Clinical Effectiveness of Culturally and Linguistically Adapted Evidence-Based Psychosocial Intervention Compared With Enhanced Usual Care for Adults Experiencing Depression or Anxiety: The Strong Minds-Strong Communities Randomized Clinical Trial

Accountable care organizations (ACOs) aim to provide care coordination, reduce disparities, and link with community-based services within capitated financing. Many ACOs have not yet incorporated mental health services into their provider networks. The present study aims to examine the effectiveness of an intervention provided by community health workers as mental health providers, thereby expanding ACO infrastructure and increasing access to and quality of mental healthcare for racial, ethnic, and linguistic minoritized populations in North Carolina and Massachusetts. The Strong Minds-Strong Communities Randomized Clinical Trial (RCT) focused on (1) increasing engagement in mental health care, (2) decreasing depression and anxiety symptoms, (3) improving functioning, and (4) increasing the perceived quality of care. Participants include Latinx, Asian, Black, and non-Latinx White adults 18 years old and above with moderate to severe depression or anxiety symptoms and fluent in English, Spanish, Mandarin, or Cantonese. Participants were assessed at four time points throughout the study: baseline and 3-, 6-, and 12-months post-baseline. The effectiveness of the intervention, including moderation by race and ethnicity and by site, will be evaluated using a between-subjects design comparing outcomes at each post-baseline assessment between intervention and control participants.