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.
David Geffen School of Medicine at UCLA, Los Angeles CA.
Ethn Dis. 2019 Apr 18;29(2):277-286. doi: 10.18865/ed.29.2.277. eCollection 2019 Spring.
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.
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.
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).
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.
少数民族在抑郁症方面存在差异,并且缺乏循证干预措施来改善抑郁症的护理获取和结果。社区合作伙伴关爱(CPIC)是一项在资源匮乏的城市社区中进行的抑郁症护理质量改进(QI)的社区合作伙伴研究:社区参与和规划(CEP)用于多部门联盟,以及服务资源(RS)用于项目技术援助。CEP 为整个 CPIC 研究人群带来了益处;对于黑人和拉丁裔亚人群的影响尚不清楚。
本亚分析检查了从 90 个项目中招募的 409 名拉丁裔和 488 名非拉丁裔(黑人)成年人的基线或 6 个月随访结果。回归分析用于估计 CEP 与 RS 干预对 6 个月时主要(心理健康相关生活质量 [MHRQL]、患者健康问卷-9 [PHQ-9])和社区优先(心理健康、身体活动、无家可归风险)结果的影响。
在两组中,干预组的基线特征在统计学上没有显著差异。在黑人成年人的调整分析中,CEP 导致较差的 MHRQL 可能性降低(OR:0.62,95%CI:0.41-0.94,P=0.028),并有降低无家可归风险的趋势(OR:0.60,0.35-1.05,P=0.69)。对于拉丁裔成年人,CEP 导致更高的心理健康可能性(OR:1.81,1.05-3.13,P=0.034),并有增加身体活动的趋势(OR:1.52,0.93-2.49,P=0.091)。
CPIC 对抑郁症质量改进的探索性分析表明,黑人和拉丁裔参与者在心理健康结果方面有显著的 6 个月获益,并且两组在社区优先结果方面都有改善的趋势。这些发现可能为促进抑郁症护理公平的多部门联盟研究提供信息。