Healthcare Disparities, Mental Health
Conditions
Keywords
Social Determinants of Health, Minority Health, Veterans Health, Patient Participation, Patient Navigation, Mental Health Services
Brief summary
The purpose of this study was to develop and pilot test an intervention to reduce mental health disparities for racially and ethnically minoritized Veterans receiving outpatient VA mental health services. The program was delivered by trained VA peer navigators. The specific aims of the program were to enhance navigation of mental health services, increase patient engagement, and improve patient-provider communication. Study participants were randomized into one of two study groups, which determined when they received the study intervention. Regardless of study group, participants had the opportunity to receive services in addition to their regular mental health treatment (either immediately after enrollment into the study or after a 6-month waiting period). Participants were asked to complete study questionnaires at different timepoints throughout the study to assess their overall satisfaction with the study program and the mental health services that they received. Some participants also completed an interview to discuss their experience in the program.
Interventions
The study intervention consisted of a 6-month, manualized, peer-led navigation program. It involved assessing and addressing patients' unmet social needs and barriers to care, delivery of peer support services, navigation to VA mental health services, and psychoeducation.
Sponsors
Study design
Intervention model description
The study consisted of two groups, an active treatment group and a waitlist control group. Participants randomized to the active treatment group received the peer-administered intervention program for 6 months and then were followed for 3 months after completion of the program. The waitlist control group received the peer-administered intervention program for 6 months following a 6-month waiting period.
Eligibility
Inclusion criteria
To be eligible: * Must be a Veteran belonging to a racial/ethnic minoritized group * Must be actively receiving mental health care in the Outpatient Mental Health Clinic at Veteran Health Indiana (Richard L. Roudebush VA Medical Center) * Must have started receiving mental health care as a new patient in the Outpatient Mental Health within 12 months prior to enrollment into the study
Exclusion criteria
Not eligible if: * Is a Veteran not belonging to a racial/ethnic minoritized group * Not actively receiving mental health care in the Outpatient Mental Health Clinic at Veteran Health Indiana (Richard L. Roudebush VA Medical Center) * Started receiving mental health care as a new patient in the Outpatient Mental Health outside of the 12-month window
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Trust and Satisfaction Survey Responses Change | Change from Baseline to 6 months | The Trust and Satisfaction Survey is a 5-item scale which assess a respondent's degree of trust toward the VA, VA mental health care services, and the study program. Respondents are asked to rate how much they agree with each of the 5 items. Items are rated on a scale ranging from 1 (strongly disagree) to 5 (strongly agree). The survey yields final scores ranging from 5 (minimum) to 25 (maximum) with higher scores representing greater trust and satisfaction. No subscale. |
| Peer Coaching Experience Satisfaction Questionnaire | Administered after completion of the study program (6 months for Active PARTNER-MH ) | Peer Coaching Experience Satisfaction Questionnaire is designed to collect feedback on a respondent's overall experience with a peer coach at the end of a 6-month period. Only participants in active PARTNER-MH were administered this questionnaire. This questionnaire was developed for the study. Question 1: Overall, how satisfied are you with PARTNER-MH program? Question 2: How satisfied are you with your assigned peer. Answers are rated on a Likert scale ranging from 1 (very satisfied) to 5 (very dissatisfied). |
| Patient Activation Measure- Mental Health (PAM-MH) | Change from Baseline to 6 months | Measure Description: The PAM-MH is a 13-item questionnaire that measures an individual's perceived ability to manage illness and health behaviors. The questions are rated on a 4-point Likert-type scale (1= strongly disagree, 2=disagree, 3=agree, 4=strongly agree). Scores are then converted using Rasch analysis to a 100-point scale. Raw scores range from 13 to 52 and converted activation scores range from 0-100. Higher activation scores indicate higher level of patient activation. |
