Table 4. Service Utilization By Poverty Status and Intervention Assignment (Model 1).
| Not Below the Federal Poverty Line (N=268) | Below the Federal Poverty Line (N=750) | |||||||
|---|---|---|---|---|---|---|---|---|
| RS | CEP | CEP vs. RS | RS | CEP | CEP vs. RS | |||
|
|
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| Estimate (SE) |
Estimate (SE) |
Test (95% CI) | ES | Estimate (SE) |
Estimate (SE) |
Test (95% CI) | ES | |
| Behavioral health hospital nights | OR | OR | ||||||
|
| ||||||||
| 6-month follow-up (%) | 10.9 (4.0) | 5.4 (2.6) | 0.5 (0.2, 1.3) | .20 | 10.4 (2.2) | 5.9 (1.6) | 0.5 (0.3, 1.1) | 0.17 |
| 12-month follow-up (%) | 5.0 (1.9) | 3.9 (1.5) | 0.8 (0.2, 2.4) | .05 | 5.1 (1.2) | 4.5 (1.0) | 0.9 (0.4, 1.7) | 0.03 |
|
| ||||||||
| Any MHS outpatient visits | ||||||||
|
| ||||||||
| 6-month follow-up (%) | 50.3 (6.7) | 51.0 (5.4) | 1.0 (0.5, 2.0) | .01 | 55.4 (3.4) | 54.4 (3.6) | 0.9 (0.6, 1.6) | 0.02 |
| 12-month follow-up (%) | 44.4 (6.1) | 40.3 (6.0) | 0.8 (0.3, 2.1) | .08 | 44.5 (3.8) | 43.4 (3.8) | 0.9 (0.6, 1.5) | 0.02 |
|
| ||||||||
| # MHS outpatient visits | IRR | IRR | ||||||
|
| ||||||||
| 6-month follow-up (mean) | 7.5 (2.6) | 8.0 (1.7) | 1.1 (0.5, 2.5) | .03 | 11.7 (2.4) | 8.0 (1.3) | 0.7 (0.4, 1.3) | 0.15 |
| 12-month follow-up (mean) | 5.5 (1.9) | 4.7 (1.2) | 0.9 (0.4, 1.9) | .06 | 6.0 (1.0) | 4.8 (0.5) | 0.8 (0.5, 1.2) | 0.09 |
|
| ||||||||
| # MHS outpatient visits received advice for medication if visited | ||||||||
|
| ||||||||
| 6-month follow-up (mean) | 7.0 (3.3) | 5.3 (0.8) | 0.8 (0.3, 2.2) | .11 | 12.2 (2.8) | 5.2 (0.5) | 0.4 (0.2, 0.7)** | 0.30 |
| 12-month follow-up (mean) | 6.4 (2.5) | 8.2 (2.0) | 1.3 (0.5, 3.4) | .12 | 6.0 (1.0) | 6.1 (0.8) | 1.0 (0.6, 1.6) | 0.01 |
|
| ||||||||
| # MHS outpatient visits received counseling if visited | ||||||||
|
| ||||||||
| 6-month follow-up (mean) | 10.5 (3.6) | 10.7 (1.9) | 1.0 (0.5, 2.3) | .01 | 17.3 (3.3) | 10.7 (1.4) | 0.6 (0.3, 1.2) | 0.24 |
| 12-month follow-up (mean) | 9.3 (2.6) | 10.3 (2.4) | 1.1 (0.5, 2.3) | .06 | 8.9 (1.3) | 7.7 (0.8) | 0.9 (0.6, 1.3) | 0.10 |
|
| ||||||||
| Any outpatient substance abuse service or self-help group | OR | OR | ||||||
|
| ||||||||
| 6-month follow-up (%) | 22.3 (3.9) | 28.3 (5.5) | 1.5 (0.6, 3.6) | .14 | 28.0 (4.3) | 30.6 (3.7) | 1.2 (0.7, 2.1) | 0.06 |
| 12-month follow-up (%) | 13.7 (3.2) | 18.4 (3.6) | 1.5 (0.7, 3.3) | .13 | 18.6 (3.0) | 20.5 (3.3) | 1.1 (0.6, 2.3) | 0.05 |
|
| ||||||||
| Stayed in residential treatment for substance abuse problem | ||||||||
|
| ||||||||
| 6-month follow-up (%) | 12.8 (4.1) | 12.4 (4.1) | 1.0 (0.4, 2.6) | .01 | 12.8 (3.5) | 15.1 (3.7) | 1.3 (0.6, 2.6) | 0.07 |
| 12-month follow-up (%) | 5.2 (2.4) | 3.8 (2.8) | 0.6 (0.0, 11.6) | .07 | 7.4 (1.9) | 5.9 (2.0) | 0.8 (0.3, 1.9) | 0.06 |
|
| ||||||||
| Visited primary care | ||||||||
|
| ||||||||
| 6-month follow-up (%) | 73.0 (3.9) | 67.5 (5.6) | 0.8 (0.4, 1.5) | .12 | 66.7 (3.5) | 67.8 (3.6) | 1.1 (0.7, 1.6) | 0.02 |
| 12-month follow-up (%) | 71.1 (4.9) | 68.6 (4.7) | 0.9 (0.4, 1.8) | .05 | 61.1 (2.7) | 71.7 (2.7) | 1.7 (1.2, 2.4)** | 0.23 |
|
| ||||||||
| # visits in community (informal) sector for depression | ||||||||
|
| ||||||||
| 6-month follow-up (mean) | 3.7 (1.7) | 3.0 (1.5) | 0.8 (0.2, 3.0) | .04 | 2.2 (0.5) | 4.4 (1.0) | 2.0 (1.1, 3.9)* | 0.15 |
| 12-month follow-up (mean) | 2.5 (1.0) | 2.5 (1.5) | 0.9 (0.3, 3.6) | .00 | 1.7 (0.4) | 3.9 (1.2) | 2.3 (1.1, 5.1)* | 0.14 |
|
| ||||||||
| # outpatient contacts for depression all sectors | ||||||||
|
| ||||||||
| 6-month follow-up (mean) | 16.4 (3.8) | 19.8 (4.8) | 1.2 (0.6, 2.3) | .09 | 25.0 (4.8) | 22.6 (3.1) | 0.9 (0.5, 1.6) | 0.05 |
| 12-month follow-up (mean) | 14.7 (4.9) | 14.6 (3.9) | 1.0 (0.4, 2.2) | .00 | 19.8 (2.8) | 18.0 (2.6) | 0.9 (0.6, 1.3) | 0.04 |
Note: Intervention-by-poverty status interaction models used multiple imputed data, weighted for eligible sample for enrollment and accounted for the design effect of the cluster randomization. A logistic regression model was used for a binary variable (presented as odds ratio, OR) or a Poisson regression model for a count variables (presented as incidence rate ratios, IRR), adjusted for baseline status of the dependent variable, age, education, race/ethnicity, 12-month depressive disorder and community, and accounted for the design effect of the cluster randomization; no significant interactions of intervention by poverty status were found for all outcome variables.
MHS, mental health service; RS, resource for services; CEP, community engagement and planning; SE, standard error; CI, 95% confidence interval; ES, standardized effect size.
p value < 0.01;
p value < 0.05