Community Partners in Care is a Research Project Funded by the National Institutes of Health

NCT01699789 | Completed Results

• 9 other identifiers: CPIC-2012-KWR01MH078853P30MH082760P30MH068639PPRN-1501-26518R01MD007721G08LM011058UL1TR00012464244
• Study Type: interventional
• Target: 1,246
• Locations: 1 country
• Sites: 1

Brief Summary

CPIC is a community initiative and research study funded by the NIH. CPIC was developed and is being run by community and academic partners in Los Angeles underserved communities of color. CPIC compares two ways of supporting diverse health and social programs in under-resourced communities to improve their services to depressed clients. One approach is time-limited expert technical assistance coupled with culturally-competent community outreach to individual programs, on how to use quality improvement toolkits for depression that have already been proven to be effective or helpful in primary care settings, but adapted for this study for use in diverse community-based programs in underserved communities. The other approach brings different types of agencies and members in a community together in a 4 to 6-month planning process, to fit the same depression quality improvement programs to the needs and strengths of the community and to develop a network of programs serving the community to support clients with depression together. The study is designed to determine the added value of community engagement and planning over and above what might be offered through a community-oriented, disease management company. Both intervention models are based on the same quality improvement toolkits that support team leadership, care management, Cognitive Behavioral Therapy, medication management, and patient education and activation. Investigators hypothesized that the community engagement approach would increase agency and clinician participation in evidence-based trainings and improve client mental health-related quality of life. In addition, during the design phase, community participants prioritized adding as outcomes indicators of social determinants of mental health, including physical functioning, risk factors for homelessness and employment. Investigators hypothesized by activating community agencies that can address health and social services needs to engage depressed clients, these outcomes would also be improved more in the collaboration condition. Investigators also hypothesized that the collaboration approach would increase use of services.

Conditions

Depression; Information Dissemination; Social Determinants of Health

Keywords

Community Partnered Participatory Research; Community Engagement; Implementation; Community Based Participatory Research; Quality Improvement; Evidence Based Practice; Patient Centered Outcomes Research

Outcome Measures

Primary Outcomes (5)

• Percent of Participants With Poor Mental Health Quality of Life, MCS12≤ 40

  From the Short Form, 12-item quality of life measure, mental health-related quality of life is the primary client outcome. Poor mental health related quality of life is defined as MCS12≤ 40 (one standard deviation below population mean).

  6 months follow-up

• Percent of Participants With PHQ-9 Score ≥ 10

  Patient Health Questionnaire 9-item version (PHQ-9) at least mild depression (score ≥ 10)

  6 months follow-up

• Percent of Participants With Poor Mental Health Quality of Life, MCS12≤ 40

  From the Short Form, 12-item quality of life measure, mental health-related quality of life is the primary client outcome. Poor mental health related quality of life is defined as MCS12≤ 40 (one standard deviation below population mean).

  12 months follow-up

• Percent of Participants With Poor Mental Health Quality of Life, MCS12≤ 40

  From the Short Form, 12-item quality of life measure, mental health-related quality of life is the primary client outcome. Poor mental health related quality of life is defined as MCS12≤ 40 (one standard deviation below population mean).

  36 months follow-up

• Percent of Participants With PHQ-8 Score ≥ 10

  Patient Health Questionnaire 8-item version (PHQ-8) at least mild depression (score ≥ 10)

  36 months follow-up

Secondary Outcomes (47)

• Percent of Participants With Mental Wellness

  6 months follow-up

• Percent of Participants Reported Organized Life

  6 months follow-up

• Percent of Participants With Physically Active

  6 months follow-up

• Percent of Participants With Homeless or ≥ 2 Risk Factors for Homelessness

  6 months follow-up

• Percent of Participants With Working for Pay

  6 months follow-up

Study Arms (2)

Resources for Services

ACTIVE COMPARATOR

The Resources for Services condition offers time-limited technical assistance to individual agencies, coupled with outreach from a community engagement specialty, to participate in structured reviews of components of the Quality Improvement Program Intervention as implemented by the Resources for Services Expert Team.

