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Improving Patient-Provider Communication to Reduce Mental Health Disparities

Improving Patient-provider Communication to Reduce Mental Health Disparities (CDA 16-153)

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04515771
Acronym
PARTNER-MH
Enrollment
50
Registered
2020-08-17
Start date
2020-08-17
Completion date
2022-04-15
Last updated
2024-09-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Healthcare Disparities, Mental Health

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

BEHAVIORALPARTNER-MH

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

VA Office of Research and Development
Lead SponsorFED

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE

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

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

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

MeasureTime frameDescription
Trust and Satisfaction Survey Responses ChangeChange from Baseline to 6 monthsThe 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 QuestionnaireAdministered 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 monthsMeasure 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) ChangeChange from Baseline to 6 monthsThe 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-MHChange from Baseline to 6 monthsThe 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

MeasureTime frameDescription
Patient Health Questionnaire (PHQ-9) ChangeChange from Baseline to 6 monthsMeasure 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) ChangeChange from Baseline to 6 monthsThe 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) ChangeChange from Baseline to 6 monthsThe 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) ChangeChange from Baseline to 6 monthsWorking 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) ChangeChange from Baseline to 6 monthsThe 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

MeasureTime frameDescription
Lubben Social Network Scale-6change in scores from baseline to 6 monthsThe 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 ResponsesChange in score from baseline to 6 monthsMeasure 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

ArmCount
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
Total50

Withdrawals & dropouts

PeriodReasonFG000FG001
Period 1: 6 Month Randomized PeriodLost to Follow-up91
Period 1: 6 Month Randomized PeriodWithdrawal by Subject31
Period 2. 6 Month Waitlist CrossoverLost to Follow-up05

Baseline characteristics

CharacteristicActive PARTNER-MHWaitlist ControlTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
2 Participants0 Participants2 Participants
Age, Categorical
Between 18 and 65 years
28 Participants20 Participants48 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
CollaboRATE73.5 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-614.2 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 Questionnaire1.1 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 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Black
20 Participants15 Participants35 Participants
Race/Ethnicity, Customized
Hispanic
4 Participants2 Participants6 Participants
Race/Ethnicity, Customized
Multiracial
5 Participants1 Participants6 Participants
Race/Ethnicity, Customized
Other
2 Participants3 Participants5 Participants
Race/Ethnicity, Customized
White (Hispanic)
3 Participants0 Participants3 Participants
Region of Enrollment
United States
30 Participants20 Participants50 Participants
Sex: Female, Male
Female
8 Participants11 Participants19 Participants
Sex: Female, Male
Male
22 Participants9 Participants31 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 Function31 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 Function42 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 typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 300 / 20
other
Total, other adverse events
1 / 300 / 20
serious
Total, serious adverse events
0 / 300 / 20

Outcome results

Primary

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHAltarum Consumer Engagement (ACE) Change5.5 score on a scaleStandard Deviation 11.5
Waitlist ControlAltarum Consumer Engagement (ACE) Change2.9 score on a scaleStandard Deviation 10.4
Primary

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHPatient Activation Measure- Mental Health (PAM-MH)5.7 score on a scaleStandard Deviation 16.5
Waitlist ControlPatient Activation Measure- Mental Health (PAM-MH)9.1 score on a scaleStandard Deviation 11.7
Primary

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.

ArmMeasureGroupValue (NUMBER)
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 1 Very satisified6 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 1 Satisified4 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 1 Neutral2 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 1 Dissatisfied1 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 1 Very dissatisfied1 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 2 Neutral1 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 2 Dissatisfied1 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 2 Very dissatisfied0 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 2 Very satisfied11 participants
Active PARTNER-MHPeer Coaching Experience Satisfaction QuestionnaireQuestion 2 Satisfied1 participants
Primary

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHSDM-Q9 PARTNER-MH1.9 units on a scaleStandard Deviation 13.5
Waitlist ControlSDM-Q9 PARTNER-MH1.3 units on a scaleStandard Deviation 7.1
Primary

