Youth Partners in Care: Depression and Quality Improvement

Not Applicable

Completed

• Conditions: Depression
• Interventions: Other: Usual Care; Other: Quality Improvement (QI) for depression

• Registration Number: NCT02030782
• Lead Sponsor: Agency for Healthcare Research and Quality (AHRQ)

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.

Detailed Description

Not available

Study Timeline

• Study Start: 1999-10
• Primary Completion: 2003-12
• Study Completion: 2003-12
• Status Verified: 2008-12
• Study First Submitted: 2012-01-19
• Study First Submitted QC: 2014-01-07
• Last Update Submitted: 2014-01-07
• Study First Posted: 2014-01-09
• Last Update Posted: 2014-01-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 418

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Usual Care	Usual Care	Patients received usual care through primary care, enhanced by provider education regarding depression evaluation and management (1-2 hour training, plus study manual)
Quality Improvement for Depression	Quality Improvement (QI) for depression	Major intervention components included a) expert leader teams who planned and implemented the intervention at each clinic, b) care managers who supported primary care clinicians with depression evaluation and management, c) access to cognitive-behavior therapy for depression within each primary care clinic, and d) patient and provider choice regarding treatment modality.

Primary Outcome Measures

Name	Time	Method
Self-reported depressive symptoms on the CES-D (Center for Epidemiologic Studies Depression Scale)	6-months

Secondary Outcome Measures

Name	Time	Method
satisfaction with care	6 months with follow up at 12 and 18 months
mental health related quality of life as assessed using self-report on the Medical Outcomes Study Short Form 12 Health Survey.	6 months, with follow up at 12 and 18 months
Rates of mental health care, counseling/psychotherapy, and medication treatment.	6-months with follow-up at 12 and 18 months	Youth self report on the study version of the Service Assessment for Children \& Adolescents provided measures of rates of mental health care(dichotomous indicator of whether any mental health treatment received), counseling/psychotherapy (dichotomous indicator of whether counseling/psychotherapy was received, number of counseling/psychotherapy sessions), and medication treatment (dichotomous indicator of whether youth received any medication treatment for mental health problems). These measures were obtained using .

Trial Locations

Locations (5)

Kaiser Permanente Los Angeles Medical Center; 🇺🇸 Los Angeles, California, United States

University of California; 🇺🇸 Los Angeles, California, United States

Venice Family Clinic; 🇺🇸 Venice, California, United States

University of Pittsburgh; 🇺🇸 Pittsburgh, Pennsylvania, United States

Ventura County Medical Center; 🇺🇸 Ventura, California, United States