Harlem Strong Mental Health Coalition

NCT ID: NCT05833555

Last Updated: 2024-08-12

Study Results

Results pending

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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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

700 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-05

Study Completion Date

2026-08-31

Brief Summary

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Addressing health disparities, especially in the face of coronavirus pandemic, requires an integrated multi-sector equity-focused, community-based approach. This study will examine the impact of Harlem Strong Community Mental Health Collaborative, a community-wide multi-sectoral coalition in which a health insurer works with a network of community-based organizations, medical providers, and behavioral health providers to engage in a network-wide implementation planning process to: (1) problem-solve financing, access, and quality of care barriers, (2) support capacity building for mental health (MH) task-sharing for community health workers, (3) facilitate coordination and collaboration across MH/behavioral health, primary care, and a range of social services, including case management, housing supports, financial education, employment support, and other community resources to improve linkages to services, and (4) identify a set of common MH, social risk, and health metrics and strategies to integrate these metrics into data systems across the network for continuous quality improvement of the system. The long-term goal of our study is to develop sustainable model for task-sharing MH care that will be embedded in a coordinated comprehensive network of services, including primary care, behavioral/MH, social services, and other community resources.

Detailed Description

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This study examines the impact of Harlem Strong Community Mental Health Collaborative, a community-wide multi-sectoral coalition in which a health insurer works with community-based organizations and medical and behavioral health providers to (1) problem-solve financing, access, and quality of care barriers, (2) support capacity building for MH task-sharing for community health workers, (3) facilitate coordination and collaboration across MH/behavioral health, primary care, and social services, and (4) identify a set of common metrics and strategies for continuous system quality improvement. The research study will evaluate the impact using a Hybrid Implementation-Effectiveness design to assess the effects of the Harlem Strong Collaborative on implementation and consumer outcomes. The investigators will also describe implementation outcomes and key informant interviews to explore impact of community engagement, organization variables, and provider factors on model impact. The long-term goal of this study is to develop a sustainable model for task-sharing MH care that will be embedded in a coordinated comprehensive network of services.

The investigators will conduct a stepped-wedge clustered randomized control study evaluating the effectiveness of a MH task-sharing intervention, that involves randomization and sequenced exposure to three implementation conditions: (1) online education and resources (E\&R) about MH task-sharing (screening, education, and referral), (2) community-engaged multisector collaborative care model (MCC), where a neighborhood-based coalition will support implementation of MH task-sharing, and (3) community crowdsourced technology solution to support implementation (MCC+Tech).

Conditions

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Stress-related Problem Depression, Anxiety Mental Health Wellness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Study Groups

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Education and Resources

Education and Resources (E\&R) involves online training through the E-Hub on delivery of basic MH task-shifting skills, such as screening, psychoeducation, and referral to MH care. A community directory along with training on community resources will be made available to all participants. Specifically, we will recommend that those identified to have common MH problems (PHQ-4≥3) are offered a single two-hour zoom-based group psychoeducation session about depression and anxiety, COVID-19 impact on MH, wellness and self-care skills, and directory of Harlem-based MH services and other community resources. Participants exhibiting higher level needs are referred to MH specialists.

Group Type ACTIVE_COMPARATOR

MH task-sharing training

Intervention Type BEHAVIORAL

Providers will be trained to screen for MH, provide education, refer, and coordinate to range of social services. MH training typically consists of education and resources, such as one-time workshops and toolkits, provided with limited technical assistance.

Multisector Collaborative Care

Multisector Collaborative Care (MCC) Model will consist of all resources offered in E\&R and additional trainings on skills related to working in a multisectoral team, care navigation, syndemic risks and coordination of services related to MH, social services, and health care.

Group Type EXPERIMENTAL

MH task-sharing training

Intervention Type BEHAVIORAL

Providers will be trained to screen for MH, provide education, refer, and coordinate to range of social services. MH training typically consists of education and resources, such as one-time workshops and toolkits, provided with limited technical assistance.