Other: Quality Improvement Program; Behavioral: Resources for Services Expert Team

Community Engagement and Planning

EXPERIMENTAL

The Community Engagement and Planning arm supported 4 months of planning for the Community Engagement and Planning Council consisting representatives of all assigned programs in biweekly 2 hour meetings to fit trainings in the Quality Improvement Program to the community and develop strategies across programs to collaborate as a network. The CEP Council developed a written plan for training and monitoring and supported implementation of the training plan. CEP sites were provided with enrolled client lists.

Other: Quality Improvement Program; Behavioral: Community Engagement and Planning Council

Interventions

Quality Improvement Program OTHER

The quality improvement program is an evidence-based toolkit from prior studies (see Names above) that supported team leadership, case and care management, medication management, and Cognitive Behavioral Therapy for Depression. The Case management manual supported depression screening and monitoring/tracking of outcomes; patient education and activation, care coordination, and behavioral activation and problem solving. The toolkit includes education on depression and a community health worker manual.

Also known as: Partners in Care, We Care, IMPACT, Mental Health Infrastructure and Training Project

Community Engagement and Planning; Resources for Services

Resources for Services Expert Team BEHAVIORAL

The expert team consisted for RS consisted of 3 psychiatrists, a psychologist expert in Cognitive Behavioral Therapy, a nurse care manager, a community engagement specialist, a quality improvement expert, and staff support. They team offered 12 web-based seminars to each community on components of collaborative care as well as site visits to primary care clinics on clinical assessment and medication management.

Also known as: Quality Improvement Team

Resources for Services

Community Engagement and Planning Council BEHAVIORAL

The CEP Council was supported by a workbook developed by the overall CPIC Council that provided principles, approach, agendas, and resources for the multi-sector planning meetings. The CEP Councils met twice a month for 4-6 months to develop their plan and met monthly during implementation of trainings. The study Council supported CEP meetings. Community leaders co-led trainings with study experts to help assure sustainability. Each CEP council had $15K to defray costs of venues, materials, and consultations, while the study provided that for RS.

Also known as: Quality Improvement Team

Community Engagement and Planning

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Administrators
• Age 18 and above
• Work or volunteer for an enrolled program in the study and be designated as a liaison by the program
• Providers
• Age 18 and above
• Have direct contact with patients/clients
• Clients
• Age 18 and above
• Score 10 or greater on modified Patient Health Questionnaire (PHQ-8)

You may not qualify if:

• Administrators - Under age 18
• Providers
• \- Under age 18
• Clients
• Under age 18
• Gross cognitive disorganization by screener staff assessment
• Providing no contact information

Sponsors & Collaborators

• RAND: lead
• National Institute of Mental Health (NIMH): collaborator
• Robert Wood Johnson Foundation: collaborator
• National Library of Medicine (NLM): collaborator
• Patient-Centered Outcomes Research Institute: collaborator
• National Institute on Minority Health and Health Disparities (NIMHD): collaborator

Study Sites (1)

Krystal M Griffith

Gardena, California, 90249, United States

Location

Related Publications (26)

• Chung B, Jones L, Dixon EL, Miranda J, Wells K; Community Partners in Care Steering Council. Using a community partnered participatory research approach to implement a randomized controlled trial: planning community partners in care. J Health Care Poor Underserved. 2010 Aug;21(3):780-95. doi: 10.1353/hpu.0.0345.

  PMID: 20693725 BACKGROUND

• Khodyakov D, Mendel P, Dixon E, Jones A, Masongsong Z, Wells K. Community Partners in Care: Leveraging Community Diversity to Improve Depression Care for Underserved Populations. Int J Divers Organ Communities Nations. 2009;9(2):167-182.

  PMID: 21528111 BACKGROUND

• Dixon EL, Flaskerud JH. Community tailored responses to depression care. Issues Ment Health Nurs. 2010 Sep;31(9):611-3. doi: 10.3109/01612841003675303. No abstract available.

  PMID: 20701424 BACKGROUND

• Mango J, Cabiling E, Jones L, Lucas-Wright A, Williams P, Wells K, Pulido E, Meldrum M, Ramos A, Chung B. Community Partners in Care (CPIC): Video Summary of Rationale, Study Approach / Implementation, and Client 6-month Outcomes. CES4healthinfo. 2014 Feb 25;2014:87LWR5H2.

