Primary Care Internet Based Depression Prevention for Adolescents (CATCH-IT) Also Known as Promoting AdolescenT Health
Condition: Major Depression; Depressive Episodes
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      The purpose of this randomized multiple-site clinical study is to determine whether a revised
      CATCH-IT (Internet-based depression prevention program) is more effective than a general
      health education Internet intervention (Health Education)on teens ages 13-18 (inclusive). It
      is hypothesized that teens in CATCH-IT will exhibit lower levels of depressed mood and/or
      maintain lower depressive scores over 2 years long-term follow up as compared to teens in
      Health Education group.
    

Detailed description: 
      Additional aims and hypothesis are provided below:

      -Aim 1: To determine whether the CATCH-IT depression prevention intervention prevents or
      delays major depressive episodes, as well as non-affective disorder episodes, compared to
      HEALTH EDUCATION.

      Hypothesis 1: Compared to youth in the HEALTH EDUCATION condition, youth assigned to CATCH-IT
      will have a lower hazard ratio of major depressive episodes and non-affective disorder
      episodes over 2 years.

      -Aim 2: To determine if participants in the CATCH-IT group exhibit more rapid favorable
      changes of depressive symptoms/and or vulnerability/protective factors compared to the HEALTH
      EDUCATION group.

      Hypothesis 2: Compared to youth in the HEALTH EDUCATION condition, youth in the CATCH-IT
      program will demonstrate a steeper slope of improved symptoms and fewer depressed days over 2
      years.

      -Aim 3: To determine if participants in the CATCH-IT program report lower perceived
      educational impairment, greater quality of life, greater health-related quality of life, and
      lower incidence of other mental disorders (anxiety, substance/alcohol use) as compared to
      participants in HEALTH EDUCATION.

      Hypothesis 3: Compared to youth in the HEALTH EDUCATION group, youth in the CATCH-IT program
      will demonstrate more rapid benefits in reduced educational impairment, improved quality of
      life, and fewer disorders over 2 years.

      -Aim 4: To determine for whom (moderators)among 13-18 year old (inclusive) and how
      (mediators) the CATCH-IT program works.

      Hypothesis 4.1: CATCH-IT effects will be moderated by six domains: (1) demographic/cultural
      factors, (2) vulnerability factors/adverse events,(3) motivation,(4) physician relationship,
      (5) parent/child co-morbid psychopathology, and (6) treatment.

      Hypothesis 4.2: The relation between CATCH-IT participation and reduction in depressive
      episodes will be mediated by adherence to the Internet, motivational interview fidelity as
      they alter vulnerability factors (e.g. motivation, cognition and social support) and
      responses to adverse events, which in turn impact the likelihood of episodes.

      Exploratory Aim 1: To determine the implementation feasibility of the intervention from the
      physician/nurse practitioner and office nurse/medical assistant perspective as well as to
      describe the practices in relationship to the medical home model.

      Exploratory Aim 2: To determine whether CATCH-IT has a favorable cost-benefit ratio and/or
      cost effectiveness of <$50,000/disability adjusted life year compared to the HEALTH EDUCATION
      group.
    

Intervention name(s): CATCH-IT
Intervention type(s): Behavioral
Intervention description(s): It contains 14 modules focused on behavioral activation, cognitive behavioral therapy, interpersonal therapy and a resiliency building model, including elements such as narratives, video diaries, skill building exercises and a booster program (not yet initiated) with 6 modules that involves interaction with a live therapist. It also includes three 15-minute meetings with the primary care provider at baseline, 2 months and 12 months post intervention. These meetings are focused on the motivational interview approach where the patient and the doctor talk about the mental/physical health goals of the patient and determine the best approach for the patient by allowing the patient to have full input into the plan.
Other intervention name(s): CATCH-IT 2; CATCH-IT 3
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Prevention
Keywords: depression; prevention; teen; at risk; internet