Clinical trial NCT03637478: Enhancing Systems of Care: Supporting Families and Improving Youth Outcomes
Official title: Enhancing Systems of Care: Supporting Families and Improving Youth Outcomes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pediatric Mental Health Services
Lead sponsor: Cambridge Health Alliance
Sponsor class: OTHER
First posted: 2018-08-20
Enrollment: 171
Sex: ALL
Minimum age (years): 0
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: The E-SOC Model consists of the delivery of intensively integrated clinical care within pediatrics, combined with community-based parent support from family support specialists. Innovations include child mental health specialists joining the pediatrics team for "huddles", psychiatry notes shared with pediatricians via the Electronic Medical Records and active inclusion of pediatricians in pre-evaluation discussions with the E-SOC Team and post-evaluation recommendations for the families. In addition, the E-SOC model includes active communication with school personnel, child welfare, and community-based resources, when needed.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The aim of the study is to improve access to child mental health and substance abuse (MH/SA) care by expanding primary care screening and increasing availability of timely mental health evaluation and treatment.

Detailed description: This is a quasi-experimental, longitudinal study. Identified youth and families will receive the intervention within the four study site clinic locations. Comparison group families will receive usual care. Each primary care study site will have designated Family Support Specialist, Clinical Care Manager and Child Psychiatry resources. The intervention includes an integrated care consultation which combines diagnostic evaluation, family assessment, and multi-disciplinary, team-based treatment recommendations, with follow-up community linkages and support, as indicated.

Eligibility criteria: Inclusion Criteria:

* Must be between ages 0 to 17.5 years
* Referred by primary care physician at one of these Cambridge Health Alliance clinics: Windsor Street Care Center, Broadway Care Center, Everett Care Center, Malden Family Medicine Center
* Referred youth must have a caregiver (a parent of guardian) who agrees to participate in the assessment and treatment process

Exclusion Criteria:

* 17.6 years or older

Primary outcomes:
measure: Access to child mental health and substance abuse (MH/SA) care
timeFrame: Comparative analysis of access to care trends (0-6 months)
measure: Engagement in child mental health and substance abuse (MH/SA) treatment
timeFrame: Comparative analysis of service use trends (6-12 months)
Secondary outcomes:
measure: Family Care Experience
timeFrame: Analysis of baseline and follow-up family perceptions of care (baseline collected at enrollment, follow-up assessments collected at 6 months and 12 months)
measure: Changes in Children's Global Assessment Scale (CGAS) Score
timeFrame: Comparative analysis of baseline and follow-up clinical functioning scores (baseline collected at enrollment, follow-up assessments collected at 6 months and 12 months)
measure: Changes in Child and Adolescent Functional Assessment Scale (CAFAS) Score
timeFrame: Comparative analysis of baseline and follow-up clinical functioning scores (baseline collected at enrollment, follow-up assessments collected at 6 months and 12 months)
Other outcomes:
Locations:
city: Cambridge
country: United States
facility: Cambridge Health Alliance
state: Massachusetts
Study officials:
affiliation: Cambridge Health Alliance
name: Katherine E Grimes, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: