Figure 1
Study Flow Diagram.
Figure 2
HOPE IBH Program Logic Model.
Table 1
Availability of Services for Usual and Integrated Care Participants.
| HOPE Usual Care | HOPE Integrated Care | |
|---|---|---|
| Coordinated information sharing (e.g. development of care plans, record keeping) | ✓ | |
| Primary care services | ✓ | ✓ |
| Individual and group behavioral health counseling services | ✓ | ✓ |
| Behavioral Health Specialist (BHS) assessments | ✓ | |
| BHS initial individual counseling and follow-up sessions | ✓ | |
| Chronic care management visits (with transitional nurse) | ✓ | |
| Referrals to social and health education services | ✓ | ✓ |
| Coordination of referrals to external social and health education services | ✓ | |
| Warm hand-offs between services within HOPE | ✓ |
Table 2
Study Participant Characteristics at Baseline by Intervention Group.
| Intervention (n = 270) | Control (n = 312) | p-value | |||
|---|---|---|---|---|---|
| n | % | n | % | ||
| Demographics | |||||
| Sex | |||||
| Female | 199 | 73.7 | 229 | 73.4 | 0.93 |
| Male | 71 | 26.3 | 83 | 26.6 | |
| Ethnicity | |||||
| Hispanic | 217 | 80.4 | 267 | 85.6 | 0.09 |
| Non-Hispanic | 53 | 19.6 | 45 | 14.4 | |
| Age, mean (SD) | 51.2 (10.3) | — | 50.6 (10.7) | — | 0.51 |
| Employment Status | |||||
| Employed | 2 | 0.7 | 5 | 1.6 | 0.34 |
| Unemployed | 268 | 99.3 | 307 | 98.4 | |
| Marital Status | |||||
| Married | 135 | 50.0 | 161 | 51.6 | 0.70 |
| Not Married | 135 | 50.0 | 151 | 48.4 | |
| Primary Language Spoken | |||||
| English | 28 | 10.4 | 40 | 12.8 | 0.36 |
| Spanish | 242 | 89.6 | 272 | 87.2 | |
| Health, mean (SD) | |||||
| Systolic Blood Pressure | 133.4 (21.3) | 134.5 (19.4) | 0.48 | ||
| Diastolic Blood Pressure | 81.0 (9.6) | 82.0 (9.2) | 0.17 | ||
| BMI | 33.9 (7.5) | 33.6 (6.6) | 0.85 | ||
| PHQ-9 score | 7.1 (7.1) | 5.0 (6.3) | 0.001 | ||
| HbA1c | 8.0 (2.5) | 7.6 (2.3) | 0.12 | ||
Table 3
Effect of IBH Intervention on Health Outcomes at 12 Months, Intent-to-Treat Analyses.
| n | Intervention Mean (SD) | Control Mean (SD) | Intervention – Control Adjusted Mean Difference (SE) | p-value | |
|---|---|---|---|---|---|
| Systolic Blood Pressurea | 370 | 128.4 (18.3) | 130.0 (20.3) | –2.47 (1.70) | 0.15 |
| Diastolic Blood Pressureb | 370 | 78.1 (7.1) | 79.0 (8.5) | –0.93 (0.75) | 0.22 |
| HbA1cc | 146 | 8.0 (1.9) | 7.7 (1.9) | –0.11 (0.24) | 0.67 |
| BMId | 370 | 34.3 (7.7) | 33.1 (6.9) | 0.14 (0.22) | 0.52 |
| PHQ-9 scoree | 370 | 4.6 (5.4) | 5.3 (6.2) | –1.67 (0.66) | 0.01 |
[i] a adjusted for age, sex, marital status, baseline systolic blood pressure, and baseline PHQ-9 score b adjusted for marital status, baseline diastolic blood pressure, and number of comorbidities at baseline c adjusted for baseline HbA1c level d adjusted for baseline BMI and baseline PHQ-9 score e adjusted for age, primary language, employment status, and baseline PHQ-9 score.
Table 4
Effect of IBH Intervention on Health Outcomes at 12 Months, Per Protocol Analysis.
| n | Intervention – Control Adjusted Mean Difference (SE) | p-value | |
|---|---|---|---|
| Systolic Blood Pressurea | 285 | –1.11 (1.87) | 0.55 |
| Diastolic Blood Pressureb | 285 | –0.77 (0.76) | 0.33 |
| HbA1cc | 102 | –0.23 (0.28) | 0.42 |
| BMId | 281 | –0.01 (0.23) | 0.97 |
| PHQ-9 scoree | 188 | –1.64 (0.74) | 0.04 |
[i] a adjusted for age, marital status, baseline systolic blood pressure, and number of comorbidities at baseline b adjusted for age, baseline diastolic blood pressure, and number of comorbidities at baseline c adjusted for baseline HbA1c level d adjusted for baseline BMI e adjusted for baseline PHQ-9 score.