Trauma-informed Collaborative Care for African American Primary Care Patients in Federally Qualified Health Centers

A Pilot Randomized Trial

Bibliographic Data

ID9101335
AuthorsLisa S Meredith (0000-0003-4523-7098, RAND Corporation, Santa Monica, corresponding author), Eunice Wong (0000-0001-9274-7547, RAND Corporation, Santa Monica, corresponding author), Karen Chan Osilla (0000-0002-6222-5833, RAND Corporation, Santa Monica, corresponding author), Margaret Sanders (Louisiana Public Health Institute, New Orleans, LA), Mahlet G Tebeka (Pardee RAND Graduate School, Santa Monica, CA), Bing Han (0000-0003-2804-928X, Kaiser Permanente Department of Research and Evaluation, Southern California, SC), Stephanie L Williamson (RAND Corporation, Santa Monica, corresponding author), Thomas W Carton (0000-0003-0059-1990, Louisiana Public Health Institute, New Orleans, LA)
Year2022
Volume60
Issue3
Pages232-239
Publication date2022-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001681
PMID35157622
OpenAlexW4200160262
LanguageEN
Citations received3
References cited36

BACKGROUND: African Americans have nearly double the rate of posttraumatic stress disorder (PTSD) compared with other racial/ethnic groups. OBJECTIVE: To understand whether trauma-informed collaborative care (TICC) is effective for improving PTSD among African Americans in New Orleans who receive their care in Federally Qualified Health Centers (FQHCs). DESIGN AND METHOD: In this pilot randomized controlled trial, we assigned patients within a single site to either TICC or to enhanced usual care (EUC). We performed intent to treat analysis by nonparametric exact tests for small sample sizes. PARTICIPANTS: We enrolled 42 patients from October 12, 2018, through July 2, 2019. Patients were eligible if they considered the clinic their usual source of care, had no obvious physical or cognitive obstacles that would prevent participation, were age 18 or over, self-identified as African American, and had a provisional diagnosis of PTSD. MEASURES: Our primary outcome measures were PTSD measured as both a symptom score and a provisional diagnosis based on the PTSD Checklist for DSM-5 (PCL-5). KEY RESULTS: Nine months following baseline, both PTSD symptom scores and provisional PTSD diagnosis rates decreased substantially more for patients in TICC than in EUC. The decreases were by 26 points in EUC and 36 points in TICC for symptoms (P=0.08) and 33% in EUC and 57% in TICC for diagnosis rates (P=0.27). We found no effects for mediator variables. CONCLUSIONS: TICC shows promise for addressing PTSD in this population. A larger-scale trial is needed to fully assess the effectiveness of this approach in these settings

African american · Collaborative Care · Collaborative model · Health care · MEDLINE · Primary care · Primary health care · Digital Mental Health Interventions · Posttraumatic Stress Disorder Research · Trauma and Emergency Care Studies

Tools

Open DOIOpen Access