| Altarum Consumer Engagement (ACE) Change | Change from Baseline to 6 months | The ACE is administered as a 5-level Likert scale. The subscale scores range from 5 to 25, and the total engagement score is computed by adding the 3 subscale scores and multiplying the sum by 4/3 to obtain a possible range score of 20 to 100. Higher scores represent higher patient engagement. |
| SDM-Q9 PARTNER-MH | Change from Baseline to 6 months | The SDM-Q9 PARTNER-MH was adapted from Braddock et al.'s SDM-Q-9 informed decision-making scale. The original, validated scale, the SDM-Q-9, has 9 items measured on a 6-point Likert Scale, ranging from 0=completely disagree to 5=completely agree. The total score is calculated by summing the scores of the nine items, range from 0 to 45. A higher score indicates a greater level of perceived SDM. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Health Questionnaire (PHQ-9) Change | Change from Baseline to 6 months | Measure Description: Patient Health Questionnaire (PHQ-9) measures severity of depressive symptoms. It includes 9 items, ranging in scores from 0 to 27. Higher scores indicate more severe symptoms of depression. |
| Veteran's RAND 12-item Health Survey (VR-12) Change | Change from Baseline to 6 months | The Veterans Rand 12-item Health Survey (VR-12) is a 12-item scale that assesses Veterans' report of health-related quality of life. It measures mental and physical functioning. The VR-12 uses five-point ordinal response choices and provides two scores: the Physical Component Summary Score and the Mental Health Summary Score, ranging from 0 to 100. VR-12 scores are standardized using a T-score metric with a mean of 50 and a standard deviation of 10. The scores are compared to the population average, measured in standard deviations. The United States population average PCS and MCS are 50 points each. The United States population standard deviation is 10 points. Higher scores indicate better self-reported health. Lower VR-12 MCS scores indicate worse psychological distress/functioning. Clinically significant scores vary based on the condition or disease population. |
| Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change | Change from Baseline to 6 months | The Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) is 5-item scale rated on a 10-point Likert scale ranging from 1 (not confident at all) to 10 (very confident) and the total score, which is the sum of all item ratings, range from 0 (minimum) to 50 (maximum). Higher scores indicate higher levels of self-efficacy. There is no subscale. |
| Working Alliance Inventory Short-Revised (WAI-SR) Change | Change from Baseline to 6 months | Working Alliance Inventory -Short Revised (WAI-SR) evaluates key aspects of the therapeutic alliance between patients and their mental health providers. It includes 12 items rated on a 5-point Likert scale ranging from 1= seldom to 5= always. The WAI-SR has 3 subscales: The Goal, Task, and Bond subscales each have 4 items and scores ranging from 4 to 20. For research purposes, use of the overall mean scores of the WAI-SR rather than its subscales have been recommended. The scale total scores range from 12 (minimum) to 60 (maximum). Higher scores indicate higher level of working alliance. There is no cut off score for this scale. |
| UCLA Loneliness Scale (ULS-6) Change | Change from Baseline to 6 months | The UCLA Loneliness Scale Short Form, (ULS-6), is a 6-item scale that assesses loneliness and is rated on a 4-point Likert Scale, ranging from 1=never to 4= often. The scale has a total summed score ranging from 6 (minimum) to 24 (maximum), with higher scores indicate higher level of loneliness. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Lubben Social Network Scale-6 | change in scores from baseline to 6 months | The Lubben Social Network Scale (LSNS-6) is a self-report measure consisting of 6 items, rated on a 6-point Likert scale ranging 0 to 5. The total score is the sum of all 6 items ranging from 0 to 30. A score of 12 indicates at risk of social isolation and scores less than 12 indicate social isolation. |
| Perceived Discrimination in Healthcare Responses | Change in score from baseline to 6 months | Measure Description: Respondents are asked to rate their experiences on a 5-point Likert-type scale, with answers ranging from 0 (never) to 4 (always). Higher scores indicate more frequent experiences of discrimination in healthcare. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Active PARTNER-MH The Active PARTNER-MH arm will test the intervention program starting immediately after enrollment in the study. Participants enrolled into this arm will continue to receive normal mental health services in addition to the peer-administered intervention.
