Clinical trial NCT02329431: Padres Efectivos (Parent Activation): Skills Latina Mothers Use to Get Healthcare for Their Children
Official title: Padres Efectivos (Parent Activation): Skills Latina Mothers Use to Get Healthcare for Their Children
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mental Disorders
Keywords: child mental health, mental health services, Latino families
Lead sponsor: University of North Carolina, Chapel Hill
Sponsor class: OTHER
Collaborators: name: University of North Carolina, Greensboro
First posted: 2014-12-31
Enrollment: 181
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The goal of this study is to develop an intervention to teach activation skills to Latino parents who bring children for mental health services.

Detailed description: Background:

Latinos are the largest and fastest growing minority population in the US; by 2050, 2 in 5 children will be Latino. Latino children are disproportionately affected by poverty and other factors associated with increased risk of psychiatric disorder. However, Latino children with mental health needs are half as likely to use services as children in white non-Latino families. Latino families are more likely to report problems getting services, lack of a usual source of care and a medical home, and dissatisfaction with the care they receive. Unmet mental health needs, in turn, are associated with poor outcomes over the lifespan, both economic and social. Assessing the comparative effectiveness of interventions to overcome these disparities is a major national health priority central to PCORI's mission and mandate.

Activation is a promising focus of research to eliminate disparities because it reflects a set of attitudes and skills that people can use to reduce disparities. Our work provides evidence that activation in Latino adults is associated with better quality health care and outcomes; and in African American parents with greater child mental health service use. There is need for further research on parent-focused interventions founded on culturally meaningful concepts to address these needs and disparities.

Objectives:

The long-term goal of this research is to improve the mental health care and outcomes of Latino children with mental health needs. The proposed study will examine the comparative effectiveness of an activation intervention for Latino families raising children with mental health needs by means of three aims:

Aim 1. To identify parent-reported facilitators of Latino child mental health service use amenable to change through parental activation Aim 2. To test the comparative effectiveness of an adapted psycho-educational intervention to teach activation skills adapted for Latino mothers of children with mental health needs compared to a parent support group control Aim 3. To enhance the intervention, based on parent input and lessons learned from the first trial, and test its comparative effectiveness with a parent support group control

Methods:

Qualitative and quantitative data from Latino mothers who have a child with mental health needs (n=294) will be used in a difference-in-difference mixed effects approach to address these aims.

Projected Patient Outcomes:

The proposed study will provide evidence of the comparative effectiveness of an enhanced, culturally sensitive, advocacy skills intervention to build activation among Latino families and improve service use of their children with mental health needs compared to a preliminary adaptation of an existing intervention and to a usual care discussion group. Activation skills are a promising strategy to improve child mental health service use and to bridge cultural differences and disparities with wide-ranging impacts consistent with PCORI's research agenda.

Eligibility criteria: Inclusion Criteria:

* For children:

  * seeking services at target clinic
  * maximum age 22 years
* For caregivers:

  * Latino ethnicity
  * bringing child for services to target clinic
  * able to attend a weekly class for 4 weeks
  * able to give informed consent

Exclusion Criteria:

* For children:

  * not living with potential participant caregiver
* For caregiver:

  * not living with target child
  * evidence of emergency mental health needs

Primary outcomes:
measure: Patient Activation Measure
timeFrame: 1 and 3 months
Secondary outcomes:
measure: 8-item Patient Health Questionnaire (PHQ-8)
timeFrame: 1 and 3 months
measure: Parental Stress Scale
timeFrame: 1 and 3 months
measure: Parent Activation, Qualitative
timeFrame: 1 month
measure: Number of Clinic Visits Child Attended Over 4 Months
timeFrame: baseline to 4-month follow-up
measure: Child Visit No-shows Over 4 Months
timeFrame: baseline to 4-month follow-up
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: UNC Chapel Hill
state: North Carolina
Study officials:
affiliation: UNC Chapel Hill
name: Kathleen C Thomas, PhD
role: PRINCIPAL_INVESTIGATOR
References: