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OBJECTIVE For implementing quality improvement programs for depression in underserved communities, a multi-sector coalition approach (Community-Engagement and Planning, CEP) was more effective than program technical assistance (Resources for Services, RS) in improving mental health-related quality of life (MHRQL), reducing behavioral health hospitalizations and shifting services toward community-based programs at 6-months. At 12-months there was continued evidence of improvement. This study objective was to evaluate for continued evidence of improvement at 3-years. METHOD Three-year extension study for Community Partners in Care (CPIC), a community-partnered cluster-randomized trial with 93 Los Angeles health and community programs assigned to CEP or RS having 1004 enrolled depressed clients eligible for 3-year follow-up and 600 completing surveys from 89 programs. Multiple regression analyses with multiple imputation controlling for baseline status and covariates are used to estimate intervention effects on poor MHRQL and depression; physical health-related quality of life (PHRQL) and behavioral health hospital nights; and healthcare, community program and medication use. RESULTS CEP versus RS did not affect 3-year depression or MHRQL but had modest effects on improving PHRQL and reducing behavioral health hospital nights; and increased having any social-community sector visit for depression and use of mood stabilizers. Sensitivity analyses with longitudinal modeling reproduced findings, but for differences between intervention groups in change from baseline to 3-years, effects were not significant. CONCLUSIONS At 3-years, CEP versus RS did not affect primary mental health outcomes but had modest effects on improving PHRQL and reducing behavioral hospital nights.

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CEP was more effective than RS in improving 6-month primary outcomes among depressed MCC clients, without significant interactions.

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