  PMID: 25364622 BACKGROUND

• Khodyakov D, Pulido E, Ramos A, Dixon E. Community-partnered research conference model: the experience of Community Partners in Care study. Prog Community Health Partnersh. 2014 Spring;8(1):83-97. doi: 10.1353/cpr.2014.0008.

  PMID: 24859106 BACKGROUND

• Mendel P, Ngo VK, Dixon E, Stockdale S, Jones F, Chung B, Jones A, Masongsong Z, Khodyakov D. Partnered evaluation of a community engagement intervention: use of a kickoff conference in a randomized trial for depression care improvement in underserved communities. Ethn Dis. 2011 Summer;21(3 Suppl 1):S1-78-88.

  PMID: 22352084 BACKGROUND

• Belin TR, Jones A, Tang L, Chung B, Stockdale SE, Jones F, Wright A, Sherbourne CD, Perlman J, Pulido E, Ong MK, Gilmore J, Miranda J, Dixon E, Jones L, Wells KB. Maintaining Internal Validity in Community Partnered Participatory Research: Experience from the Community Partners in Care Study. Ethn Dis. 2018 Sep 6;28(Suppl 2):357-364. doi: 10.18865/ed.28.S2.357. eCollection 2018.

  PMID: 30202188 BACKGROUND

• Mendel P, O'Hora J, Zhang L, Stockdale S, Dixon EL, Gilmore J, Jones F, Jones A, Williams P, Sharif MZ, Masongsong Z, Kadkhoda F, Pulido E, Chung B, Wells KB. Engaging Community Networks to Improve Depression Services: A Cluster-Randomized Trial of a Community Engagement and Planning Intervention. Community Ment Health J. 2021 Apr;57(3):457-469. doi: 10.1007/s10597-020-00632-5. Epub 2020 May 19.

  PMID: 32430557 BACKGROUND

• Goodsmith N, Zhang L, Ong MK, Ngo VK, Miranda J, Hirsch S, Jones F, Wells K, Chung B. Implementation of a Community-Partnered Research Suicide-Risk Management Protocol: Case Study From Community Partners in Care. Psychiatr Serv. 2021 Mar 1;72(3):281-287. doi: 10.1176/appi.ps.202000095. Epub 2021 Jan 27.

  PMID: 33502218 BACKGROUND

• Wells KB, Jones L, Chung B, Dixon EL, Tang L, Gilmore J, Sherbourne C, Ngo VK, Ong MK, Stockdale S, Ramos E, Belin TR, Miranda J. Community-partnered cluster-randomized comparative effectiveness trial of community engagement and planning or resources for services to address depression disparities. J Gen Intern Med. 2013 Oct;28(10):1268-78. doi: 10.1007/s11606-013-2484-3. Epub 2013 May 7.

  PMID: 23649787 RESULT

• Miranda J, Ong MK, Jones L, Chung B, Dixon EL, Tang L, Gilmore J, Sherbourne C, Ngo VK, Stockdale S, Ramos E, Belin TR, Wells KB. Community-partnered evaluation of depression services for clients of community-based agencies in under-resourced communities in Los Angeles. J Gen Intern Med. 2013 Oct;28(10):1279-87. doi: 10.1007/s11606-013-2480-7. Epub 2013 May 14.

  PMID: 23670566 RESULT

• Chung B, Ong M, Ettner SL, Jones F, Gilmore J, McCreary M, Sherbourne C, Ngo V, Koegel P, Tang L, Dixon E, Miranda J, Belin TR, Wells KB. 12-month outcomes of community engagement versus technical assistance to implement depression collaborative care: a partnered, cluster, randomized, comparative effectiveness trial. Ann Intern Med. 2014 Nov 18;161(10 Suppl):S23-34. doi: 10.7326/M13-3011.

