Table 3. Effect of the Intervention on Patients’ Symptoms of Depression and Anxiety^a.

Outcome	Patients/Clinicians, No.b	Mean Value for Psychological Symptoms (95% CI) at Follow-upc		β (95% CI)d	P Value
		Control	Intervention
Depression Symptoms
3 Months after target visit
2-Indicator latent variablee,f	262/113	0.20 (−0.02 to 0.42)	0.26 (−0.04 to 0.55)	−0.10 (−0.33 to 0.12)	.37
Standard PHQ-8 composite scoreg,h	359/119	4.88 (4.23 to 5.54)	5.92 (5.19 to 6.66)	0.26 (−0.57 to 1.10)	.54
6 Months after target visit
2-Indicator latent variablee,i	262/113	0.24 (0.07 to 0.42)	0.40 (0.11 to 0.69)	0.21 (−0.04 to 0.46)	.11
Standard PHQ-8 Composite Scoreg,j	314/118	4.84 (4.17 to 5.51)	5.927 (5.05 to 6.81)	0.45 (−0.48 to 1.37)	.34
Anxiety Symptoms
3 Months after target visit
2-Indicator latent variablee,h	277/119	0.22 (0.01 to 0.43)	0.28 (−0.04 to 0.60)	−0.03 (−0.23 to 0.16)	.73
Standard GAD-7 composite scoreh,k	366/122	3.00 (2.44 to 3.57)	3.26 (2.64 to 3.89)	0.04 (−0.95 to 1.03)	.94
6 Months after target visit
2-Indicator latent variablee,h	277/119	0.21 (−0.05 to 0.47)	0.30 (0.00 to 0.59)	−0.04 (−0.25 to 0.16)	.69
Standard GAD-7 composite scoreh,k	327/119	3.08 (2.44 to 3.72)	3.375 (2.67 to 4.08)	−0.11 (−1.20 to 1.00)	.85

Abbreviations: CFA, confirmatory factor analysis; GAD-7, 7-item Generalized Anxiety Disorder survey; PHQ-8, 8-item Patient Health Questionnaire; WLSMV, weighted least squares with mean and variance adjustment.

^aThe coefficient estimates and P values were based on complex single-group regression models with patients clustered by treating clinician, with intervention group as the predictor of interest, and with adjustment for any variables that confounded the association between the intervention-group predictor and outcome. A variable was identified as a confounder if its addition to the bivariate model changed the coefficient for the intervention group by 10% or more in either direction. For the latent variable outcomes, the sample included only those patients who provided data for both indicators at all 3 time points (baseline, 3-month follow-up, and 6-month follow-up). For all outcomes, patients were included only if they provided data for the outcome and any covariates in the model.

^bNumber of patients/number of clinician clusters.

^cFor the standard composite scores, the unadjusted mean for the standard composite score, computed with data from the follow-up questionnaire. For the 2-indicator constructs, the mean value of the construct on the follow-up questionnaire, based on a 2-group CFA model using patients with complete data for the 3 time periods, with scalar measurement invariance imposed between groups and over time, and with the baseline mean for the control group fixed at 0.

^dPoint estimate and confidence interval for the regression coefficient from a single-group model with the outcome regressed on the intervention-group predictor, after adjustment for any confounders.

^eProbit regression model, estimated with WLSMV.

^fAdjusted for baseline level on the outcome and the patient’s racial/ethnic minority status.

^gRobust linear regression model, estimated with restricted maximum likelihood.

^hAdjusted for baseline level on the outcome.

ⁱAdjusted for patient’s baseline level on the outcome, age, racial/ethnic minority status, education, and self-identified health status; and for clinician type and specialty.

^jAdjusted for patient’s baseline level on the outcome and clinician specialty.

^kThe outcome was defined as censored from below; Tobit regression model estimated with WLSMV.