Wells 2013.
| Methods |
Study design: cluster RCT Sampling frame: lists of health and social service agencies in targeted geographic area plus agencies identified by Community Partners in Care Council Sampling method: random Description of the community coalition: Los Angeles Community Health Improvement Collaborative involves Healthy African American Families, University of California Los Angeles, Charles Drew University, RAND, Queens Care Health and Faith Partnership, Los Angeles County Health Department, Veterans Affairs Greater Los Angeles Healthcare System, and others. These groups have worked together for 15 years in partnership efforts. They formed Community Partners In Care (CPIC), a participatory research initiative, to improve depression services in Los Angeles for diverse populations in under‐resourced communities. CPIC was designed and implemented by a council of 35 leaders from 3 academic and 24 community‐based agencies, using principles of equal authority of community and academic partners and 2‐way knowledge exchange. The CPIC Council oversaw implementation and evaluation of the program |
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| Participants |
Communities: For the cluster RCT, a frame of 94 organizations in the South Los Angeles and Hollywood metro areas was generated from comprehensive lists of service agencies coupled with recommendations from lead community partners in mental health, substance abuse, primary care, social service, and homeless and other community agencies Country: USA Ages included in assessment: general population Reasons provided for selection of intervention community: ethnically diverse population with higher rates of depression Intervention community (population size): South Los Angeles and Hollywood metro (2 million) Comparison community (population size): same areas |
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| Interventions |
Name of intervention: Community Partners in Care (CPIC) Theory: Community Engagement, Cognitive‐Behavioral Therapy (CBT) for Depression Aim: The CPIC program initiated by the Council was based on the idea that non‐healthcare settings can play a role in serving depressed clients, and that most people have some access to primary care services that can co‐ordinate depression services across various social service sectors. The Council developed depression care quality improvement strategies for use by diverse agencies. A randomized trial of "community engagement to activate multiple‐agency networks" compared with "resource support for agencies" to implement depression care quality improvement tested whether the community engagement process added extra value Description of costs and resources: costs not provided, several professional trainers used Components of the intervention: train‐the‐trainer for quality improvement (QI) in depression care, CBT, medication management; developed service networks across agencies. Start date: 2009 Duration: 20 months |
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| Outcomes |
Outcomes and measures (at 6‐month follow‐up) Primary
Secondary
Dates (years) of pre and post measurements: 2009 through 2011 |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Randomization was conducted by a statistician uninvolved in recruitment. Council members produced seed numbers for randomization |
| Allocation concealment (selection bias) | Low risk | Recruiters were blinded to assignment |
| Baseline outcome measurement similar | Low risk | No differences by intervention status |
| Baseline characteristics similar | Low risk | No significant differences in baseline characteristics |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Blinded to condition |
| Incomplete outcome data (attrition bias) All outcomes | High risk | 60% follow‐up rate |
| Blinding of participants and personnel (performance bias) All outcomes | Low risk | Participants and personnel were blinded to condition |
| Protection against contamination | High risk | Treatment and control conditions were implemented in the same communities |
| Selective reporting (reporting bias) | Low risk | Primary outcomes reported |