Quality improvement study of collaborative care model services at a federally qualified health center: A uniform data system-informed approach.

Abstract

Introduction: The Collaborative Care Model (CoCM) is an evidenced based approach to integrating behavioral health into primary care to improve depression outcomes. This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center to improve depression remission outcomes based on Uniform Data System metrics. Uniform Data System defines depression remission as Patient Health Questionnaire-9 (PHQ-9) score below 5 at 12 months ± 60 days after initial positive depression screening.

Method: This study used the CoCM registry and medical record data to generate a sample of 251 patients between 2021 and 2022. PHQ-9 was employed to evaluate depression outcomes. Multiple regression and repeated measures t tests were used for hypothesis testing.

Results: The sample consisted of almost three-quarters of women and over half African American with a mean age of 40. CoCM was associated with a 12.60-point reduction in PHQ-9 scores between enrollment and follow-up at 12 months ± 60 days. A 1-point increase in fidelity was associated with a ∼4-point lower PHQ-9 score at posttest, and 1-point increase in treatment adherence was related to a 1-point decrease. Each 25 additional days of enrollment was associated with ∼1/2 point decrease.

Discussion: CoCM delivered with fidelity can support federally qualified health centers in improving depression remission rates at 12 months ± 60 days after initial positive depression screen. Fidelity, treatment adherence, length of enrollment, and time in care can positively impact outcomes. Further research is needed to evaluate additional study variables including psychopharmacology, psychiatric, and medical conditions in depression outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).