Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
PHASE1
368 participants
INTERVENTIONAL
2003-10-31
2006-09-30
Brief Summary
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Detailed Description
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Primary care settings provide the most important opportunities to improve care for mood and anxiety disorders among adolescents, since most children and adolescents have some contact with a primary care provider each year for well-child visits, school physicals, or acute care. However, an ongoing trial of a quality improvement intervention for depressed adolescents in primary care settings (RAND's Youth Partners in Care study) suggests that there are significant barriers to implementing quality improvement protocols in primary care.
Study Goals: The main objective of this research is to build an empirical foundation for developing effective strategies to improve treatment of adolescent mood and anxiety disorders in primary care settings. Our specific goals are to:
1. Describe the impact of depression on adolescent and family functioning compared to that of healthy adolescents.
2. Evaluate the effect of two interventions--depression diagnosis feedback and an educational brochure, with or without patient activation, on care received.
3. Identify barriers and facilitators to receiving appropriate care for identified adolescent depression from the perspective of adolescents, parents, and the primary care providers.
Methodology: Participants for this study will be recruited from three to four study sites in each of two cities selected from among eligible general health care settings that serve high volumes of adolescent patients, including a large community-based clinic and a set of small clinics; a high school-based health clinic; and a public/free clinic.
Specific aim 1: We will describe the impact of depression on adolescent and family functioning compared to healthy controls using a 2-group longitudinal comparison between 400 adolescents identified at baseline with major depression, and 400 adolescents with no detectable mental disorders. Primary data will be collected from three types of respondents: adolescents aged 13-17, their parents, and their health care providers. Adolescent baseline and follow-up assessments (for behavioral problems, physical health, health-related quality of life, use of psychotropic medications, etc.) will be conducted through telephone interviews supplemented by mailed questionnaires. Parents will be asked to complete baseline and follow-up assessments to determine family burden, health insurance, demographics, and the adolescent's functioning at school. Study participants will be assessed twice, 6 months apart, with an interim contact at 3 months. Primary care providers (PCPs) will complete written questionnaires that will include data on demographic characteristics, medical background and training, professional practices, as well as knowledge, attitudes and reported treatment behaviors.
Specific aim 2: We will evaluate the effect of the intervention on care received by randomizing half of the 400 adolescents with major depression to one of two conditions--Feedback and Educational Brochure, with and without Patient Activation (FPA) and then observing service use over the next 6 months. The minimal intervention consists of feedback about the diagnosis to the primary care provider, teen and parent, and also includes an educational brochure to teens and parents. In the more active FPA intervention, in addition to feedback and educational brochure, telephone calls will be made to depressed teens and their parents to discuss symptoms and alternative treatment options with the aim of encouraging help-seeking. We will compare the two groups on whether they received mental health care, what kind, and their satisfaction with that care.
Specific aim 3: For the 400 depressed teens in the study, we will conduct a descriptive analysis of the preferences for treatment, barriers encountered, and use of services. We will obtain this information from the teens', parents', and providers' perspectives in order to identify barriers and facilitators to receiving appropriate care.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
NONE
Interventions
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Education
Individuals will receive information about depression
Eligibility Criteria
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Inclusion Criteria
* Attending School
* Living with parent or guardian
* Reads and writes English
* Receiving care at a participating PCP office
Exclusion Criteria
* Parents don't speak English or Spanish
13 Years
17 Years
ALL
No
Sponsors
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RAND
OTHER
Responsible Party
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RAND
Principal Investigators
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Audrey Burnam, PhD
Role: PRINCIPAL_INVESTIGATOR
RAND
Locations
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Family Care Specialists at White Memorial Medical Center
Los Angeles, California, United States
Northeast Valley Health Corporation-San Fernando Valley High School
San Fernando, California, United States
Children's National Medical Center Adolescent Health Clinic
Washington D.C., District of Columbia, United States
Children's Pediatricians and Associates
Washington D.C., District of Columbia, United States
Capital Medical Group
Chevy Chase, Maryland, United States
Kaiser Mid-Atlantic
Kensington, Maryland, United States
Kaiser Mid-Atlantic
Rockville, Maryland, United States
Kaiser Mid-Atlantic-Camp Springs
Temple Hills, Maryland, United States
Countries
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Other Identifiers
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TDAP2
Identifier Type: -
Identifier Source: org_study_id