A Pilot With Interactive Computer-assisted Screening for Mental Health in Primary Care

Study Overview
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Brief Summary
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The current protocol pertains to the evaluation of the interactive computer-assisted screening (iCAS) tool through a pilot randomized control trial. The purpose of this evaluation is to determine the efficacy of the iCAS tool in improving clinician's detection of common mental health conditions (i.e. major depression/generalized anxiety/post-traumatic stress disorder/alcohol dependence), and patients' discussion on mental health.

Detailed Description
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The iCAS tool is a health-risk assessment survey that is completed by adult patients using touch-screen iPad device in their waiting time before seeing their clinician (family physician or nurse practitioner). The computer program generates tailored risk-report for the clinician and a simple recommendation sheet for the patient, with community resources and health information, at the point of care. The iCAS tool currently includes validated screening scales for depression, generalized anxiety, posttraumatic stress disorder and alcohol abuse. There are some questions on the social determinants of mental health as well. The current versions of the tool are in English and Spanish; a Chinese language version will also be developed.

Official Title
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Interactive Computer-assisted Screening for Mental Health in Primary Care

Conditions
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Mental Health Disorders

Intervention / Treatment
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* Behavioral: Interactive computer-assisted screening (iCAS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least 18 years of age Speak/read Spanish Speak/read English Visiting the consenting clinician Exclusion Criteria: Patient accompanied by a family member for interpretation New patients coming for first visit Patients feeling unwell (self-report) Inability of the research staff to offer study details in privacy

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Interactive computer-assisted screening<br>Eligible patients completed the interactive computer-assisted screening (iCAS) tool in English or Spanish before seeing the consenting clinician. Participating patients then received the iCAS generated tailored recommendation sheet. Participating clinicians received the iCAS generated risk report. | Behavioral: Interactive computer-assisted screening (iCAS)<br> <br> |
| No Intervention: Usual Care<br>Eligible patients randomized to the control group completed their standard visit to the participating clinician. There was no pre-visit health risk screening. There were no tailored reports for the patients or clinicians. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinician Detection (probable, sub-clinical, confirmed) of major depression or generalized anxiety or post-traumatic stress disorder or alcohol dependence | Chart review for the index visit | Day 1 | 
| Patient discussion on mental health | Exit Survey of patients after the index visit | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient intention to see a mental health counselor | Exit Survey of patients after the index visit | Day 1 | 
| Patient satisfaction with health services | Exit Survey of patients after the index visit | Day 1 | 
| Patient enablement to cope with these conditions | Exit Survey of patients after the index visit | Day 1 | 
| Patient adherence to follow-up advice and referrals to mental health support | Chart review | 3 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Interactive Health-risk assessment, Primary Care, Randomized, Open Label, Efficacy Study