title: Managing Depression Among Homeless Mothers: Pilot Testing an Adapted Collaborative Care Intervention.
abstract: OBJECTIVE
  Although depression is common among homeless mothers, little progress has been made in testing treatment strategies for this group. We describe pilot test results of an adapted collaborative care model for homeless mothers with depression.
  
  
  METHODS
  We conducted a pilot intervention study of mothers screening positive for depression in 2 randomly selected shelter-based primary care clinics in New York over 18 months in 2010-2012. Study participants completed a psychosocial, health, and mental health assessment at baseline, 3 months, and 6 months.
  
  
  RESULTS
  One-third of women screened positive for depression (123 of 328 women). Sixty-seven women (63.2% of the eligible sample) enrolled in the intervention. At 6 months, compared to usual-care women, intervention group women were more likely to be receiving depression treatment (40.0% vs 5.9%, P = .01) and antidepressant medication (73.3% vs 5.9%, P = .001, respectively) and had more primary care physician and care manager visits at both 3 months (74.3% vs 53.3%, P = .009 and 91.4% vs 26.7%, P < .001, respectively) and 6 months (46.7% vs 23.5%, P = .003 and 70% vs 17.7%, P = .001, respectively). More women in the intervention group compared to usual-care women reported ≥ 50% improvement in depression symptoms at 6 months (30% vs 5.9%, P = .07).
  
  
  CONCLUSIONS
  This pilot study found that implementing an adapted collaborative care intervention was feasible in a shelter-based primary care clinic and had promising results that require further testing.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT02723058.
authors.affiliation: Family Medicine and Community Health, University of Massachusetts Medical School, Worcester.
authors.forename: Linda
authors.initials: L
authors.lastname: Weinreb
authors.affiliation: Family Medicine and Community Health, University of Massachusetts Medical School, Worcester.
authors.forename: Carole C
authors.initials: CC
authors.lastname: Upshur
authors.affiliation: Care for the Homeless, New York, New York.
authors.forename: Debbian
authors.initials: D
authors.lastname: Fletcher-Blake
authors.affiliation: Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.affiliation: Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.
authors.forename: Christine
authors.initials: C
authors.lastname: Frisard
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D009035:Mothers / Q000523:psychology*; D010348:Patient Care Team / Q000592:standards*; D010865:Pilot Projects; D016896:Treatment Outcome; D016387:Women's Health