PARTNER-MH: The study intervention consists of a peer navigation program developed by the study team. The navigation program focuses on navigating VA mental health services, as well as patient engagement in mental health services and patient-provider communication. The intervention will last for 6 months, during which the participant will commit to regularly meeting with their peer specialist (interventionist). Peer navigation sessions will be guided by the specific aims of the study program, but in a way that is tailored to the participants' specific needs. | 30 |
| Waitlist Control The Waitlist Control arm will test the intervention program after a waiting period of 6-months following enrollment into the study. During the 6-month waiting period, participants in this arm will continue to receive normal mental health services.
PARTNER-MH: The study intervention consists of a peer navigation program developed by the study team. The navigation program focuses on navigating VA mental health services, as well as patient engagement in mental health services and patient-provider communication. The intervention will last for 6 months, during which the participant will commit to regularly meeting with their peer specialist (interventionist). Peer navigation sessions will be guided by the specific aims of the study program, but in a way that is tailored to the participants' specific needs. | 20 |
| Total | 50 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Period 1: 6 Month Randomized Period | Lost to Follow-up | 9 | 1 |
| Period 1: 6 Month Randomized Period | Withdrawal by Subject | 3 | 1 |
| Period 2. 6 Month Waitlist Crossover | Lost to Follow-up | 0 | 5 |
Baseline characteristics
| Characteristic | Active PARTNER-MH | Waitlist Control | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 2 Participants | 0 Participants | 2 Participants |
| Age, Categorical Between 18 and 65 years | 28 Participants | 20 Participants | 48 Participants |
| Altarum Consumer Engagement (ACE) ACE Commitment subscale | 13.7 units on a scale STANDARD_DEVIATION 4.7 | 13.6 units on a scale STANDARD_DEVIATION 5.9 | 13.7 units on a scale STANDARD_DEVIATION 5.2 |
| Altarum Consumer Engagement (ACE) ACE Informed Choice Subscale | 10.6 units on a scale STANDARD_DEVIATION 4.8 | 10.4 units on a scale STANDARD_DEVIATION 5.4 | 10.5 units on a scale STANDARD_DEVIATION 5 |
| Altarum Consumer Engagement (ACE) ACE Navigation Subscale | 15.5 units on a scale STANDARD_DEVIATION 4.4 | 14.8 units on a scale STANDARD_DEVIATION 2.8 | 15.2 units on a scale STANDARD_DEVIATION 3.8 |
| CollaboRATE | 73.5 units on a scale STANDARD_DEVIATION 28.3 | 81.0 units on a scale STANDARD_DEVIATION 26 | 76.5 units on a scale STANDARD_DEVIATION 27.4 |
| Communication Self-Efficacy (PEPPI-5) | 35.2 units on a scale STANDARD_DEVIATION 10.6 | 36.4 units on a scale STANDARD_DEVIATION 11.4 | 35.7 units on a scale STANDARD_DEVIATION 10.8 |
| Consumer Assessment of Health Care Providers and Systems Domain 1 | 8.8 units on a scale. Average score. STANDARD_DEVIATION 2.9 | 8.8 units on a scale. Average score. STANDARD_DEVIATION 3 | 8.8 units on a scale. Average score. STANDARD_DEVIATION 2.9 |
| Consumer Assessment of Health Care Providers and Systems Domain 2 | 14.4 units on a scale. Average score. STANDARD_DEVIATION 2.1 | 12.9 units on a scale. Average score. STANDARD_DEVIATION 2.7 | 13.8 units on a scale. Average score. STANDARD_DEVIATION 2.4 |
| Consumer Assessment of Health Care Providers and Systems Domain 3 | 9.6 units on a scale. Average score. STANDARD_DEVIATION 2.5 | 9.2 units on a scale. Average score. STANDARD_DEVIATION 2.4 | 9.4 units on a scale. Average score. STANDARD_DEVIATION 2.4 |
| Consumer Assessment of Health Care Providers and Systems Domain 4 | 7.3 units on a scale. Average score. STANDARD_DEVIATION 1 | 7.4 units on a scale. Average score. STANDARD_DEVIATION 1.2 | 7.3 units on a scale. Average score. STANDARD_DEVIATION 1 |
