Enhanced Integrated Behavioral Health Model Improves Depressive Symptoms in a Low-Income, Uninsured, Primarily Hispanic Population Served by a Free and Charitable Clinic.

BACKGROUND: Residents living in US-Mexico border communities have some of the worst health outcomes nationally. This randomized trial evaluated whether patients receiving enhanced integrated behavioral health (IBH) care at a southern Texas free and charitable were more likely to improve health outcomes after 12 months compared to patients receiving standard care. THEORY & METHODS: The IBH intervention featured brief intervention by a behavioral health specialist and enhanced coordinated care. The primary outcome was systolic blood pressure. Secondary outcomes were diastolic blood pressure, HbA1c, BMI, and depressive symptoms. Linear regression models were utilized to assess the impact of IBH on participants; secondary analyses examined possible effect modification. RESULTS: After 12 months, intervention participants (n = 172) were more likely to have a lower PHQ-9 score than control participants (n = 198) (ß = -1.67, p = 0.01). There was significant modification of the intervention effect by age; there was a different effect on older participants (ß = -2.08, p = 0.01). There were no statistically significant findings for other outcomes. CONCLUSIONS: Collaborative, integrated behavioral health and primary care can improve depressive symptoms for low-income or uninsured individuals living in southern Texas border communities. These findings provide evidence that may help develop IBH programs to improve health of vulnerable populations experiencing health inequities.

A reverse colocated integrated care model intervention among persons with severe persistent mental illness at the U.S.-Mexico border: A randomized controlled trial protocol.

Persons with severe persistent mental illness (SPMI)-which includes individuals with schizophrenia, bipolar disorder, and mood disorders such as major depression-are at high risk for poor health outcomes and premature death. Persons with SPMI are largely absent from research evaluating innovative health care models due to recruitment and retention barriers. This paper presents the protocol for a randomized control trial testing a reverse colocated integrated care model in an SPMI population receiving care at a mental health clinic at the U.S.-Mexico border. The study employs a randomized control trial design to determine whether reverse colocated integrated care improves physical and mental health of persons with SPMI. Participants will be randomized to receive the integrated primary care intervention or usual care (behavioral health only). All study participants will complete baseline, 6-, and 12-month assessments. Study outcomes included blood pressure, HbA1c, cholesterol, body mass index, depression, and adult functioning. Despite challenges in recruiting and retaining SPMI patients, co-locating primary care services within a local mental health authority has the potential to improve health and reduce health disparities experienced by persons with SPMI. The study will determine the impacts of this colocated integrated care model among SPMI patients in a socio-economically disadvantaged region. Clinical Trials.gov Identifier: NCT03881657.

Small molecule specific run acceptance, specific assay operation, and chromatographic run quality assessment: recommendation for best practices and harmonization from the global bioanalysis consortium harmonization teams.

Consensus practices and regulatory guidance for liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) assays of small molecules are more aligned globally than for any of the other bioanalytical techniques addressed by the Global Bioanalysis Consortium. The three Global Bioanalysis Consortium Harmonization Teams provide recommendations and best practices for areas not yet addressed fully by guidances and consensus for small molecule bioanalysis. Recommendations from all three teams are combined in this report for chromatographic run quality, validation, and sample analysis run acceptance.