title: Development and implementation of collaborative care for depression in HIV clinics.
abstract: We sought to develop and implement collaborative depression care in human immunodeficiency virus (HIV) clinics in a project called HIV Translating Initiatives for Depression into Effective Solutions (HITIDES). Here we describe: (i) the formative evaluation (FE) conducted prior to implementation; (ii) the process used to adapt the primary care collaborative care model for depression to specialty HIV clinics; and (iii) the intervention itself. The overall design of HITIDES was a multi-site randomized trial in United States Department of Veterans Affairs (VA) HIV clinics comparing the depression collaborative care intervention to usual depression care. Qualitative methods were used for the FEs and informed the evidence-based quality improvement (EBQI) methods that were used for adapting and implementing the intervention. Baseline assessments were completed by 249 depressed HIV participants. Summaries of respective key informant interviews with eight HIV patients who were receiving depression treatment and 25 HIV or mental health (MH) providers were presented to each site. EBQI methods were used to tailor the HITIDES intervention to each site while maintaining true to the evidence base for depression collaborative care. EBQI methods provided a useful framework for intervention adaptation and implementation. The HITIDES study provides the opportunity to evaluate collaborative depression care in a specialty physical health clinic setting with a population that has a high prevalence of depression and MH comorbidity.
authors.affiliation: Central Arkansas Veterans Healthcare System, Little Rock, USA. currangeoffreym@uams.edu
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Curran
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Pyne
authors.forename: John C
authors.initials: JC
authors.lastname: Fortney
authors.forename: Allen
authors.initials: A
authors.lastname: Gifford
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Asch
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.forename: Maria
authors.initials: M
authors.lastname: Rodriguez-Barradas
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Monson
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Hilde
authors.initials: H
authors.lastname: Hagedorn
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Atkinson
mesh_terms: D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000150:complications / Q000628:therapy*; D055317:Evidence-Based Practice; D015658:HIV Infections / Q000150:complications / Q000628:therapy*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D014481:United States; D014493:United States Department of Veterans Affairs