Dr. Ong is with the Department of Medicine; Dr. Belin is with the Department of Biostatistics; Dr. Bromley, Dr. Landry, Ms. Lizaola, Ms. Williams, Ms. Zhang, Dr. Miranda, and Dr. Wells are with the Center for Health Services and Society, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine; Dr. Chung and Dr. Tang are with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine; and Dr. Dixon is with the School of Nursing, all at the University of California, Los Angeles (UCLA), Los Angeles. Dr. Ong is also with the Department of Medicine, Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles. Dr. Bromley is also with the Desert Pacific Mental Illness Research, Education and Clinical Center, West Los Angeles VA Healthcare System, Los Angeles. Ms. Williams is also with Healthy African American Families II, Los Angeles, where Dr. Jones and Ms. Jones are affiliated. Dr. Wells is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Koegel, Dr. Khodyakov, Dr. Ngo, Ms. Perlman, and Dr. Sherbourne are affiliated. Dr. Aoki is with Los Angeles Christian Health Centers, Los Angeles. Dr. Johnson is with the Department of Psychiatry, Kaiser Permanente of Southern California, Los Angeles. Ms. Mtume is with Shields for Families, Los Angeles. Ms. Pulido is with L.A. Care Health Plan, Los Angeles. Ms. Sauer is with Jewish Family Services of Los Angeles, Los Angeles. Mr. Vidaurri and Ms. Whittington are with the Los Angeles County Department of Mental Health, Los Angeles. Ms. Lucas-Wright is with the UCLA Clinical and Translational Science Institute and the Charles R. Drew University of Medicine and Science, both in Los Angeles. Dr. Southard is with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles.
Psychiatr Serv. 2017 Dec 1;68(12):1262-1270. doi: 10.1176/appi.ps.201600488. Epub 2017 Jul 17.
Community Partners in Care, a community-partnered, cluster-randomized trial with depressed clients from 93 Los Angeles health and community programs, examined the added value of a community coalition approach (Community Engagement and Planning [CEP]) versus individual program technical assistance (Resources for Services [RS]) for implementing depression quality improvement in underserved communities. CEP was more effective than RS in improving mental health-related quality of life, reducing behavioral health hospitalizations, and shifting services toward community-based programs at six months. At 12 months, continued evidence of improvement was found. This study examined three-year outcomes.
Among 1,004 participants with depression who were eligible for three-year follow-up, 600 participants from 89 programs completed surveys. Multiple regression analyses estimated intervention effects on poor mental health-related quality of life and depression, physical health-related quality of life, behavioral health hospital nights, and use of services.
At three years, no differences were found in the effects of CEP versus RS on depression or mental health-related quality of life, but CEP had modest effects in improving physical health-related quality of life and reducing behavioral health hospital nights, and CEP participants had more social- and community-sector depression visits and greater use of mood stabilizers. Sensitivity analyses with longitudinal modeling reproduced these findings but found no significant differences between groups in change from baseline to three years.
At three years, CEP and RS did not have differential effects on primary mental health outcomes, but CEP participants had modest improvements in physical health and fewer behavioral health hospital nights.
社区伙伴关怀（Community Partners in Care）是一项社区伙伴参与的、集群随机试验，研究对象为来自洛杉矶 93 个健康和社区项目的抑郁患者，该试验考察了社区联盟方法（社区参与和规划 [CEP]）与个体项目技术援助（服务资源 [RS]）对改善服务不足社区的抑郁质量改进的附加价值。在六个月时，CEP 比 RS 更有效地改善了心理健康相关的生活质量，减少了行为健康住院治疗，并将服务转向社区为基础的项目。在 12 个月时，继续发现了改善的证据。本研究检查了三年的结果。
在有资格进行三年随访的 1004 名患有抑郁的参与者中，有 89 个项目的 600 名参与者完成了调查。多元回归分析估计了干预措施对不良心理健康相关生活质量和抑郁、身体健康相关生活质量、行为健康住院夜数以及服务使用的影响。
在三年时，CEP 与 RS 在抑郁或心理健康相关生活质量方面没有差异，但 CEP 在改善身体健康相关生活质量和减少行为健康住院夜数方面具有适度影响，CEP 参与者有更多的社会和社区部门的抑郁就诊和更多地使用情绪稳定剂。使用纵向模型进行的敏感性分析复制了这些发现，但在从基线到三年的变化方面，两组之间没有显著差异。
在三年时，CEP 和 RS 对主要心理健康结果没有差异，但 CEP 参与者在身体健康方面有适度改善，行为健康住院夜数减少。
