Reverse Colocated Integrated Care Intervention Among Persons With Severe Persistent Mental Illness at US-Mexico Border

NCT03881657 | Completed

• 1 other identifier: 100001
• Study Type: interventional
• Target: 416
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study evaluated whether patients with severe and persistent mental illness (SPMI) who received coordinated co-located behavioral health and primary care services were more likely to improve health outcomes after 12 months compared to SPMI patients who receive only behavioral health services from the local mental health authority (LMHA) Tropical Texas Behavioral Health (TTBH).The study employed a randomized control trial (RCT) design where intervention participants receiving integrated behavioral health were compared to control participants receiving the usual care provided within an LMHA for SPMI patients. Patients were placed in each group using a randomized number process. Demographic and health outcome data were collected from intervention and control participants at baseline. Health outcome data was subsequently collected at 6-month and 12-month follow-up points.

Conditions

Mental Illness Persistent; Chronic Disease; Hypertension; Diabetes; Hypercholesterolemia; Depression; Obesity

Keywords

Integrated Behavioral Health; Reverse Colocation; Integrated Care

Outcome Measures

Primary Outcomes (1)

• Blood pressure

  Blood pressure was measured as a continuous variable (systolic and diastolic) in millimeters of mercury (mmHg).

  One year

Secondary Outcomes (5)

• Blood glucose concentration

  One year

• Body mass index

  One year

• Total cholesterol

  One year

• Depressive symptoms

  One year

• Life functioning

  One year

Study Arms (2)

Intervention Group

EXPERIMENTAL

The intervention group received a reverse colocated integrated behavioral health intervention or usual care

Behavioral: Reverse Colocated Integrated Care

Control Group

ACTIVE COMPARATOR

The control group received behavioral health services only (usual care)

Behavioral: Usual Care

Interventions

Reverse Colocated Integrated Care BEHAVIORAL

A reverse colocated integrated care model is one where primary care and preventive services are embedded within a behavioral health service setting.

Intervention Group

Usual Care BEHAVIORAL

Behavioral health services without primary care or integrated care services

Control Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Reside in Cameron, Hidalgo, or Willacy County
• Have a severe, persistent mental illness as diagnosed by a licensed behavioral health care provider
• Be eligible to receive behavioral health services from TTBH
• Must not be receiving any primary care outside of TTBH (as ascertained via patient self-report)
• Have a diagnosis of one or more chronic conditions:
• Hypertension (blood pressure of 140/90 mmHg or higher)
• Obesity (body mass index of 30.0 or higher)
• Poorly controlled diabetes (HbA1c over 8.5%)
• Hypercholesterolemia (Total cholesterol level above 200)

You may not qualify if:

• Not actively suicidal at time of enrollment

Sponsors & Collaborators

• Health Resources in Action, Inc.: lead
• Methodist Healthcare Ministries of South Texas, Inc.: collaborator
• Social Innovation Fund: collaborator

Related Publications (2)

• Errichetti KS, Flynn A, Gaitan E, Ramirez MM, Baker M, Xuan Z. Randomized Trial of Reverse Colocated Integrated Care on Persons with Severe, Persistent Mental Illness in Southern Texas. J Gen Intern Med. 2020 Jul;35(7):2035-2042. doi: 10.1007/s11606-020-05778-2. Epub 2020 Apr 20.

  PMID: 32314132 DERIVED

• Sautter Errichetti K, Ramirez MM, Flynn A, Xuan Z. A reverse colocated integrated care model intervention among persons with severe persistent mental illness at the U.S.-Mexico border: A randomized controlled trial protocol. Contemp Clin Trials Commun. 2019 Nov 12;16:100490. doi: 10.1016/j.conctc.2019.100490. eCollection 2019 Dec.

  PMID: 31872157 DERIVED

MeSH Terms

Conditions

Chronic Disease; Hypertension; Diabetes Mellitus; Hypercholesterolemia; Depression; Obesity

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Vascular Diseases; Cardiovascular Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Hyperlipidemias; Dyslipidemias; Lipid Metabolism Disorders; Behavioral Symptoms; Behavior; Overweight; Overnutrition; Nutrition Disorders; Body Weight; Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director, Research and Evaluation

Model Details: Treatment group participants were randomized to receive primary care in addition to behavioral health services within a behavioral health setting. Control group participants received behavioral health care services as usual.

Study Record Dates

• First Submitted: March 15, 2019
• First Posted: March 19, 2019
• Study Start: November 24, 2015
• Primary Completion: August 22, 2017
• Study Completion: August 22, 2017
• Last Updated: March 19, 2019

Record last verified: 2019-03

Data Sharing

• IPD Sharing: Will not share