METRIC: Measurement, Education and Tracking in Integrated Care

Study Overview
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Brief Summary
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The proposed study seeks to establish the feasibility of universal screening for depression in an adult primary care safety net setting, measure the effectiveness of a culturally appropriate depression education intervention to reduce stigma and increase uptake in depression treatment among Hispanics, and implement a Measurement-Based Integrated Care (MBIC) model with collaborative, multi-disciplinary treatment and culturally tailored care management strategies.

Detailed Description
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Specific Aim 1: Examine the specific effects of a Depression Education Fotonovela (DEF) to increase knowledge of depression, reduce stigma and increase engagement in depression treatment among Hispanic patients. Specific Aim 2: Evaluate the impact of Measurement-Based Integrated Care (MBIC) for the treatment of depression in one community-based Federally Qualified Health Centers (FQHC) in North Texas whose patient population is majority Hispanic. Specific Aim 3: Examine the feasibility of universal screening and accurate detection of depression among adult primary care patients utilizing innovative iPad Depression Screening technology.

Official Title
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METRIC: Measurement, Education and Tracking in Integrated Care: Strategies to Increase Patient Engagement and Reduce Mental Health Disparities Among Hispanics

Conditions
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Depression

Intervention / Treatment
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* Behavioral: Depression Education Fotonovela
* Behavioral: Standard Education
* Other: Measurement-Based Integrated Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult primary care patients Hispanic Meets diagnostic criteria for depression Exclusion Criteria: currently in treatment for depression

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MBIC + DEF<br>Measurement-Based Integrated Care with Depression Education Fotonovela | Other: Measurement-Based Integrated Care<br>* Measurement-Based Integrated Care (MBIC) synthesizes the science of integrated health care and incorporates the strategies of measurement-based care. concept of MBIC for the treatment of depression includes: systematic assessment of symptoms, antidepressant treatment side effects and medication adherence and incorporation of a Depression Care Manager (DCM) to track patients and keep them engaged in care using behavioral interventions<br>Behavioral: Depression Education Fotonovela<br>* Depression education that uses a unique, culturally adapted depression fotonovela titled Secret Feelings developed by Cabassa, Molina and Baron (2012). The fotonovela is a popular comic-book style pamphlet that portrays a dramatic story using photographs and dialogue bubbles, which has become an effective tool for engaging Hispanic audiences and increasing knowledge about specific health issues<br>|
| Experimental: MBIC + SE<br>Measurement-Based Integrated Care + Standard Education | Other: Measurement-Based Integrated Care<br>* Measurement-Based Integrated Care (MBIC) synthesizes the science of integrated health care and incorporates the strategies of measurement-based care. concept of MBIC for the treatment of depression includes: systematic assessment of symptoms, antidepressant treatment side effects and medication adherence and incorporation of a Depression Care Manager (DCM) to track patients and keep them engaged in care using behavioral interventions<br>Behavioral: Standard Education<br>* The the use of a pamphlet to educate people about depression.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants who engage in depression treatment |  | baseline to one month post education session | 
| Change in PHQ-9 (depressive symptoms) scores |  | baseline compared to one year post enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of primary care patients screened for depression using the iPad technology |  | two year participant enrollment period |