UCLA

Depression is one of the leading causes of disability in the world and affects about 10 percent of adults in the United States. Under-resourced communities of color often have low access to professional providers of evidence-based depression care. The purpose of this dissertation was to compare the effectiveness of a community engagement intervention across social service agencies relative to a more traditional technical assistance based training implementation strategy on participation in training and delivery of collaborative depression care by paraprofessional case managers in two low-income communities in Los Angeles. The direct effects of training participation versus no participation under both intervention conditions on depression care services delivery by paraprofessional case managers was also evaluated. Case managers in agencies assigned to the intensive training condition (experimental group) were more likely than their counterparts in agencies assigned to the technical-assistance-only control group to participate voluntarily in the training sessions at their agencies. They also were more likely to score higher at posttest on measures of use of evidence-based problem-solving strategies, use of depression-oriented outreach activities, and amount of time spent delivering direct depression care services. No significant differences were found with regard to knowledge about depression, attitudes toward people with depression, and perceived barriers to providing depression services. The conclusion addresses the results broadly and suggests some implications for policy, practice, and future research.