Systems of Care for New Moms: Integrating Depression Treatment
NCT ID: NCT01407783
Last Updated: 2018-05-11
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
NA
29 participants
INTERVENTIONAL
2008-08-31
2013-05-31
Brief Summary
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Detailed Description
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In the first part of the study we will gather information from women and their providers to determine what system and treatment modifications are needed to effectively deliver acceptable depression treatment in home visitation programs. Based on this information, a panel of local and national experts will provide advice on decisions regarding the intervention adaptation. Once these adaptation decisions are made a small group of experts will adapt a PST manual for use in home visitation.
In the second phase of the NUMOMS study we will carry out a small two-arm randomized trial comparing the effectiveness, acceptability, and practicality of PST provided by home visitation RNs versus usual care (referral to mental health specialty care).
Significantly, NUMOMS has the potential to provide home visitation agencies with a viable means of access to effective and acceptable depression treatment for mothers in the face of policy mandates for depression screening.The specific aims are to:
1. Adapt PST for implementation in nurse home visitation programs.
1. Examine internal (organization and client level) and external (community and policy level) factors that may impact upon PST adaptation and delivery in nurse home visitation.
2. Build protocols for targeting depression treatment to the woman's symptom severity and patient preferences.
3. Develop and routinize protocols for supervision, clinical consultation, and risk assessment for PST provided by nurse home visitors.
4. Modify protocols and systems for client tracking and outcomes.
2. Implement a two-arm randomized pilot study comparing: PST provided by non-mental health home visitation nurses and referral for treatment (Care as Usual).
1. Compare outcomes on the Beck Depression Inventory, the Patient Health Questionnaire-9, and Parenting Stress Index for women treated with PST by non-specialty RNs and Care as Usual.
2. Track pathways and barriers to care for women referred to mental health specialty care or primary care for medications.
3. Develop an R01 for a full scale randomized controlled trial using data on effect sizes and addressing organizational issues, infrastructure needs, and treatment refinements.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Problem Solving Tools
The home visitation nurse will teach and utilize the problem solving tools to help low-income depressed mothers. It is a brief treatment with the a non-pathologizing intervention being done in 4-8 sessions.
Problem Solving Tools (PST)
The problem solving tools was chosen as the depression treatment because it is well suited for use by non-mental health professionals and for in-home treatment. It is also a brief treatment (4-8 sessions) that takes a non-pathologizing approach.
Enhanced Referral
No interventions assigned to this group
Interventions
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Problem Solving Tools (PST)
The problem solving tools was chosen as the depression treatment because it is well suited for use by non-mental health professionals and for in-home treatment. It is also a brief treatment (4-8 sessions) that takes a non-pathologizing approach.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* NFNF client from a certain zip code
* Either pregnant or have a child under the age of 12 months in the home
Exclusion Criteria
* Severe Mental Illness
* Chemical Dependency
18 Years
FEMALE
No
Sponsors
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Nurses for Newborns Foundation
OTHER
Washington University School of Medicine
OTHER
Responsible Party
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Principal Investigators
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Luis H Zayas, Ph.D.
Role: PRINCIPAL_INVESTIGATOR
Washington University School of Medicine
Locations
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Washington University and Nurses for Newborns Foundations
St Louis, Missouri, United States
Countries
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Other Identifiers
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