| Consumer Assessment of Health Care Providers and Systems Domain 5 | 8.4 units on a scale. Average score. STANDARD_DEVIATION 1.8 | 7.2 units on a scale. Average score. STANDARD_DEVIATION 2.3 | 7.9 units on a scale. Average score. STANDARD_DEVIATION 2.1 |
| Lubben Social Network Scale LSNS-6 | 14.2 units on a scale STANDARD_DEVIATION 7.1 | 15.7 units on a scale STANDARD_DEVIATION 0.6 | 14.7 units on a scale STANDARD_DEVIATION 5.7 |
| Patient Activation Measure (PAM-MH) | 51.5 units on a scale STANDARD_DEVIATION 11.3 | 49.6 units on a scale STANDARD_DEVIATION 11.8 | 51.5 units on a scale STANDARD_DEVIATION 11.3 |
| Patient Health Questionnaire (PHQ-9) | 14.9 units on a scale STANDARD_DEVIATION 6.4 | 11.5 units on a scale STANDARD_DEVIATION 6.3 | 13.6 units on a scale STANDARD_DEVIATION 6.5 |
| Perceived Discrimination in Healthcare Questionnaire | 1.1 units on a scale STANDARD_DEVIATION 0.8 | 0.9 units on a scale STANDARD_DEVIATION 0.8 | 1.0 units on a scale STANDARD_DEVIATION 0.8 |
| Race/Ethnicity, Customized Asian | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized Black | 20 Participants | 15 Participants | 35 Participants |
| Race/Ethnicity, Customized Hispanic | 4 Participants | 2 Participants | 6 Participants |
| Race/Ethnicity, Customized Multiracial | 5 Participants | 1 Participants | 6 Participants |
| Race/Ethnicity, Customized Other | 2 Participants | 3 Participants | 5 Participants |
| Race/Ethnicity, Customized White (Hispanic) | 3 Participants | 0 Participants | 3 Participants |
| Region of Enrollment United States | 30 Participants | 20 Participants | 50 Participants |
| Sex: Female, Male Female | 8 Participants | 11 Participants | 19 Participants |
| Sex: Female, Male Male | 22 Participants | 9 Participants | 31 Participants |
| Shared-Decision-Making-9 (SDM-Q-9) | 25.8 units on a scale STANDARD_DEVIATION 9.1 | 28.3 units on a scale STANDARD_DEVIATION 9.7 | 26.8 units on a scale STANDARD_DEVIATION 9.4 |
| UCLA 6 Item Loneliness Scale (ULS-6) | 17.1 units on a scale STANDARD_DEVIATION 4.2 | 14.8 units on a scale STANDARD_DEVIATION 6.3 | 16.2 units on a scale STANDARD_DEVIATION 5.2 |
| VR-12 Mental Function | 31 units on a scale. T-score STANDARD_DEVIATION 9.2 | 35 units on a scale. T-score STANDARD_DEVIATION 5.8 | 32 units on a scale. T-score STANDARD_DEVIATION 8.2 |
| VR-12 Physical Function | 42 units on a scale. T-score STANDARD_DEVIATION 7.2 | 42 units on a scale. T-score STANDARD_DEVIATION 8.8 | 42 units on a scale. T-score STANDARD_DEVIATION 7.7 |
| Working Alliance Inventory (WAI-SR) BOND subscale | 13.5 units on a scale STANDARD_DEVIATION 5.7 | 15.1 units on a scale STANDARD_DEVIATION 4.4 | 14.1 units on a scale STANDARD_DEVIATION 5.2 |
| Working Alliance Inventory (WAI-SR) Goal subscale | 12.7 units on a scale STANDARD_DEVIATION 6.2 | 14.8 units on a scale STANDARD_DEVIATION 4.1 | 13.5 units on a scale STANDARD_DEVIATION 5.5 |
| Working Alliance Inventory (WAI-SR) Task subscale | 11.8 units on a scale STANDARD_DEVIATION 4.9 | 12.8 units on a scale STANDARD_DEVIATION 4.5 | 12.2 units on a scale STANDARD_DEVIATION 4.7 |
| Working Alliance Inventory (WAI-SR) Total WAI-SR scores | 38.0 units on a scale STANDARD_DEVIATION 15.4 | 42.6 units on a scale STANDARD_DEVIATION 11.9 | 39.8 units on a scale STANDARD_DEVIATION 14.2 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 30 | 0 / 20 |
| other Total, other adverse events | 1 / 30 | 0 / 20 |
| serious Total, serious adverse events | 0 / 30 | 0 / 20 |
Outcome results
Altarum Consumer Engagement (ACE) Change
The ACE is administered as a 5-level Likert scale. The subscale scores range from 5 to 25, and the total engagement score is computed by adding the 3 subscale scores and multiplying the sum by 4/3 to obtain a possible range score of 20 to 100. Higher scores represent higher patient engagement.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | Altarum Consumer Engagement (ACE) Change | 5.5 score on a scale | Standard Deviation 11.5 |
