Results Summary

What was the research about?

People who have a serious mental illness, or SMI, are at higher risk for other health problems. An SMI, such as depression or bipolar disorder, may make it hard for people to work or live on their own or to arrange for health care. These problems can be worse if language or cultural issues are barriers to receiving care.

In this study, the research team compared two types of care. The first type was integrated care. Integrated care includes both physical and mental health care at the same clinic. The second type was integrated care with a peer navigator. Peer navigators have backgrounds similar to patients and help patients find and use healthcare services. The team looked to see how well these two types of care worked to help Latinx patients with an SMI get the care they need.

What were the results?

Compared with Latinx patients who didn’t work with a peer navigator, patients who did reported

  • More scheduled doctors’ visits
  • Going to more of their scheduled doctors’ visits
  • Having more improvement in their mental health
  • Feeling more in control of their health
  • Having better quality of life

Latinx patients who didn’t work with a peer navigator and patients who did reported similar physical health.

Who was in the study?

The study included 110 Latinx patients with an SMI in the Chicago area. Of these, 66 percent had depression, 21 percent had an anxiety disorder, 7 percent had bipolar disorder, 3 percent had schizophrenia, and 2 percent had posttraumatic stress disorder. In addition, 63 percent preferred to speak Spanish, and 72 percent were born outside of the United States. The average age was 46, and 58 percent were women. All patients received care at a health clinic that offered physical and mental health care in the same place.

What did the research team do?

Before the study, peer navigators completed 20 hours of training. They continued to receive more training and supervision during the study.

The research team assigned patients by chance to one of two groups. One group received integrated care. The other group received integrated care and worked with a peer navigator. For one year, the navigators

  • Talked with patients by phone once a week
  • Helped patients work with doctors and get the health care they needed
  • Answered patients’ questions
  • Talked to patients about their health goals
  • Helped patients get access to community resources and services

To see how many doctors’ visits the patients scheduled and went to, the research team called all patients every week. Patients filled out health surveys at the beginning of the study and 4, 8, and 12 months after the study started.

During the study, Latinx patients with an SMI, a health researcher with a mental illness, a Latinx public health professional, and local health center staff worked with the research team.

What were the limits of the study?

The study included a small number of patients living in one area. Results may differ for people who live in different areas. Most patients had either depression or anxiety disorder. Results may be different for Latinx people with other types of SMI. The research team got information about patients’ SMI from the patient, not their doctor. Information provided by the doctor might differ.

Future studies could include more patients from other locations or with different SMI diagnoses.

How can people use the results?

Clinics that offer integrated care might use these results to decide if they want to have peer navigators work with Latinx patients with SMI. Patients can use these results to help decide if they want to work with a peer navigator if one is available at their clinic.

Final Research Report

View this project's final research report.

More to Explore...

Blogs

Patients Helping Patients Navigate Serious Mental Illness
In a blog post, two patient partners from PCORI-funded projects discuss their personal experiences and their projects' findings that integrating peer navigators into routine care can improve the physical health of patients with serious mental illness.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. Those comments and responses included the following:

  • Reviewers noted that the report describes the patient population under study as having serious mental illness. They also stated that for most readers serious mental illness would indicate the more severe and less common mental illnesses, like bipolar disorder and schizophrenia. However, most of the patient sample had depression or anxiety, which are more common mental illnesses. The researchers clarified that they determined study eligibility more by functional disability—as reported by the patient—than by a specific diagnosis.
  • Reviewers expressed concern that researchers ascertained the primary outcomes, scheduled appointments and achieved appointments, through patient self-reporting and not through more objective means, like the patients’ medical records. Reviewers further noted that participants in the peer navigation program might have more incentive to overestimate the number of their appointments because they felt more accountable to their peer navigators. The researchers acknowledged this concern with a statement in the study limitations section.
  • Reviewers noted that the data did not support the conclusion that study participants in the peer navigator program had more achieved appointments than participants in the integrated care program, despite the significant interaction term in the multivariable analysis. The results instead seemed to indicate a positive trend in achieved appointments for the integrated care group rather than for the peer navigator program group. In response, the researchers added a statement to the results indicating that post-hoc analyses failed to show that the significant interaction resulted in a greater increase in achieved appointments for either condition.

Conflict of Interest Disclosures

Project Information

Patrick William Corrigan, PsyD
Illinois Institute of Technology
$1,646,565
10.25302/8.2019.AD.130601419
Integrated Care and Patient Navigators for Latinos with Serious Mental Illness

Key Dates

December 2013
July 2018
2013
2018

Study Registration Information

Tags

Has Results
Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
Research Priority Area
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: November 30, 2022