Clinical trial NCT02421874: Development and Testing of an Electronic Behavioral Health Record Specific to the Wraparound Care Coordination Process
Official title: Development, Usability Testing, and Effectiveness Evaluation of Wraparound Team Monitoring System
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
PHASE2
Conditions: Serious Emotional Disturbance of Youth
Keywords: Patient care team
Care management
Electronic health records
Lead sponsor: University of Washington
Sponsor class: OTHER
First posted: 2015-04-21
Enrollment: 160
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this Phase II Small Business Technology Transfer (STTR) project is to complete development and evaluate usability and effectiveness of the Wraparound Team Monitoring System (Wrap-TMS), a web-based, electronic behavioral health information system (EBHIS) for the most widely implemented care coordination model in children's behavioral health, the wraparound process. Though wraparound is now considered "evidence-based," implementation in the real world often fails to conform to standards of fidelity and/or use objective data to guide management, supervision, and clinical decision making. Availability of such a system will support efficiency, implementation quality and fidelity, and outcomes for youths enrolled in wraparound. Wrap-TMS features functionality for data entry, management, and basic reporting for the full array of data and information elements needed to manage an integrated care coordination initiative for youths with serious emotional and behavioral disorder (SEBD). In light of our success in Phase I, subsequent partnerships with federal agencies, and inquiries of interest from several states and over 20 provider and managed care organizations, in this Phase II STTR the investigators will complete development of Wrap-TMS, followed by a randomized controlled effectiveness study comparing n=25 wraparound facilitators who use Wrap-TMS serving n=100 families to 25 non-user facilitators serving 100 families on practitioner, implementation, and youth/family outcomes. The evaluation will test two primary hypotheses:

1. Compared to facilitators in the control group, wraparound facilitators trained to use Wrap-TMS will demonstrate (a) greater use of data and feedback in service delivery; (b) greater fidelity to the wraparound process; (c) higher self-reported teamwork, working alliance, and satisfaction with the intervention; and (d) more positive attitudes toward standardized assessment.
2. Compared to the control group, parents of youths receiving services from facilitators trained to use TMS will report (a) greater goal clarity, (b) more data collection and use (c) greater satisfaction with services and progress, (d) better fidelity to wraparound, (e) more effective team functioning, (f) greater treatment alliance, and (f) better youth outcomes including greater progress and improved symptoms and functioning.


Eligibility criteria: Inclusion Criteria:

* Parent or legal guardian of a youth aged 6-17 with SEBD (serious emotional and behavioral disorder): at least one MH (mental health) diagnosis that results in long-term (\>6 mos) impairment in home, school and/or community functioning).

Exclusion Criteria:

* Non English speaking parents
* Foster parents

Primary outcomes:
measure: more effective teamwork (Team Climate Inventory (TCI)
timeFrame: 6 months
measure: treatment alliance (Working Alliance Inventory (WAI)
timeFrame: 6 months
measure: improved youth functioning (Top Problem Assessment (TPA)
timeFrame: 6 months
Secondary outcomes:
measure: parent and provider satisfaction (Parent and Child Satisfaction Scales)
timeFrame: 3 months
measure: attitudes toward standardized assessment (Attitudes toward Standardized Assessment Scale (ASA)105)
timeFrame: 3 months
Other outcomes:
Locations:
city: Seattle
country: United States
facility: University of Washington
state: Washington
Study officials:
affiliation: University of Washington
name: Eric J Bruns, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bruns EJ, Hook AN, Parker EM, Esposito I, Sather A, Parigoris RM, Lyon AR, Hyde KL. Impact of a Web-Based Electronic Health Record on Behavioral Health Service Delivery for Children and Adolescents: Randomized Controlled Trial. J Med Internet Res. 2018 Jun 14;20(6):e10197. doi: 10.2196/10197.