Screening Wizard- Phase 2
Condition: Depression; Suicidal Ideation
MeSH terms: Depression; Depressive Disorder; Suicidal Ideation
Study type: Interventional

Summary: 
      Screening Wizard (SW). Primary Care Providers (PCPs) are often uncertain about how to best
      refer adolescents who screen positive for depression or suicidality. Screen-positive youth
      who are either not in treatment, or express dissatisfaction with current treatment will be
      consented by an on-site research assistant (RA). Participants will answer questions via
      adaptive screens developed in a previous NIMH study (MH100155) for suicidal risk, anxiety,
      and mania. These will address perceived barriers and preferences about treatment.
      Participants are then randomized into 1 of 3 groups: 1) Providing the symptoms scores report
      of results to their provider based on their Screening Wizard responses (Screening as Usual);
      2) Providing the symptoms scores report and their responses to treatment preferences and
      barriers including treatment recommendations their provider might suggest (Screening Wizard
      2.0); or 3) Providing the report with treatment recommendations to their provider and a
      website called SOVA or Supporting Our Valued Adolescent, that is aimed at addressing
      perceptions about mental health providing support to teens through peer interaction that
      social workers and doctors moderate on a 24 hour a day basis (Screening Wizard 2.0 + SOVA).
    

Detailed description: 
      Screening Wizard will be delivered by Primary Care Providers (PCPs) at well child visits,
      beginning with screening occurring within the waiting room which will yield decision support
      guidance delivered and followed by the PCP at the same visit.

      Assignment of Interventions: This study will randomize participants to one of three
      conditions in a 2:2:1 randomization scheme to either receive "screening as usual" (n=20),
      Screening Wizard 2.0 (n=40), or Screening Wizard 2.0 + SOVA (n =40)

      Hypothesis: H1: Screening Wizard 2.0 will result in more referrals compared to "screening as
      usual" (increase >30% compared to "screening as usual")

      H2: Screening Wizard 2.0 will result in higher rates of follow-through with mental health
      services compared to "screening as usual" (increase >30% compared to "screening as usual")

      H3: Screening Wizard 2.0 will have higher adolescent and parent perception of being involved
      in a shared decision-making process compared to "Treatment as usual" (SW involvement >
      "screening as usual" involvement )

      H4: Adolescent and parents in Screening Wizard 2.0 + SOVA will have less negative attitudes
      about psychotherapy, higher depression literacy, and a higher readiness for treatment as
      compared to Screening Wizard 2.0 alone or "screening as usual"

      H5: Adolescent and parents in Screening Wizard 2.0 + SOVA will result in higher rates of
      follow-through with mental health services (defined as attendance at an initial appointment)
      compared to Screening wizard 2.0 alone (increase >10%) and "screening as usual" (increase
      >40%)
    

Intervention name(s): "screening as usual"; Screening Wizard 2.0; Screening Wizard 2.0 + SOVA
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Participants in this group will receive usual care at their pediatric primary care practice following information, psychoeducation, and referral to a mental health treatment provider; Screening Wizard is a decision support tool to guide the primary care provider to make a referral that reflects patient clinical needs and patient and parental treatment preferences and perceived barriers to treatment.; Screening Wizard is a decision support tool to guide the primary care provider to make a referral that reflects patient clinical needs and patient and parental treatment preferences and perceived barriers to treatment. SOVA is a peer-support website that social workers and doctors moderate on a 24 hour a day basis.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study will use a parallel study design, where participants are randomized into three intervention groups ("screening as usual", Screening Wizard 2.0, Screening Wizard 2.0 + SOVA) and will receive interventions in parallel.
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: depression; anxiety; suicidal ideation; treatment; referral; screening