume Norma, Johnson Megan, Tang Lingqi, Wells Kenneth Brooks, Sherbourne Cathy, Miranda Jeanne
Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail:
Psychiatr Serv. 2015 Aug 1;66(8):831-9. doi: 10.1176/appi.ps.201400099. Epub 2015 May 1.
Community engagement and planning (CEP) could improve dissemination of depression care quality improvement in underresourced communities, but whether its effects on provider training participation differ from those of standard technical assistance, or resources for services (RS), is unknown. This study compared program- and staff-level participation in depression care quality improvement training among programs enrolled in CEP, which trained networks of health care and social-community agencies jointly, and RS, which provided technical support to individual programs.
Matched programs from health care and social-community service sectors in two communities were randomly assigned to RS or CEP. Data were from 1,622 eligible staff members from 95 enrolled programs. Primary outcomes were any staff trained (for programs) and total hours of training (for staff). Secondary staff-level outcomes were hours of training in specific depression collaborative care components.
CEP programs were more likely than RS programs to participate in any training (p=.006). Within health care sectors, CEP programs were more likely than RS programs to participate in training (p=.016), but within social-community sectors, there was no difference in training by intervention. Among staff who participated in training, mean training hours were greater among CEP programs versus RS programs for any type of training (p<.001) and for training related to each component of depression care (p<.001) except medication management.
CEP may be an effective strategy to promote staff participation in depression care improvement efforts in underresourced communities.
社区参与和规划(CEP)有助于在资源匮乏社区推广抑郁症护理质量改善工作,但它对提供者培训参与度的影响是否与标准技术援助或服务资源(RS)不同尚不清楚。本研究比较了参与CEP(联合培训医疗保健和社会社区机构网络)和RS(为单个项目提供技术支持)的项目在抑郁症护理质量改善培训中的项目层面和工作人员层面的参与情况。
从两个社区的医疗保健和社会社区服务部门匹配的项目中随机分配到RS或CEP。数据来自95个参与项目的1622名符合条件的工作人员。主要结果是接受培训的工作人员(针对项目)和培训总时长(针对工作人员)。次要工作人员层面的结果是特定抑郁症协作护理组成部分的培训时长。
CEP项目比RS项目更有可能参与任何培训(p = 0.006)。在医疗保健部门内,CEP项目比RS项目更有可能参与培训(p = 0.016),但在社会社区部门内,不同干预措施的培训情况没有差异。在参与培训的工作人员中,CEP项目中任何类型培训(p < 0.001)以及与抑郁症护理各组成部分相关的培训(除药物管理外,p < 0.001)的平均培训时长均高于RS项目。
CEP可能是促进资源匮乏社区工作人员参与抑郁症护理改善工作的有效策略。