Engaging the Community to Improve Outcomes
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University of California-Los Angeles
South Los Angeles and Hollywood
Depression
Underserved communities
African Americans, Latinos |
PROJECT
A community engagement approach is used to improve depression management skills and adoption of evidence-based depression quality improvement programs.
This project is based on a community-partnered participatory research design: community partners are
considered equal partners with the academic staff members and are involved in every stage of the design and implementation of the intervention. The staff at lead community agencies are involved in grant-writing; identification and recruitment of other agencies, administrators and providers; and organizing and carrying out pre-implementation kick-off activities.
During implementation, communityagency representatives participate in biweekly planning meetings and the entire leadership team is involved in setting the agenda for subsequent meetings. The project leadership team includes a diverse set of community agencies including mental health agencies, faith-based organizations, social service agencies and substance-abuse agencies. Project participants include licensed mental health professionals and lay community health workers or agency administrators. Community members are invited to participate and co-lead several committees. Invitation to committees is based on expertise and interest.
RATIONALE
Many patients with depression do not receive mental health care. Those who do often receive their care through primary care, but primary care clinicians often do not detect depression and many patients do not receive evidence-based treatments.
Delivering evidence-based care for depression is challenging, particularly among the poor and ethnic minorities, due to organizational and financing factors like limited psychotherapy coverage or diversity in third-party management of services; clinical features of depression like social withdrawal; societal factors like social stigma; and clinician factors like limited knowledge or experience.
This community engagement approach hopes to increase agency and provider use of evidence-based depression treatment programs across the network, thereby increasing patient access to appropriate care, satisfaction with services, and health outcomes.
Community engagement promotes organizational and community member participation and leadership
in goal setting, program development, implementation and evaluation by shifting the authority for action to the community. This intervention promotes community commitment and leadership to form a network committed to evidence-based, quality improvement.
EVALUATION PLAN
Funded by Finding Answers in 2008.
This study is evaluating the effectiveness of a community-engagement intervention versus a standard approach of using expert consultants to develop depression toolkits and design provider resources. Information and data is being collected from everyone participating in the project including: agencies, administrators, providers and patients. Baseline administrator and provider surveys will are being administered online and in paper format. One-year follow-up surveys are being conducted online or over the telephone.
Structured computer-assisted telephone interviews or face-to-face interviews are being conducted with patients enrolled in the study. Six- and 12-month followup interviews are also being conducted.
The effect of differences in provider depression-management skills on patient depression outcomes is being measured. Additionally, facilitators and barriers to the community-engagement approach and uptake of the intervention are being identified.
Principal Investigator:
For More Information
Please Contact:
Michael Ong, MD
MOng@mednet.ucla.edu
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