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

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

Author information

1
Department of Psychiatry, Harbor-UCLA Medical Center/Los Angeles Biomedical Research Institute, Los Angeles, CA.
2
Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA.
3
RAND Corporation, Los Angeles, CA.
4
Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
5
Greater Los Angeles VA Health care System, Los Angeles, CA.
6
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA.
7
Healthy African American Families II, Los Angeles, CA.
8
Behavioral Health Services, Los Angeles, CA.
9
School of Nursing, UCLA, Los Angeles, CA.

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

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