This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Depression is a health problem that makes people feel sad or hopeless. It is a leading cause of disability worldwide. Lesbian, gay, bisexual, transgender, and queer, or LGBTQ, adults have high rates of depression. Depression quality improvement programs can improve the care patients receive, especially those who are African American or Latino. These programs integrate mental health care into primary health care. But the clinics where LGBTQ adults get care may not have these programs.

In this study, the research team is testing two ways to improve depression symptoms among LGBTQ adults. The first way is depression care quality improvement training for staff at primary care, mental health, and community agencies. The second way includes the same agencywide training plus classes for patients in resilience, or the ability to recover quickly from set-backs. The team is focusing the study in areas with large African-American and Latino populations.

Who can this research help?

Primary care, mental health, and community agencies can use these results when considering ways to improve care for LGBTQ adults with depression.

What is the research team doing?

The research team is working with staff from LGBTQ-focused primary care, mental health, and community agencies in Los Angeles and New Orleans. Staff at all clinics receive a depression care quality improvement training called Resources for Services. In addition to a one-day training, this program includes 12 follow-up webinars on topics such as

Cognitive behavioral therapy, a type of treatment that helps people identify and change habits of thinking that are unhelpful.

• Team-based management of depression
• Medicine management
• Case management
• Psychotherapy

The research team is recruiting 265 adults who receive care from the LGBTQ agencies that received the Resources for Services training. All patients have moderate to severe depression symptoms. Then, the research team is assigning patients to one of the two groups by chance. Patients in both groups receive care from staff who were offered the Resources for Services training.

Half of the patients can also choose to take part in seven weekly resiliency classes. Classes are 90–120 minutes long. Community health workers lead the classes in a community setting. Topics include improving mood and goal setting. These patients also receive text messages that reinforce concepts learned in the classes and provide follow-up care reminders.

At the start of the study and again 6 and 12 months later, the research team is asking patients about their depression symptoms, quality of life, and resilience.

LGBTQ patients, community agencies, and LGBTQ health advocates help with this study.

Research methods at a glance