| Waitlist Control | Altarum Consumer Engagement (ACE) Change | 2.9 score on a scale | Standard Deviation 10.4 |
Patient Activation Measure- Mental Health (PAM-MH)
Measure Description: The PAM-MH is a 13-item questionnaire that measures an individual's perceived ability to manage illness and health behaviors. The questions are rated on a 4-point Likert-type scale (1= strongly disagree, 2=disagree, 3=agree, 4=strongly agree). Scores are then converted using Rasch analysis to a 100-point scale. Raw scores range from 13 to 52 and converted activation scores range from 0-100. Higher activation scores indicate higher level of patient activation.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | Patient Activation Measure- Mental Health (PAM-MH) | 5.7 score on a scale | Standard Deviation 16.5 |
| Waitlist Control | Patient Activation Measure- Mental Health (PAM-MH) | 9.1 score on a scale | Standard Deviation 11.7 |
Peer Coaching Experience Satisfaction Questionnaire
Peer Coaching Experience Satisfaction Questionnaire is designed to collect feedback on a respondent's overall experience with a peer coach at the end of a 6-month period. Only participants in active PARTNER-MH were administered this questionnaire. This questionnaire was developed for the study. Question 1: Overall, how satisfied are you with PARTNER-MH program? Question 2: How satisfied are you with your assigned peer. Answers are rated on a Likert scale ranging from 1 (very satisfied) to 5 (very dissatisfied).
Time frame: Administered after completion of the study program (6 months for Active PARTNER-MH )
Population: Only 14 participants answered the question.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 1 Very satisified | 6 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 1 Satisified | 4 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 1 Neutral | 2 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 1 Dissatisfied | 1 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 1 Very dissatisfied | 1 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 2 Neutral | 1 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 2 Dissatisfied | 1 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 2 Very dissatisfied | 0 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 2 Very satisfied | 11 participants |
| Active PARTNER-MH | Peer Coaching Experience Satisfaction Questionnaire | Question 2 Satisfied | 1 participants |
SDM-Q9 PARTNER-MH
The SDM-Q9 PARTNER-MH was adapted from Braddock et al.'s SDM-Q-9 informed decision-making scale. The original, validated scale, the SDM-Q-9, has 9 items measured on a 6-point Likert Scale, ranging from 0=completely disagree to 5=completely agree. The total score is calculated by summing the scores of the nine items, range from 0 to 45. A higher score indicates a greater level of perceived SDM.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | SDM-Q9 PARTNER-MH | 1.9 units on a scale | Standard Deviation 13.5 |
| Waitlist Control | SDM-Q9 PARTNER-MH | 1.3 units on a scale | Standard Deviation 7.1 |
Trust and Satisfaction Survey Responses Change
The Trust and Satisfaction Survey is a 5-item scale which assess a respondent's degree of trust toward the VA, VA mental health care services, and the study program. Respondents are asked to rate how much they agree with each of the 5 items. Items are rated on a scale ranging from 1 (strongly disagree) to 5 (strongly agree). The survey yields final scores ranging from 5 (minimum) to 25 (maximum) with higher scores representing greater trust and satisfaction. No subscale.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Active PARTNER-MH | Trust and Satisfaction Survey Responses Change | Trust the VA | 0.05 score on a scale | Standard Deviation 0.85 |
| Active PARTNER-MH | Trust and Satisfaction Survey Responses Change | Trust the Mental Health Clinic | 0.03 score on a scale | Standard Deviation 0.69 |
