The Role of Social Support and Stressful Life Events in the Effectiveness of Collaborative Care for Depression: A Rural-Urban Comparison.

While there has been a relative lack of attention to the effectiveness of collaborative depression treatment as it may vary across rural and urban populations, recent work by Adams et al. (2006) suggests that collaborative care interventions improve the outcomes for urban, but not rural, primary care patients. We use Quality Enhancement for Strategic Teaming (QuEST) study data to examine whether these differences remain when feelings of social support and/or the prevalence of stressful life events are included in the analyses. Our results show that even when these psychosocial variables are controlled for, the collaborative depression care intervention has differential effectiveness for rural and urban patients: the intervention improved outcomes for urban patients, but failed to do so for rural patients. Our analyses also show that the intervention functions to improve feelings of social support in urban, but not rural, patients, and that it does not affect stressful life events in either population. Implications are discussed. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]