Outreach to Reduce Depression Disparities
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Kaiser Permanente
- Enrollment
- 309
- Locations
- 4
- Primary Endpoint
- Initiation of formal depression treatment
Study Overview
Brief Summary
Previous research by Mental Health Research Network (MHRN) investigators and others demonstrates that online messaging and other telehealth technologies can effectively and efficiently address premature discontinuation of depression treatment. These interventions, however, have focused on adherence after treatment initiation and have been tested primarily in non-Hispanic white populations. Less is known about the acceptability and effectiveness of different communication modalities (online messaging, mailed letters, telephone) among racial and ethnic minority populations. Implementation of electronic-Health (eHealth) technologies must take care not to exacerbate health disparities.
This clinical trial involves a pilot trial to evaluate a population-based outreach program to improve rates of depression treatment initiation among traditionally underserved racial and ethnic groups. This pilot work intends to inform a subsequent full-scale pragmatic trial to examine impact on health disparities.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •New diagnosis of major depressive disorder or dysthymic disorder at a primary care visit ("new" defined as no depression diagnosis, psychotherapy visit or filled antidepressant prescription in the prior year)
- •Continuously enrolled in the participating health system for 365 days prior to the eligible diagnosis (to assure capture of prior diagnoses or treatments)
- •Patients Health Questionnaire-9 (PHQ-9) depression score of 10 or more within 14 days before to 7 days after the eligible diagnosis
- •No filled prescription for any antidepressant medication OR psychotherapy visit attended within 30 days of the eligible diagnosis*
- •No recorded PHQ-9 depression score less than 5 since the eligible diagnosis
- •At least 18 years of age or older
Exclusion Criteria
- •Diagnosis of schizophrenia or bipolar disorder in the prior 2 years
- •Not registered to use Electronic Health Record (EHR) patient portal
- •Previously requested to not be contacted for research
Arms & Interventions
Usual Care
Participants assigned to usual care will not receive outreach messages (online or via telephone) by study staff.
Outreach Messaging
Participants in the outreach messaging arm will receive messages via online secure message system (embedded within the health care record) and/or telephone.
Intervention: Outreach messaging (Behavioral)
Outcomes
Primary Outcomes
Initiation of formal depression treatment
Time Frame: within 60 days of randomization
Defined as either at least one filled prescription for any antidepressant medication or attending at least one individual psychotherapy visit.
Number of Participants With Initiation of Formal Depression Treatment
Time Frame: within 60 days of randomization
Defined as either at least one filled prescription for any antidepressant medication or attending at least one individual psychotherapy visit.
Secondary Outcomes
No secondary outcomes reported