  PMID: 25402400 RESULT

• Chang ET, Wells KB, Gilmore J, Tang L, Morgan AU, Sanders S, Chung B. Comorbid depression and substance abuse among safety-net clients in Los Angeles: a community participatory study. Psychiatr Serv. 2015 Mar 1;66(3):285-94. doi: 10.1176/appi.ps.201300318. Epub 2014 Dec 1.

  PMID: 25727117 RESULT

• Chung B, Ngo VK, Ong MK, Pulido E, Jones F, Gilmore J, Stoker-Mtume N, Johnson M, Tang L, Wells KB, Sherbourne C, Miranda J. Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support. Psychiatr Serv. 2015 Aug 1;66(8):831-9. doi: 10.1176/appi.ps.201400099. Epub 2015 May 1.

  PMID: 25930037 RESULT

• Ngo VK, Sherbourne C, Chung B, Tang L, Wright AL, Whittington Y, Wells K, Miranda J. Community Engagement Compared With Technical Assistance to Disseminate Depression Care Among Low-Income, Minority Women: A Randomized Controlled Effectiveness Study. Am J Public Health. 2016 Oct;106(10):1833-41. doi: 10.2105/AJPH.2016.303304. Epub 2016 Aug 23.

  PMID: 27552274 RESULT

• Landry CM, Jackson AP, Tang L, Miranda J, Chung B, Jones F, Ong MK, Wells K. The Effects of Collaborative Care Training on Case Managers' Perceived Depression-Related Services Delivery. Psychiatr Serv. 2017 Feb 1;68(2):123-130. doi: 10.1176/appi.ps.201500550. Epub 2016 Sep 15.

  PMID: 27629796 RESULT

• Ong MK, Jones L, Aoki W, Belin TR, Bromley E, Chung B, Dixon E, Johnson MD, Jones F, Koegel P, Khodyakov D, Landry CM, Lizaola E, Mtume N, Ngo VK, Perlman J, Pulido E, Sauer V, Sherbourne CD, Tang L, Vidaurri E, Whittington Y, Williams P, Lucas-Wright A, Zhang L, Southard M, Miranda J, Wells K. A Community-Partnered, Participatory, Cluster-Randomized Study of Depression Care Quality Improvement: Three-Year Outcomes. Psychiatr Serv. 2017 Dec 1;68(12):1262-1270. doi: 10.1176/appi.ps.201600488. Epub 2017 Jul 17.

  PMID: 28712349 RESULT

• Mehta P, Brown A, Chung B, Jones F, Tang L, Gilmore J, Miranda J, Wells K. Community Partners in Care: 6-Month Outcomes of Two Quality Improvement Depression Care Interventions in Male Participants. Ethn Dis. 2017 Jul 20;27(3):223-232. doi: 10.18865/ed.27.3.223. eCollection 2017 Summer.

  PMID: 28811733 RESULT

• Castillo EG, Shaner R, Tang L, Chung B, Jones F, Whittington Y, Miranda J, Wells KB. Improving Depression Care for Adults With Serious Mental Illness in Underresourced Areas: Community Coalitions Versus Technical Support. Psychiatr Serv. 2018 Feb 1;69(2):195-203. doi: 10.1176/appi.ps.201600514. Epub 2017 Oct 16.

  PMID: 29032700 RESULT

• Sherbourne CD, Aoki W, Belin TR, Bromley E, Chung B, Dixon E, Gilmore JM, Johnson MD, Jones F, Koegel P, Khodyakov D, Landry CM, Lizaola E, Mtume N, Ngo VK, Ong MK, Perlman J, Pulido E, Sauer V, Tang L, Whittington Y, Vidaurri E, Williams P, Lucas-Wright A, Zhang L, Miranda J, Jones L, Wells K. Comparative Effectiveness of Two Models of Depression Services Quality Improvement in Health and Community Sectors. Psychiatr Serv. 2017 Dec 1;68(12):1315-1320. doi: 10.1176/appi.ps.201700170. Epub 2017 Nov 1.

