Comparing Two Ways to Improve Depression Symptoms among Adults who Identify as LGBTQ+ -- The RADD Study

• Download Summary
• Español (pdf)
• Audio Recording (mp3)

What was the research about?

Depression is a mental health problem that makes people feel sad or hopeless. Many adults who are lesbian, gay, bisexual, transgender, or queer, or LGBTQ+, experience depression.

In this study, the research team compared two ways to improve depression:

• Staff training alone. The team trained clinic staff and clinicians in depression care. Training taught ways to keep patients safe, screen for symptoms, educate patients, and refer patients to depression services. Clinicians also learned about medicines and therapy to treat depression.
• Staff training plus resilience classes for people receiving services. People with depression received care from staff who received the same training. They could also attend seven weekly classes led by community health workers. Classes taught ways to improve mood and recover quickly from setbacks. They also got follow-up text messages on class topics and how to get care when needed.

The research team looked at how well these two ways worked for people receiving services from local clinics. These clinics mainly serve people who identify as LGBTQ+.

Who was in the study?

The study included 253 adults with depression. All were receiving services at local clinics in Los Angeles and New Orleans. Of these, 34 percent were Hispanic, 29 percent were Black or African American, 28 percent were White, and 9 percent were another race or ethnicity. The average age was 42. Also, 66 percent were male, 27 percent were female, 4 percent were transgender, and 4 percent didn’t identify as one gender. Eighty-eight percent identified as LGBTQ+ or as men who have sex with men.

What did the research team do?

The research team assigned people by chance to one of two groups: staff training alone or staff training plus resilience classes for people receiving services. At the start of the study, and again 6 and 12 months later, the team surveyed people by phone. They asked about depression symptoms, quality of life, ability to recover quickly from setbacks, and mental well-being.

Adults who identify as LGBTQ+, community agencies, and LGBTQ+ health advocates helped to design and conduct the study.

What were the results?

PCORI is committed to making full information on all funded research projects publicly available. This summary doesn’t include results from or the limits of this study because the research team hasn’t yet responded to peer reviewers’ comments on their work. We will post the results and additional information if the research team completes the peer review process. Click here to learn more about the peer review process.

Objective

To compare the effectiveness of depression care training for community-based agency staff plus resiliency education for patients versus depression training for staff alone in improving depression symptoms in adults with depression who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+)

Study Design

In this randomized controlled trial, researchers compared the effectiveness of two interventions in improving depression symptoms, quality of life, and wellness in adults with moderate to severe depression who identify as LGBTQ+.

Staff in community-based agencies in Los Angeles, California, and New Orleans, Louisiana, that primarily serve adults who identify as LGBTQ+ received evidence-based quality improvement training for depression care. Staff who were licensed providers received training in clinical assessment, medication management, and cognitive behavioral therapy. Non-clinical staff received training in depression screening, education coordination, and patient safety and referral. All staff received training in team management.

Researchers randomly assigned adults receiving services in these community-based agencies to one of two groups:

• Staff training plus resiliency education for people receiving services. This group received care from staff who took the training. In addition, people with depression could attend seven weekly classes on ways to improve mood and recover quickly from setbacks. They also received follow-up text messages on topics covered in the classes and ways to get care when needed. Community health workers led the classes.
• Staff training alone. This group received care from staff who took the training but did not attend the classes or receive follow-up messages.

The study included 253 adults with depression. Among participants, 34% were Hispanic, 29% were Black or African American, 28% were White, and 9% were another race or ethnicity. The average age was 42. Among participants, 66% were male, 27% were female, 2% were female-to-male transgender, 2% were male-to-female transgender, and 4% were genderqueer or did not subscribe to conventional gender distinctions; 88% identified as LGBTQ+ or as men who have sex with men.

At baseline, and 6 and 12 months later, participants completed telephone surveys about depression symptoms, physical and mental health-related quality of life, resilience, and mental wellness.

People who identify as LGBTQ+, community agencies, and LGBTQ+ health advocates helped to design and conduct the study.

Results and Limitations

PCORI is committed to making full information on all funded research projects publicly available. This summary does not include results and limitations from this study because the researchers have not yet responded to peer reviewers’ comments on their work. We will post the results and additional information if the researchers complete the peer review process.