Evaluating the Late-Life Depression Initiative

Evaluation of the initiative will use a mixed-methods approach (i.e., the collection and analysis of both qualitative and quantitative data). This approach will allow the evaluation team to describe the processes, contexts and outcomes of the interventions from both qualitative and quantitative perspectives, providing a richer account of the key elements of success that will help guide future efforts and knowledge dissemination.

The Phase 2 evaluation will build on the evaluation of Phase 1. For the Phase 1 evaluation, we have identified early lessons learned and measured initial outcomes. For Phase 2, sites are expanding or enhancing their interventions and new sites will be added. Thus, the evaluation will examine the evolving strategies and practices Care Partner sites have adopted. The primary outcomes of interest will continue to be how the intervention affects the care experiences of patients and staff as well as its impact on depression outcomes (i.e., PHQ-9 measure of depression symptoms). Secondary outcome measures include identifying the costs associated with the intervention at each site, examining changes in care networks and depression care task sharing, and describing the development of the learning community and overall initiative. 

The qualitative data will be collected through annual in-depth key informant interviews with staff and administrators at all participating sites, annual cross-site focus group interviews of project key stakeholders, and document analysis of participating sites’ quarterly and annual reports. In Phase 1, we conducted exit interviews of participating patients, however, this will not be continued in Phase 2. Qualitative thematic analysis, facilitated with NVivo qualitative data analysis software, will be used to analyze and interpret the qualitative data.

The quantitative data (i.e., numbers of patients recruited, PHQ-9 depression outcomes) will be collected in a collaborative care patient registry developed by UW. The Care Management Tracking System (CMTS) is a clinical registry where care managers track depression care. CMTS is also a tool that enables AIMS Center staff and consultants ongoing access to de-identified data on patient enrollment and care. Quantitative outcomes are regularly assessed by care managers and supervisors at sites and by the AIMS Center. CMTS has been modified for this project to track CBO and family involvement in care as a process of care measure that will also be summarized in final reports and other project deliverables. 

Evaluation Aims

  1. To examine how the intervention was experienced by key stakeholders at primary care clinics and community-based organizations.  
  2. To describe the interventions and their implementation across sites, including challenges and lessons learned. 
  3. To evaluate the outcome of the interventions at the level of 1) patients and families and 2) participating organizations.  What worked and didn't work?  For whom and under what conditions did the intervention produce positive outcomes?    
  4. To describe the development and evolution of the overall initiative. What is the emerging and projected impact of the overall initiative on late life depression care locally and nationally

Evaluation Data Overview

  • Care Management Tracking System (CMTS) Data (Qualitative): Patient process of care and outcome data (patient consent, see below)
  • Interviews: Staff
  • Focus Groups: Staff
  • Document Analysis:  Proposals, progress reports, and practice coaching notes
  • Cost Analysis: Spreadsheet capturing care activities for one month period 

Patient Consent

The consent template can be modified to fit each site’s program and contacts. Please share a copy of your final patient consent form with Kat James.