  PMID: 29089009 RESULT

• Springgate B, Tang L, Ong M, Aoki W, Chung B, Dixon E, Johnson MD, Jones F, Landry C, Lizaola E, Mtume N, Ngo VK, Pulido E, Sherbourne C, Wright AL, Whittington Y, Williams P, Zhang L, Miranda J, Belin T, Gilmore J, Jones L, Wells KB. Comparative Effectiveness of Coalitions Versus Technical Assistance for Depression Quality Improvement in Persons with Multiple Chronic Conditions. Ethn Dis. 2018 Sep 6;28(Suppl 2):325-338. doi: 10.18865/ed.28.S2.325. eCollection 2018.

  PMID: 30202185 RESULT

• Choi KR, Sherbourne C, Tang L, Castillo E, Dixon E, Jones A, Chung B, Eisen C, Wells K. A Comparative Effectiveness Trial of Depression Collaborative Care: Subanalysis of Comorbid Anxiety. West J Nurs Res. 2019 Jul;41(7):1009-1031. doi: 10.1177/0193945918800333. Epub 2018 Sep 18.

  PMID: 30226112 RESULT

• Chung B, Ong M, Ettner SL, Jones F, Gilmore J, McCreary M, Ngo VK, Sherbourne C, Tang L, Dixon E, Koegel P, Miranda J, Wells KB. 12-Month Cost Outcomes of Community Engagement Versus Technical Assistance for Depression Quality Improvement: A Partnered, Cluster Randomized, Comparative-Effectiveness Trial. Ethn Dis. 2018 Sep 6;28(Suppl 2):349-356. doi: 10.18865/ed.28.S2.349. eCollection 2018.

  PMID: 30202187 RESULT

• Arevian AC, Jones F, Tang L, Sherbourne CD, Jones L, Miranda J; Community Partners in Care Writing Group. Depression Remission From Community Coalitions Versus Individual Program Support for Services: Findings From Community Partners in Care, Los Angeles, California, 2010-2016. Am J Public Health. 2019 Jun;109(S3):S205-S213. doi: 10.2105/AJPH.2019.305082.

  PMID: 31242001 RESULT

• Barcelo NE, Lopez A, Tang L, Aguilera Nunez MG, Jones F, Miranda J, Chung B, Arevian A, Bonds C, Izquierdo A, Dixon E, Wells K. Community Engagement and Planning versus Resources for Services for Implementing Depression Quality Improvement: Exploratory Analysis for Black and Latino Adults. Ethn Dis. 2019 Apr 18;29(2):277-286. doi: 10.18865/ed.29.2.277. eCollection 2019 Spring.

  PMID: 31057313 RESULT

• Morton I, Hurley B, Castillo EG, Tang L, Gilmore J, Jones F, Watkins K, Chung B, Wells K. Outcomes of two quality improvement implementation interventions for depression services in adults with substance use problems. Am J Drug Alcohol Abuse. 2020;46(2):251-261. doi: 10.1080/00952990.2019.1708085. Epub 2020 Jan 14.

  PMID: 31935133 RESULT

Related Links

• Click here for more information about this study: Community Partners in Care

MeSH Terms

Conditions

Depression

Interventions

Health Resources

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Health Planning; Health Care Economics and Organizations; Delivery of Health Care; Health Care Quality, Access, and Evaluation

Limitations and Caveats

Communities had history of using CPPR for depression. Response rates moderate for agencies, high for programs. Convenience samples of sites. Client retention rates lower than other QI studies. Outcomes rely on client self-report at 6-month follow-up.

Results Point of Contact

• Title: Kenneth B. Wells
• Organization: RAND Corporation

kwells@mednet.ucla.edu

310-794-3728

Study Officials

• Kenneth B Wells, M.D., M.P.H

  RAND Corporation, UCLA Semel Institute

  PRINCIPAL INVESTIGATOR

• Bowen Chung, MD, MSHS

  Harbor-UCLA Medical Center, UCLA Semel Institute

  PRINCIPAL INVESTIGATOR

• Jeanne Miranda, PhD

  UCLA Semel Institute

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 27, 2012
• First Posted: October 4, 2012
• Study Start: January 1, 2009
• Primary Completion: May 31, 2016
• Study Completion: May 31, 2016
• Last Updated: June 24, 2021
• Results First Posted: November 17, 2014

Record last verified: 2021-06

Locations

US (1)