| Active PARTNER-MH | Trust and Satisfaction Survey Responses Change | Would recommend MH clinic | 0.16 score on a scale | Standard Deviation 0.87 |
| Active PARTNER-MH | Trust and Satisfaction Survey Responses Change | Satisfied with the care I received at MH clinic | 0.24 score on a scale | Standard Deviation 0.72 |
| Waitlist Control | Trust and Satisfaction Survey Responses Change | Satisfied with the care I received at MH clinic | -0.53 score on a scale | Standard Deviation 0.72 |
| Waitlist Control | Trust and Satisfaction Survey Responses Change | Trust the VA | -0.13 score on a scale | Standard Deviation 0.83 |
| Waitlist Control | Trust and Satisfaction Survey Responses Change | Would recommend MH clinic | -0.19 score on a scale | Standard Deviation 0.64 |
| Waitlist Control | Trust and Satisfaction Survey Responses Change | Trust the Mental Health Clinic | -0.03 score on a scale | Standard Deviation 0.65 |
Patient Health Questionnaire (PHQ-9) Change
Measure Description: Patient Health Questionnaire (PHQ-9) measures severity of depressive symptoms. It includes 9 items, ranging in scores from 0 to 27. Higher scores indicate more severe symptoms of depression.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | Patient Health Questionnaire (PHQ-9) Change | -3.6 units on a scale | Standard Deviation 6.7 |
| Waitlist Control | Patient Health Questionnaire (PHQ-9) Change | 0.1 units on a scale | Standard Deviation 5.2 |
Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change
The Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) is 5-item scale rated on a 10-point Likert scale ranging from 1 (not confident at all) to 10 (very confident) and the total score, which is the sum of all item ratings, range from 0 (minimum) to 50 (maximum). Higher scores indicate higher levels of self-efficacy. There is no subscale.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change | 6.5 score on a scale | Standard Deviation 11.5 |
| Waitlist Control | Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change | 1.2 score on a scale | Standard Deviation 10.2 |
UCLA Loneliness Scale (ULS-6) Change
The UCLA Loneliness Scale Short Form, (ULS-6), is a 6-item scale that assesses loneliness and is rated on a 4-point Likert Scale, ranging from 1=never to 4= often. The scale has a total summed score ranging from 6 (minimum) to 24 (maximum), with higher scores indicate higher level of loneliness.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | UCLA Loneliness Scale (ULS-6) Change | -0.6 units on a scale | Standard Deviation 4.1 |
| Waitlist Control | UCLA Loneliness Scale (ULS-6) Change | -0.3 units on a scale | Standard Deviation 3.9 |
Veteran's RAND 12-item Health Survey (VR-12) Change
The Veterans Rand 12-item Health Survey (VR-12) is a 12-item scale that assesses Veterans' report of health-related quality of life. It measures mental and physical functioning. The VR-12 uses five-point ordinal response choices and provides two scores: the Physical Component Summary Score and the Mental Health Summary Score, ranging from 0 to 100. VR-12 scores are standardized using a T-score metric with a mean of 50 and a standard deviation of 10. The scores are compared to the population average, measured in standard deviations. The United States population average PCS and MCS are 50 points each. The United States population standard deviation is 10 points. Higher scores indicate better self-reported health. Lower VR-12 MCS scores indicate worse psychological distress/functioning. Clinically significant scores vary based on the condition or disease population.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Active PARTNER-MH | Veteran's RAND 12-item Health Survey (VR-12) Change | VR-12 Physical Function | -4.4 score on a scale | Standard Deviation 6.8 |
| Active PARTNER-MH | Veteran's RAND 12-item Health Survey (VR-12) Change | VR-12 Mental Function | 8.3 score on a scale | Standard Deviation 6.5 |
