Development and implementation of collaborative care for depression in HIV clinics

Area of Science:

• Implementation Science
• Public Health
• Clinical Psychology

Background:

• Depression is highly prevalent in human immunodeficiency virus (HIV) patients.
• Integrating mental health care into specialty clinics is crucial for this population.
• Existing collaborative care models need adaptation for HIV settings.

Purpose of the Study:

• To develop and implement a collaborative depression care intervention within HIV clinics (HITIDES project).
• To describe the formative evaluation, adaptation process, and intervention design.
• To assess the feasibility and effectiveness of collaborative depression care in a specialty physical health setting.

Main Methods:

• Multi-site randomized trial design in US Department of Veterans Affairs (VA) HIV clinics.
• Formative evaluations using qualitative methods, including key informant interviews with patients and providers.
• Evidence-based quality improvement (EBQI) methods for intervention adaptation and implementation.

Main Results:

• Qualitative data from formative evaluations informed intervention adaptation.
• EBQI methods successfully tailored the collaborative care model to specific HIV clinic contexts.
• Baseline assessments completed by 249 depressed HIV participants.

Conclusions:

• EBQI provides a robust framework for adapting and implementing collaborative depression care in specialty HIV clinics.
• The HITIDES study offers a valuable model for evaluating integrated mental health care in this high-need population.
• Further research is warranted to confirm the effectiveness of this adapted model.