Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 May-Jun;29(3):325-38.
doi: 10.3122/jabfm.2016.03.150306.

The Impact of Community Engagement on Health, Social, and Utilization Outcomes in Depressed, Impoverished Populations: Secondary Findings from a Randomized Trial

Christine A Lam  1 , Cathy Sherbourne  2 , Lingqi Tang  2 , Thomas R Belin  2 , Pluscedia Williams  2 , Angela Young-Brinn  2 , Jeanne Miranda  2 , Kenneth B Wells  2
Affiliations
Randomized Controlled Trial

The Impact of Community Engagement on Health, Social, and Utilization Outcomes in Depressed, Impoverished Populations: Secondary Findings from a Randomized Trial

Christine A Lam et al. J Am Board Fam Med. 2016 May-Jun.

Abstract

Background: Disparities in depression care exist among the poor. Community Partners in Care (CPIC) compared a community coalition model with technical assistance to improve depression services in under-resourced communities. We examine effects on health, social, and utilization outcomes among the poor and, non-poor depressed, and poor subgroups.

Methods: This study analyzed clients living above (n = 268) and below (n = 750) the federal-poverty level and, among the poor, 3 nonoverlapping subgroups: justice-involved (n = 158), homeless and not justice-involved (n = 298), and other poor (n = 294). Matched programs (n = 93) from health and community sectors were randomly assigned to community engagement and planning (CEP) or resources for services (RS). Primary outcomes were poor mental health-related quality of life and 8-item Patient Health Questionnaire scores, whereas community-prioritized and utilization outcomes were secondary. Effects were scrutinized using false discovery rate-adjusted P values to account for multiple comparisons.

Results: In the impoverished group, CEP and RS clients of participating study programs did not differ in primary outcomes, but CEP more than RS improved mental wellness among the depressed poor (unadjusted P = .004) while providing suggestive evidence for other secondary outcomes. Within the poor subgroups, evidence favoring CEP was only suggestive but was strongest among justice-involved clients.

Conclusions: A coalition approach to improving outcomes for low-income clients with depression, particularly those involved in the justice system, may offer additional benefits over standard technical assistance programs.

Keywords: Depression; Health Care Disparities; Homelessness; Populations; Social Determinants of Health; Underserved.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest / Disclosures: None.

Comment in

References

    1. Insel TR, Charney DS. Research on major depression: strategies and priorities. JAMA. 2003;289:3167–3168. - PubMed
    1. Kessler RC, Chiu WT, Demler O, Walters E. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psych. 2005;62:617–627. - PMC - PubMed
    1. Williams DR, Gonzalez HM, Neighbors H, et al. Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: results from the National survey of American Life. Arch Gen Psych. 2007;64:305–315. - PubMed
    1. Jackson-Triche M, Wells KB, Minnium K. Beating Depression: The Journey to Hope. McGraw-Hill Companies; 2002.
    1. Alegria M, Chatterji P, Wells KB, et al. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatr Serv. 2008;59:1264–1272. - PMC - PubMed

Publication types

MeSH terms