Community partners in care: 6-month outcomes of two quality improvement depression care interventions in male participants

Abstract

Objective: Limited data exist on approaches to improve depression services for men in under-resourced communities. This article explores this issue using a sub-analysis of male participants in Community Partners in Care (CPIC). Design: Community partnered, cluster, randomized trial. Setting: Hollywood-Metropolitan and South Los Angeles, California. Participants: 423 adult male clients with modified depression (PHQ-8 score≥10). Interventions: Depression collaborative care implementation using community engagement and planning (CEP) across programs compared with the more-traditional individual program, technical assistance (Resources for Services, RS). Main Outcomes Measured: Depressive symptoms (PHQ-8 score), mental healthrelated quality of life (MHRQL), mental wellness, services utilization and settings. Results: At screening, levels of probable depression were moderate to high (17.5%-47.1%) among men across services sectors. Intervention effects on primary outcomes (PHQ-8 score and MHRQL) did not differ. Men in CEP compared with RS had improved mental wellness (OR 1.85, 95% CI 1.00-3.42) and reduced hospitalizations (OR .40, 95% CI .16-.98), with fewer mental health specialty medication visits (IRR 0.33, 95% CI .15-.69), and a trend toward greater faith-based depression visits (IRR 2.89, 95% CI .99-8.45). Conclusions: Exploratory sub-analyses suggest that high rates of mainly minority men in under-resourced communities have high prevalence of depression. A multisector coalition approach may hold promise for improving community-prioritized outcomes, such as mental wellness and reduced hospitalizations for men, meriting further development of this approach for future research and program design.