Clinical trial NCT02030782: Youth Partners in Care: Depression and Quality Improvement
Official title: Youth Partners in Care: Depression & Quality Improvement
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Depression
Keywords: depression
quality improvement
treatment
adolescents
Lead sponsor: Agency for Healthcare Research and Quality (AHRQ)
Sponsor class: FED
Collaborators: name: RAND
name: Kaiser Permanente
name: University of Pittsburgh
name: Venice Family Clinic
First posted: 2014-01-09
Enrollment: 418
Sex: ALL
Minimum age (years): 13
Maximum age (years): 21
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This randomized effectiveness trial evaluates a quality improvement intervention aimed at providing access to evidence-based depression treatments (particularly cognitive-behavior therapy for depression and or pharmacotherapy) through primary care for youth ages 13-21, as compared to enhanced usual care. The major hypothesis is that the quality improvement intervention will be associated with improved outcomes, relative to enhanced usual care.


Eligibility criteria: Inclusion Criteria:

* Met either of two criteria: 1) endorsed "stem items" for major depression or dysthymia from the 12-month Composite International Diagnostic Interview(CIDI-12,2.1) modified slightly to conform to diagnostic criteria for adolescents, 1-week or more of past-month depressive symptoms, and a total Center for Epidemiological Studies- Depression Scale(CES-D)40 score ≥ 16, or 2) CES-D score ≥ 24.
* Age 13-21
* Presented at primary care clinic

Exclusion Criteria:

* not English-speaking
* provider not in study
* sibling already in study
* completed eligibility screener previously

Primary outcomes:
measure: Self-reported depressive symptoms on the CES-D (Center for Epidemiologic Studies Depression Scale)
timeFrame: 6-months
Secondary outcomes:
measure: mental health related quality of life as assessed using self-report on the Medical Outcomes Study Short Form 12 Health Survey.
timeFrame: 6 months, with follow up at 12 and 18 months
measure: satisfaction with care
timeFrame: 6 months with follow up at 12 and 18 months
measure: Rates of mental health care, counseling/psychotherapy, and medication treatment.
timeFrame: 6-months with follow-up at 12 and 18 months
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: University of California
state: California
city: Los Angeles
country: United States
facility: Kaiser Permanente Los Angeles Medical Center
state: California
city: Venice
country: United States
facility: Venice Family Clinic
state: California
city: Ventura
country: United States
facility: Ventura County Medical Center
state: California
city: Pittsburgh
country: United States
facility: University of Pittsburgh
state: Pennsylvania
Study officials:
affiliation: University of California, Los Angeles
name: Joan R Asarnow, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Asarnow JR, Jaycox LH, Anderson M. Depression among youth in primary care models for delivering mental health services. Child Adolesc Psychiatr Clin N Am. 2002 Jul;11(3):477-97, viii. doi: 10.1016/s1056-4993(02)00006-8.
citation: Wells KB, Kataoka SH, Asarnow JR. Affective disorders in children and adolescents: addressing unmet need in primary care settings. Biol Psychiatry. 2001 Jun 15;49(12):1111-20. doi: 10.1016/s0006-3223(01)01113-1.
citation: Asarnow JR, Jaycox LH, Tang L, Duan N, LaBorde AP, Zeledon LR, Anderson M, Murray PJ, Landon C, Rea MM, Wells KB. Long-term benefits of short-term quality improvement interventions for depressed youths in primary care. Am J Psychiatry. 2009 Sep;166(9):1002-10. doi: 10.1176/appi.ajp.2009.08121909. Epub 2009 Aug 3.
citation: Asarnow JR, Jaycox LH, Duan N, LaBorde AP, Rea MM, Murray P, Anderson M, Landon C, Tang L, Wells KB. Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: a randomized controlled trial. JAMA. 2005 Jan 19;293(3):311-9. doi: 10.1001/jama.293.3.311.
citation: Jaycox LH, Asarnow JR, Sherbourne CD, Rea MM, LaBorde AP, Wells KB. Adolescent primary care patients' preferences for depression treatment. Adm Policy Ment Health. 2006 Mar;33(2):198-207. doi: 10.1007/s10488-006-0033-7.
citation: Asarnow JR, Jaycox LH, Duan N, LaBorde AP, Rea MM, Tang L, Anderson M, Murray P, Landon C, Tang B, Huizar DP, Wells KB. Depression and role impairment among adolescents in primary care clinics. J Adolesc Health. 2005 Dec;37(6):477-83. doi: 10.1016/j.jadohealth.2004.11.123.
citation: Ngo VK, Asarnow JR, Lange J, Jaycox LH, Rea MM, Landon C, Tang L, Miranda J. Outcomes for youths from racial-ethnic minority groups in a quality improvement intervention for depression treatment. Psychiatr Serv. 2009 Oct;60(10):1357-64. doi: 10.1176/ps.2009.60.10.1357.
citation: Tang L, Duan N, Klap R, Asarnow JR, Belin TR. Applying permutation tests with adjustment for covariates and attrition weights to randomized trials of health-services interventions. Stat Med. 2009 Jan 15;28(1):65-74. doi: 10.1002/sim.3453.
citation: Goldstein RB, Asarnow JR, Jaycox LH, Shoptaw S, Murray PJ. Correlates of "non-problematic" and "problematic" substance use among depressed adolescents in primary care. J Addict Dis. 2007;26(3):39-52. doi: 10.1300/J069v26n03_05.
citation: Fordwood SR, Asarnow JR, Huizar DP, Reise SP. Suicide attempts among depressed adolescents in primary care. J Clin Child Adolesc Psychol. 2007 Jul-Sep;36(3):392-404. doi: 10.1080/15374410701444355.