The Impact of Community Engagement on Health,Social,and Utilization Outcomes in Depressed,Impoverished Populations: Secondary Findings from a Randomized Trial

Background: disparities in depression care exist among the poor. community partners in care (cpic) compared a community coalition model with technical assistance to improve depression services in under- resourced communities. we examine effects on health,social,and utilization outcomes among the poor and,non-poor depressed,and poor subgroups. methods: this study analyzed clients living above (n = 268) and below (n = 750) the federal-poverty level and,among the poor,3 nonoverlapping subgroups: justice-involved (n = 158),homeless and not justice- involved (n = 298),and other poor (n = 294). matched programs (n = 93) from health and community sectors were randomly assigned to community engagement and planning (cep) or resources for services (rs). primary outcomes were poor mental health-related quality of life and 8-item patient health questionnaire scores,whereas community-prioritized and utilization outcomes were secondary. effects were scrutinized using false discovery rate-adjusted p values to account for multiple comparisons. results: in the impoverished group,cep and rs clients of participating study programs did not differ in primary outcomes,but cep more than rs improved mental wellness among the depressed poor (unadjusted p = .004) while providing suggestive evidence for other secondary outcomes. within the poor subgroups,evidence favoring cep was only suggestive but was strongest among justice-involved clients. conclusions: a coalition approach to improving outcomes for low-income clients with depression,particularly those involved in the justice system,may offer additional benefits over standard technical assistance programs.