| Waitlist Control | Veteran's RAND 12-item Health Survey (VR-12) Change | VR-12 Physical Function | -0.3 score on a scale | Standard Deviation 7.8 |
| Waitlist Control | Veteran's RAND 12-item Health Survey (VR-12) Change | VR-12 Mental Function | -2.8 score on a scale | Standard Deviation 6.8 |
Working Alliance Inventory Short-Revised (WAI-SR) Change
Working Alliance Inventory -Short Revised (WAI-SR) evaluates key aspects of the therapeutic alliance between patients and their mental health providers. It includes 12 items rated on a 5-point Likert scale ranging from 1= seldom to 5= always. The WAI-SR has 3 subscales: The Goal, Task, and Bond subscales each have 4 items and scores ranging from 4 to 20. For research purposes, use of the overall mean scores of the WAI-SR rather than its subscales have been recommended. The scale total scores range from 12 (minimum) to 60 (maximum). Higher scores indicate higher level of working alliance. There is no cut off score for this scale.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Active PARTNER-MH | Working Alliance Inventory Short-Revised (WAI-SR) Change | BOND subscale | 0.7 score on a scale | Standard Deviation 3.4 |
| Active PARTNER-MH | Working Alliance Inventory Short-Revised (WAI-SR) Change | GOAL subscale | 1.6 score on a scale | Standard Deviation 5.7 |
| Active PARTNER-MH | Working Alliance Inventory Short-Revised (WAI-SR) Change | TASK Subscale | 1.4 score on a scale | Standard Deviation 2.7 |
| Active PARTNER-MH | Working Alliance Inventory Short-Revised (WAI-SR) Change | Summed scores | 3.8 score on a scale | Standard Deviation 9.9 |
| Waitlist Control | Working Alliance Inventory Short-Revised (WAI-SR) Change | Summed scores | 2.9 score on a scale | Standard Deviation 10.9 |
| Waitlist Control | Working Alliance Inventory Short-Revised (WAI-SR) Change | BOND subscale | 0.7 score on a scale | Standard Deviation 3.6 |
| Waitlist Control | Working Alliance Inventory Short-Revised (WAI-SR) Change | TASK Subscale | 0.7 score on a scale | Standard Deviation 5.5 |
| Waitlist Control | Working Alliance Inventory Short-Revised (WAI-SR) Change | GOAL subscale | 1.6 score on a scale | Standard Deviation 4 |
CollaboRATE
CollaboRATE consists of 3-items, each scored on a scale of 0-9. Scores range from 0-100. Higher scores indicate more shared decision.
Time frame: Change in score from baseline to 6-months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | CollaboRATE | 1.8 score on a scale | Standard Deviation 8.8 |
| Waitlist Control | CollaboRATE | 0.4 score on a scale | Standard Deviation 6 |
Lubben Social Network Scale-6
The Lubben Social Network Scale (LSNS-6) is a self-report measure consisting of 6 items, rated on a 6-point Likert scale ranging 0 to 5. The total score is the sum of all 6 items ranging from 0 to 30. A score of 12 indicates at risk of social isolation and scores less than 12 indicate social isolation.
Time frame: change in scores from baseline to 6 months
Population: Include changes in scores for patients from baseline to 6-months. This measure was added later as an exploratory measure. Only a few participants completed it.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | Lubben Social Network Scale-6 | 6.3 score on a scale | Standard Deviation 7 |
| Waitlist Control | Lubben Social Network Scale-6 | 0.0 score on a scale | Standard Deviation 2.6 |
Perceived Discrimination in Healthcare Responses
Measure Description: Respondents are asked to rate their experiences on a 5-point Likert-type scale, with answers ranging from 0 (never) to 4 (always). Higher scores indicate more frequent experiences of discrimination in healthcare.
Time frame: Change in score from baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Active PARTNER-MH | Perceived Discrimination in Healthcare Responses | -1.9 score on a scale | Standard Deviation 5.3 |
| Waitlist Control | Perceived Discrimination in Healthcare Responses | -1.6 score on a scale | Standard Deviation 4.5 |