12-Month Cost Outcomes of Community Engagement Versus Technical Assistance for Depression Quality Improvement: A Partnered, Cluster Randomized, Comparative-Effectiveness Trial

Ethn Dis. 2018 Sep 6;28(Suppl 2):349-356. doi: 10.18865/ed.28.S2.349. eCollection 2018.

Abstract

Objective: To compare community engagement and planning (CEP) for coalition support to implement depression quality improvement (QI) to resources for services (RS) effects on service-use costs over a 12-month period.

Design: Matched health and community programs (N=93) were cluster-randomized within communities to CEP or RS.

Setting: Two Los Angeles communities.

Participants: Adults (N=1,013) with depressive symptoms (Patient Health Questionnaire (PHQ-8) ≥10); 85% African American and Latino.

Interventions: CEP and RS to support programs in depression QI.

Main outcome measures: Intervention training and service-use costs over 12 months.

Results: CEP planning and training costs were almost 3 times higher than RS, largely due to greater CEP provider training participation vs RS, with no significant differences in 12-month service-use costs.

Conclusions: Compared with RS, CEP had higher planning and training costs with similar service-use costs.

Keywords: Collaborative Care; Community-Based Participatory Research; Cost Analysis; Depression; Mental Health Services; Racial Disparities.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cluster Analysis
  • Community Mental Health Services* / economics
  • Community Mental Health Services* / methods
  • Community Participation* / economics
  • Community Participation* / methods
  • Depression* / economics
  • Depression* / therapy
  • Female
  • Health Planning Technical Assistance / economics*
  • Humans
  • Los Angeles
  • Male
  • Mental Health / economics
  • Middle Aged
  • Psychosocial Support Systems*
  • Quality Improvement