Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Collaborative Child Mental Healthcare in Low-Resource Settings
Brief Summary: Background: Mental health problems cause a disproportionate burden of disability among children and youth compared to adults. Primary care plays an important role in efforts to prevent and intervene early in the course of child and adolescent mental health problems. While research with adults has shown the feasibility of integrating mental health care into primary care settings, there have been few studies among children and youth. Evidence remains lacking that integration is feasible in diverse settings, that it improves outcomes, and that methods can be developed to address the mixed symptoms of emerging child/youth problems and their overlap with developmental and parental disorders.

Goals: The purpose of this project is to test the effectiveness of adding a child/youth mental health component into an existing collaborative care program for adult mental health problems. The work will refine a framework for efficient cultural adaption and tailoring of an existing child/youth primary care mental health intervention and then test whether the tailored intervention results in improved child and parent outcomes. The work will also provide evidence about the mechanisms by which those outcomes are achieved and what factors influence uptake of the child/youth component by general practitioners (GPs). These results should be generalizable to low and middle income countries and to underserved areas of the US where there are minimal child mental health resources and family physicians provide the bulk of medical care for children and youth.

Methods: The planned work involves the adaptation/tailoring process followed by a trial with 45 GPs already engaged in collaborative care for adults; the trial will study adding collaborative care for children ages 5-15. GPs will be randomly assigned in groups to begin 6-month control periods involving child mental health screening and referral. They will then receive child/youth training and begin second 6-month periods of screening plus ongoing coaching and booster sessions and collaborative management. Primary outcomes will be measured by recruiting and following for 6 months two cohorts of children/youth and their parents (one control, one collaborative care). Data collected from GPs, parents, youth, and the collaborative care data system will allow measurement of key factors that determine the program's success in helping children and families.


Options:
A: Arm Label: treatment as usual; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: treatment as usual | Arm Label: interpersonal psychotherapy; Type: EXPERIMENTAL; Interventions: Behavioral: interpersonal psychotherapy | Intervention Type: BEHAVIORAL; Name: interpersonal psychotherapy; Assigned to Arm(s): interpersonal psychotherapy | Intervention Type: BEHAVIORAL; Name: treatment as usual; Assigned to Arm(s): treatment as usual
B: Arm Label: Psychosocial counselling + Enhanced usual care (EUC); Type: EXPERIMENTAL; Interventions: Behavioral: Psychosocial counselling, Other: Enhanced Usual Care | Arm Label: Enhanced Usual Care (EUC); Type: ACTIVE_COMPARATOR; Interventions: Other: Enhanced Usual Care | Intervention Type: BEHAVIORAL; Name: Psychosocial counselling; Assigned to Arm(s): Psychosocial counselling + Enhanced usual care (EUC) | Intervention Type: OTHER; Name: Enhanced Usual Care; Assigned to Arm(s): Enhanced Usual Care (EUC), Psychosocial counselling + Enhanced usual care (EUC)
C: Arm Label: cognitive behavioral group therapy; Type: EXPERIMENTAL; Interventions: Behavioral: cognitive behavioral group therapy | Arm Label: health education group; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: health education group | Intervention Type: BEHAVIORAL; Name: cognitive behavioral group therapy; Assigned to Arm(s): cognitive behavioral group therapy | Intervention Type: BEHAVIORAL; Name: health education group; Assigned to Arm(s): health education group
D: Arm Label: Control; Type: ACTIVE_COMPARATOR; Interventions: Other: Current collaborative care protocol | Arm Label: Intervention; Type: EXPERIMENTAL; Interventions: Other: Training in management of children's mental health problems | Intervention Type: OTHER; Name: Training in management of children's mental health problems; Assigned to Arm(s): Intervention | Intervention Type: OTHER; Name: Current collaborative care protocol; Assigned to Arm(s): Control

Answer: D