Patient Characteristics at Baseline
| Total | Control | Active | P Value | ||||
|---|---|---|---|---|---|---|---|
| No. (%) | Mean (SD) | No. (%) | Mean (SD) | No. (%) | Mean (SD) | ||
| na | 2,426 | 1,459 | 967 | ||||
| Age,b y | 61.9 (13.1) | 61.9 (13.4) | 61.9 (12.7) | .49 | |||
| Sexb | .15 | ||||||
| Female | 1,588 (65.5) | 970 (66.5) | 618 (63.9) | ||||
| Male | 832 (34.3) | 483 (33.1) | 349 (36.1) | ||||
| Raceb | .01 | ||||||
| White | 1,859 (76.8) | 1,157 (79.3) | 702 (72.9) | ||||
| Black or African American | 281 (11.6) | 154 (10.6) | 127 (13.2) | ||||
| Asian | 71 (2.9) | 35 (2.4) | 36 (3.7) | ||||
| Native Hawaiian/Other Pacific Islander | 37 (1.5) | 17 (1.2) | 20 (2.1) | ||||
| American Indian or Alaskan Native | 21 (0.9) | 13 (0.9) | 8 (0.8) | ||||
| Other | 153 (6.3) | 83 (5.7) | 70 (7.3) | ||||
| Ethnicityb | .14 | ||||||
| Non-Hispanic | 2,207 (91.5) | 1,342 (92.4) | 865 (90.1) | ||||
| Hispanic | 180 (7.5) | 96 (6.6) | 84 (8.8) | ||||
| Prefer not to say | 26 (1.1) | 15 (1.0) | 11 (1.1) | ||||
| Marital statusb | .13 | ||||||
| Married | 1,082 (44.8) | 621 (42.7) | 461 (47.9) | ||||
| Divorced | 517 (21.4) | 318 (21.9) | 199 (20.7) | ||||
| Never married | 405 (16.8) | 249 (17.1) | 156 (16.2) | ||||
| Widowed | 290 (12.0) | 183 (12.6) | 107 (11.1) | ||||
| Separated | 62 (2.6) | 44 (3.0) | 18 (1.9) | ||||
| Living as married | 61 (2.5) | 39 (2.7) | 22 (2.3) | ||||
| Employmentb | .11 | ||||||
| Retired | 864 (36.6) | 525 (36.8) | 339 (36.2) | ||||
| Disabled | 627 (26.5) | 372 (26.1) | 255 (27.2) | ||||
| Full-time | 486 (20.6) | 274 (19.2) | 212 (22.6) | ||||
| Part-time | 205 (8.7) | 136 (9.5) | 69 (7.4) | ||||
| Homemaker | 94 (4.0) | 60 (4.2) | 34 (3.6) | ||||
| Unemployed/looking | 68 (2.9) | 43 (3.0) | 25 (2.7) | ||||
| Student | 15 (0.6) | 13 (0.9) | 2 (0.2) | ||||
| Other | 3 (0.1) | 2 (0.1) | 1 (0.1) | ||||
| Annual household income,b $ | |||||||
| <15,000 | 681 (29.5) | 416 (30.0) | 265 (28.7) | .04 | |||
| 15,000-29,999 | 509 (22.0) | 308 (22.2) | 201 (21.8) | ||||
| 30,000-44,999 | 281 (12.2) | 180 (13.0) | 101 (10.9) | ||||
| 45,000-59,999 | 186 (8.0) | 116 (8.4) | 70 (7.6) | ||||
| 60,000-74,999 | 190 (8.2) | 121 (8.7) | 69 (7.5) | ||||
| 75,000-99,999 | 188 (8.1) | 103 (7.4) | 85 (9.2) | ||||
| >100,000 | 277 (12.0) | 144 (10.4) | 133 (14.4) | ||||
| Educationb | .92 | ||||||
| <Grade 9 | 56 (2.4) | 32 (2.2) | 24 (2.5) | ||||
| Grades 9-12, no diploma | 208 (8.8) | 123 (8.6) | 85 (9.0) | ||||
| High school graduate (including GED) | 1,004 (42.2) | 608 (42.6) | 396 (41.7) | ||||
| Associate degree | 378 (15.9) | 222 (15.5) | 156 (16.4) | ||||
| Bachelor’s degree | 387 (16.3) | 229 (16.0) | 158 (16.6) | ||||
| Graduate or professional degree | 344 (14.5) | 214 (15.0) | 130 (13.7) | ||||
| Chronic conditionsb | |||||||
| Arthritis | 1,023 (42.2) | 613 (42.0) | 410 (42.4) | .85 | |||
| Asthma | 545 (22.5) | 316 (21.7) | 229 (23.7) | .24 | |||
| Chronic obstructive pulmonary disease | 330 (13.6) | 214 (14.7) | 116 (12.0) | .06 | |||
| Chronic pain | 2,037 (84.0) | 1,213 (83.1) | 824 (85.2) | .17 | |||
| Diabetes (nongestational) | 1,075 (44.3) | 671 (46.0) | 404 (41.8) | .04 | |||
| Heart failure | 188 (7.8) | 119 (8.2) | 69 (7.1) | .36 | |||
| Hypertension | 2,012 (82.9) | 1,207 (82.7) | 805 (83.3) | .74 | |||
| Irritable bowel syndrome | 102 (4.2) | 56 (3.8) | 46 (4.8) | .27 | |||
| Anxiety | 830 (34.2) | 491 (33.7) | 339 (35.1) | .48 | |||
| Depression | 1,136 (46.8) | 697 (47.8) | 439 (45.4) | .25 | |||
| Insomnia | 570 (23.5) | 339 (23.2) | 231 (23.9) | .71 | |||
| Any substance use disorder | 559 (23.0) | 339 (23.2) | 220 (22.8) | .78 | |||
| Tobacco use | 445 (18.3) | 274 (18.8) | 171 (17.7) | .49 | |||
| Alcohol use disorder | 155 (6.4) | 93 (6.4) | 62 (6.4) | .97 | |||
| Mean number of chronic conditionsb | 4.4 (1.6) | 4.4 (1.6) | 4.3 (1.6) | .6 | |||
| Neighborhood characteristicsb (home census tract) | |||||||
| Social Deprivation Index (higher score indicates more deprivation) | 52.6 (27.7) | 53.5 (26.9) | 51.2 (29.0) | .05 | |||
| Rural | 477 (19.8) | 341 (23.4) | 136 (14.3) | <.001 | |||
| Population density, persons per square mile | 3,768 (6,656) | 2,978 (3,315) | 4,980 (9,645) | <.001 | |||
| Primary outcomes – PROMIS-29 t-scoresc | |||||||
| Anxiety | 53.9 (10.0) | 53.8 (9.9) | 54.1 (10.1) | .34 | |||
| Depression | 52.7 (9.8) | 52.7 (9.8) | 52.9 (9.7) | .46 | |||
| Fatigue | 52.6 (10.4) | 52.6 (10.4) | 52.5 (10.4) | .66 | |||
| Sleep disturbance | 53.1 (8.9) | 52.9 (8.8) | 53.3 (8.9) | .26 | |||
| Pain interference | 58.1 (10.0) | 58.0 (10.1) | 58.2 (10.0) | .54 | |||
| Pain intensity | 4.5 (2.8) | 4.4 (2.7) | 4.5 (2.8) | .58 | |||
| Social participationc | 48.3 (9.9) | 48.4 (9.8) | 48.1 (10.0) | .65 | |||
| Physical functionc | 43.6 (9.4) | 43.5 (9.4) | 43.7 (9.3) | .49 | |||
| Secondary outcomes | |||||||
| PROMIS-29 Physical Health Summary t-scorec | 45.9 (9.4) | 45.8 (9.5) | 46.0 (9.3) | .7 | |||
| PROMIS-29 Mental Health Summary t-scorec | 50.3 (8.8) | 50.4 (8.8) | 50.2 (8.9) | .67 | |||
| CARE total scorec | 4.3 (0.9) | 4.3 (0.9) | 4.3 (0.9) | .03 | |||
| MMAS total scorec | 1.0 (1.1) | 1.0 (1.1) | 1.0 (1.1) | .57 | |||
| ED visits in past year | 1.0 (1.8) | 1.0 (1.7) | 1.1 (1.8) | .94 | |||
| Health care visits in past month | 2.5 (2.7) | 2.4 (2.6) | 2.6 (2.8) | .05 | |||
| Hospital days in past year | 1.0 (2.4) | 1.0 (2.3) | 1.0 (2.5) | .28 | |||
| Restricted activity days | 1.1 (2.5) | 1.1 (2.5) | 1.1 (2.5) | .86 | |||
| Metabolic equivalents (DASI)c | 6.4 (2.0) | 6.4 (1.9) | 6.4 (2.0) | .96 | |||
| PHQ-9 total score | 6.4 (6.1) | 6.3 (6.1) | 6.5 (6.1) | .48 | |||
| GAD-7 total score | 4.5 (5.2) | 4.4 (5.2) | 4.7 (5.3) | .17 | |||
| Asthma Symptom Utility Index | 0.8 (0.2) | 0.8 (0.2) | 0.8 (0.2) | .57 | |||
| GAIN Lifetime SUD screener | 1.7 (1.9) | 1.7 (1.9) | 1.8 (1.9) | .55 | |||
| GAIN 1 Year SUD screener | 0.6 (1.2) | 0.6 (1.1) | 0.6 (1.2) | .57 | |||
| GAIN 3 Month SUD screener | 0.5 (1.0) | 0.5 (1.0) | 0.5 (1.0) | .62 | |||
| GAIN 1 Month SUD screener | 0.5 (0.9) | 0.4 (0.9) | 0.5 (1.0) | .63 | |||
| Unhealthy alcohol use | 171 (9.6) | 109 (9.7) | 62 (9.6) | .94 | |||
| Patient-Centeredness Indexc | 83.9 (15.9) | 84.0 (15.9) | 83.8 (15.7) | .62 | |||
CARE = Consultation and Relational Empathy; DASI = Duke Activity Status Index; ED = emergency department; GAD-7 = 7-item Generalized Anxiety Disorder screener; GAIN = Global Appraisal of Individual Needs; GED = General Education Development; MMAS = Morisky Medication Adherence Scale; PHQ-9 = 9-item Patient Health Questionnaire; PROMIS-29 = Patient-Reported Outcomes Measurement Information System; SUD = substance use disorder.
Note: Wilcoxon rank-sum test used for continuous variables; χ2 test used for categorical variables.
↵a No. varies for some characteristics.
↵b Included as possible confounding effect. Other possible confounders included various county characteristics (age, racial composition, ethnicity, sex, income, education, employment, population density, urban/rural status).
↵c Greater score indicates better health. T-score is a measure in which 50 is the mean of a relevant population, and 10 is the SD of that population.