TABLE 2.
Outcomes and Services Utilizations at 3-years by Intervention Condition
Unadjusted Estimatesa | Adjusted Analysisb | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
RS | CEP | RS | CEP | CEP vs. RS | ||||||||
| ||||||||||||
No. | % | No. | % | Est. | 95% CI | Est. | 95% CI | OR | 95% CI | p | pFDRc | |
Primary outcomes | ||||||||||||
MCS12≤40 | 119 | 41.3 | 131 | 43.7 | 39.4 | 32.0–47.4 | 45.0 | 36.2–54.2 | 1.3 | .7–2.3 | .381 | .762 |
PHQ8≥10 | 195 | 66.6 | 201 | 66.3 | 65.8 | 58.6–72.3 | 66.0 | 60.1–71.5 | 1.0 | .6–1.7 | .965 | .965 |
Secondary outcomes | ||||||||||||
| ||||||||||||
Community-prioritized (secondary) | Difference | |||||||||||
| ||||||||||||
PCS-12 (M ±SD) | 38.5±7 | 39.6±7 | 38.7 | 37.9–39.5 | 39.9 | 39.2–40.6 | 1.2 | .2–2.2 | .022 | .022 | ||
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IRR | ||||||||||||
| ||||||||||||
# behavioral health hospital nights | 1.1 | 11.4 | .2 | 1.1 | 1.2 | .3–4.6 | .2 | .1–.4 | .2 | .1–.8 | .020 | .022 |
Other secondary (Services use past 6-months) | ||||||||||||
Healthcare sector | ||||||||||||
# ER or urgent care visits | 1.7 | 7.7 | 1.4 | 7.7 | 1.5 | 1.0–2.2 | 1.9 | .7–4.9 | 1.2 | .4–3.7 | .675 | .987 |
# visits to a PCP | 4.3 | 9.4 | 3.9 | 6.4 | 3.9 | 2.7–5.4 | 4.1 | 3.5–4.9 | 1.1 | .8–1.5 | .661 | .987 |
# outpatient primary care services for depression | 1.2 | 5.3 | 1 | 1.8 | 1.1 | .6–2.1 | 1.1 | .8–1.5 | 1.0 | .5–2.1 | .987 | .987 |
# mental health outpatient visits | 5.4 | 13.3 | 5 | 13.8 | 5.5 | 3.7–8.0 | 5.6 | 3.2–9.8 | 1.0 | .7–1.6 | .931 | .987 |
# visits to outpatient SA agency or self-help group | 8.6 | 29.8 | 10.2 | 32.4 | 11.1 | 4.7–24.5 | 12.3 | 5.6–25.8 | 1.1 | .3–4.0 | .826 | .987 |
Social-community sector | ||||||||||||
# social services for depression | .6 | 3.2 | .6 | 1.5 | .6 | .3–1.2 | .6 | .4–.9 | 1.1 | .4–2.7 | .838 | .838 |
# called hotline for ADM problem | .2 | 2.8 | .2 | 1.1 | .2 | .1–.6 | .3 | .1–1.1 | 1.4 | .2–8.6 | .732 | .838 |
# days self-help visit for mental health | 6.6 | 18.5 | 5.8 | 15.4 | 6.3 | 4.1–9.6 | 5.6 | 3.4–9.1 | .9 | .4–1.8 | .708 | .838 |
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N | % | N | % | OR | ||||||||
| ||||||||||||
Any faith-based services for depression | 29 | 9.9 | 43 | 14.1 | 9.4 | 6.5–13.2 | 15.2 | 10.3–21.7 | 1.8 | 1.2–2.6 | .006 | .023 |
Medication | ||||||||||||
Use of any antidepressant | 91 | 31.1 | 88 | 28.7 | 28.7 | 22.5–35.9 | 26.9 | 19.8–35.4 | .9 | .5–1.5 | .688 | .688 |
Use of any mood stabilizer | 8 | 2.7 | 20 | 6.5 | 2.5 | 1.1–5.6 | 6.4 | 3.1–12.3 | 2.9 | 1.0–8.3 | .049 | .147 |
Use of any antipsychotic | 65 | 22.2 | 74 | 24.1 | 21.7 | 16.1–28.7 | 23.4 | 17.1–30.9 | 1.1 | .7–1.7 | .638 | .688 |
Summary utilization | ||||||||||||
Any visit in healthcare sector | 255 | 87 | 258 | 84.9 | 84.2 | 78.0–88.9 | 84.3 | 75.8–90.4 | 1.0 | .5–2.0 | .959 | .959 |
Any community sector visit for depression | 82 | 28.3 | 105 | 34.8 | 28.3 | 23.9–33.2 | 35.6 | 30.1–41.5 | 1.4 | 1.0–2.0 | .042 | .127 |
Any depression treatmentd | 134 | 45.7 | 137 | 44.9 | 43.2 | 36.1–50.5 | 43.5 | 33.9–53.6 | 1.0 | .6–1.7 | .947 | .959 |
See Table 1 for variables definitions; RS=Resources for Services or individual program technical assistance; CEP=Community Engagement and Planning; #=numbers; SE=standard error
Raw data without weighting or imputation (N=600)
Adjusted analyses used multiply imputed data at 3-years (N=980), weighted for eligible sample for enrollment; linear regression model for PCS-12 (presented as between-group difference), logistic regression models for binary variables (presented as odds ratio, OR) or Poisson regression models for count variables, adjusted for baseline status of the dependent variable, age, sex, ≥3 chronic conditions, education, race/ethnicity, family income < poverty level, 12-month alcohol abuse or use of illicit drugs, 12-month depressive disorder, and community and accounted for the design effect of the cluster randomization
pFDR, adjusted p value from the False Discovery Rate procedure calculated separately for primary outcomes, secondary outcomes, services use from health care sector, social-community sector, medication, and summary utilization
Antidepressant ≥2 mo. or ≥4 mental health or PCP depression visits