Adolescents' Well-being in Community-based Treatment Versus Residential Treatment
NCT Number: NCT06498427
Status: ENROLLING_BY_INVITATION
Study Type: OBSERVATIONAL
Conditions: Adolescent Well-Being|Mental Disorders, Severe
Sponsor: Outcome Referrals, Inc.
Collaborators: The Duke Endowment|Children's Hope Alliance
Sex: ALL
Age: CHILD, ADULT
Enrollment: 210
Study Design: Observational Model: |Time Perspective: p
Start Date: 2022-01-04
Completion Date: 2025-06-19
Locations: Outcome Referrals, Inc., Framingham, Massachusetts, 01701, United States

Summary:
This is a quasi-experimental longitudinal study to compare the outcomes of youth in Psychiatric Residential Treatment Facility (PRTF) compared to youth in the at-home Child-Focused Assertive Community Treatment Team \[Child ACTT\] program. The hypothesis is that Child ACTT will be associated with better outcomes and lower cost than PRTF among adolescents admitted to Child ACTT or PRTF.

Primary Outcome Measures: Mean change on average z-scores from participant self report on Clinical Scale of the Treatment Outcome Package (TOP-CS) over time, TOP is a comprehensive well-being assessment that is used in behavioral health and child welfare settings. The Adolescent TOP Clinical Scale (TOP-CS) is a 58-item scale for adolescents who are between the ages of 11 - 21. The TOP-CS assesses the client's past 2-week experience on 12 domains including Depression, Attention Problems, Conduct Disorders, and Suicidality (scores are risk-adjusted for case mix variables assessed via 37 items on the companion TOP-Case Mix form, such as divorce, job loss, comorbidity). Participants indicate "All" to "None of the Time" for each item on a 6-point Likert scale. The z-scores (standard deviation units relative to the general population mean for each domain) will be averaged together to create one summary score. Higher scores suggest higher severity/lower behavioral well-being., Baseline completed within 3 weeks of treatment start then a TOP every month up to Month 6 during treatment then at 3 months post-discharge.
Secondary Outcome Measures: Satisfaction score most proximal to discharge (up to Month 6) from participant self report on the Overall Provider Quality subscale of the TOP Satisfaction Scale, The Overall Provider Quality subscale of the TOP Satisfaction Scale assesses patient satisfaction with behavioral health care. 4 Likert scale items about satisfaction with treatment plus single qualitative item (i.e., What are two reasons for your rating of the overall quality of the treatment received?). Scores range between 1 and 6 (higher scores indicate higher satisfaction)., Every month up to Month 6 during treatment|Mean change on average z-scores from legal guardian ratings for the participants on the Treatment Outcome Package, See Outcome 1 description, Baseline completed within 3 weeks of treatment start then a TOP every month up to Month 6 during treatment then at 3 months post-discharge.|Satisfaction score most proximal to discharge (up to Month 6) from legal guardian report on the Overall Provider Quality subscale of the TOP Satisfaction Scale, See Outcome 2 description, Every month up to Month 6 during treatment|Mean change on the z-score for individual domains from participant self report on the Treatment Outcome Package, See Outcome 1 description, Baseline completed within 3 weeks of treatment start then a TOP every month up to Month 6 during treatment then at 3 months post-discharge.
Other Outcome Measures: Cost of treatment, Estimated treatment cost per condition will be assessed by calculating the number of days in treatment times cost per day, Through study treatment completion, a maximum of 6 months