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

ArmMeasureGroupValue (MEAN)Dispersion
Active PARTNER-MHTrust and Satisfaction Survey Responses ChangeTrust the VA0.05 score on a scaleStandard Deviation 0.85
Active PARTNER-MHTrust and Satisfaction Survey Responses ChangeTrust the Mental Health Clinic0.03 score on a scaleStandard Deviation 0.69
Active PARTNER-MHTrust and Satisfaction Survey Responses ChangeWould recommend MH clinic0.16 score on a scaleStandard Deviation 0.87
Active PARTNER-MHTrust and Satisfaction Survey Responses ChangeSatisfied with the care I received at MH clinic0.24 score on a scaleStandard Deviation 0.72
Waitlist ControlTrust and Satisfaction Survey Responses ChangeSatisfied with the care I received at MH clinic-0.53 score on a scaleStandard Deviation 0.72
Waitlist ControlTrust and Satisfaction Survey Responses ChangeTrust the VA-0.13 score on a scaleStandard Deviation 0.83
Waitlist ControlTrust and Satisfaction Survey Responses ChangeWould recommend MH clinic-0.19 score on a scaleStandard Deviation 0.64
Waitlist ControlTrust and Satisfaction Survey Responses ChangeTrust the Mental Health Clinic-0.03 score on a scaleStandard Deviation 0.65
Secondary

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHPatient Health Questionnaire (PHQ-9) Change-3.6 units on a scaleStandard Deviation 6.7
Waitlist ControlPatient Health Questionnaire (PHQ-9) Change0.1 units on a scaleStandard Deviation 5.2
Secondary

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHPerceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change6.5 score on a scaleStandard Deviation 11.5
Waitlist ControlPerceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) Change1.2 score on a scaleStandard Deviation 10.2
Secondary

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHUCLA Loneliness Scale (ULS-6) Change-0.6 units on a scaleStandard Deviation 4.1
Waitlist ControlUCLA Loneliness Scale (ULS-6) Change-0.3 units on a scaleStandard Deviation 3.9
Secondary

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

ArmMeasureGroupValue (MEAN)Dispersion
Active PARTNER-MHVeteran's RAND 12-item Health Survey (VR-12) ChangeVR-12 Physical Function-4.4 score on a scaleStandard Deviation 6.8
Active PARTNER-MHVeteran's RAND 12-item Health Survey (VR-12) ChangeVR-12 Mental Function8.3 score on a scaleStandard Deviation 6.5
Waitlist ControlVeteran's RAND 12-item Health Survey (VR-12) ChangeVR-12 Physical Function-0.3 score on a scaleStandard Deviation 7.8
Waitlist ControlVeteran's RAND 12-item Health Survey (VR-12) ChangeVR-12 Mental Function-2.8 score on a scaleStandard Deviation 6.8
Secondary

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

ArmMeasureGroupValue (MEAN)Dispersion
Active PARTNER-MHWorking Alliance Inventory Short-Revised (WAI-SR) ChangeBOND subscale0.7 score on a scaleStandard Deviation 3.4
Active PARTNER-MHWorking Alliance Inventory Short-Revised (WAI-SR) ChangeGOAL subscale1.6 score on a scaleStandard Deviation 5.7
Active PARTNER-MHWorking Alliance Inventory Short-Revised (WAI-SR) ChangeTASK Subscale1.4 score on a scaleStandard Deviation 2.7
Active PARTNER-MHWorking Alliance Inventory Short-Revised (WAI-SR) ChangeSummed scores3.8 score on a scaleStandard Deviation 9.9
Waitlist ControlWorking Alliance Inventory Short-Revised (WAI-SR) ChangeSummed scores2.9 score on a scaleStandard Deviation 10.9
Waitlist ControlWorking Alliance Inventory Short-Revised (WAI-SR) ChangeBOND subscale0.7 score on a scaleStandard Deviation 3.6
Waitlist ControlWorking Alliance Inventory Short-Revised (WAI-SR) ChangeTASK Subscale0.7 score on a scaleStandard Deviation 5.5
Waitlist ControlWorking Alliance Inventory Short-Revised (WAI-SR) ChangeGOAL subscale1.6 score on a scaleStandard Deviation 4
Post Hoc

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHCollaboRATE1.8 score on a scaleStandard Deviation 8.8
Waitlist ControlCollaboRATE0.4 score on a scaleStandard Deviation 6
Other Pre-specified

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.

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHLubben Social Network Scale-66.3 score on a scaleStandard Deviation 7
Waitlist ControlLubben Social Network Scale-60.0 score on a scaleStandard Deviation 2.6
Other Pre-specified

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

ArmMeasureValue (MEAN)Dispersion
Active PARTNER-MHPerceived Discrimination in Healthcare Responses-1.9 score on a scaleStandard Deviation 5.3
Waitlist ControlPerceived Discrimination in Healthcare Responses-1.6 score on a scaleStandard Deviation 4.5

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026