Supervision

Intervention Type BEHAVIORAL

Additionally, Community Health Workers (CHWs) will receive bi-weekly group supervision for the first 6-months, and monthly supervision for the remaining year on Zoom from a supervisor at Center for Innovation in Mental Health.

Learning Collaborative

Intervention Type BEHAVIORAL

A learning collaborative with multidisciplinary teams from various healthcare organizations will support continuous quality improvement and develop develop structured approach to improve provision of care.

Multisector Collaborative Care and Technology

MCC sites will be randomized to receive an additional technology-based implementation tool to evaluate impact on implementation and consumer outcomes.

Group Type EXPERIMENTAL

MH task-sharing training

Intervention Type BEHAVIORAL

Providers will be trained to screen for MH, provide education, refer, and coordinate to range of social services. MH training typically consists of education and resources, such as one-time workshops and toolkits, provided with limited technical assistance.

Supervision

Intervention Type BEHAVIORAL

Additionally, Community Health Workers (CHWs) will receive bi-weekly group supervision for the first 6-months, and monthly supervision for the remaining year on Zoom from a supervisor at Center for Innovation in Mental Health.

Learning Collaborative

Intervention Type BEHAVIORAL

A learning collaborative with multidisciplinary teams from various healthcare organizations will support continuous quality improvement and develop develop structured approach to improve provision of care.

Technology Intervention

Intervention Type OTHER

To be determined by community crowdsourcing after the first phase of implementation of the multisector collaborative care for MH task-sharing.

Interventions

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MH task-sharing training

Providers will be trained to screen for MH, provide education, refer, and coordinate to range of social services. MH training typically consists of education and resources, such as one-time workshops and toolkits, provided with limited technical assistance.

Intervention Type BEHAVIORAL

Supervision

Additionally, Community Health Workers (CHWs) will receive bi-weekly group supervision for the first 6-months, and monthly supervision for the remaining year on Zoom from a supervisor at Center for Innovation in Mental Health.

Intervention Type BEHAVIORAL

Learning Collaborative

A learning collaborative with multidisciplinary teams from various healthcare organizations will support continuous quality improvement and develop develop structured approach to improve provision of care.

Intervention Type BEHAVIORAL

Technology Intervention

To be determined by community crowdsourcing after the first phase of implementation of the multisector collaborative care for MH task-sharing.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Black and Latino adults between 18 and 65 years
* Harlem residents from low-income housing developments or receiving primary care services in Harlem
* PHQ-4 Total Score ≥3, moderate risk for depression

Exclusion Criteria

* Those with risk for depression or anxiety who screen positive for severe mental illness (e.g., psychosis, mania, substance abuse, and high suicide risk) using screening items from the Mini-International Neuropsychiatric Interview will be excluded from the study and referred to MH services at higher levels of care
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Harlem Congregation for Community Improvement, Inc.

UNKNOWN

Sponsor Role collaborator

Healthfirst

OTHER

Sponsor Role collaborator

City University of New York, School of Public Health

OTHER

Sponsor Role lead

Responsible Party

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Victoria Ngo

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Victoria K Ngo, PhD

Role: PRINCIPAL_INVESTIGATOR

City University of New York

Locations

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CUNY Graduate School of Public Health and Health Policy

New York, New York, United States

Site Status RECRUITING

Harlem Congregation for Community Improvement

New York, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Srividhya Sharma, PhD, MPH

Role: CONTACT

347-395-7943

Deborah Levine, LCSW

Role: CONTACT

917-549-6155

Facility Contacts

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Victoria K Ngo, PhD

Role: primary

626-780-7899

Malcolm Punter, Ed.D

Role: primary

212-281-4887 ext. 205

References

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Ngo VK, Vu TT, Levine D, Punter MA, Beane SJ, Weiss MR, Wyka K, Florez-Arango JF, Zhou X. A multisector community-engaged collaborative for mental health integration in primary care and housing developments: Protocol for a stepped-wedge randomized controlled trial (the Harlem Strong Program). BMC Public Health. 2024 Sep 19;24(1):2554. doi: 10.1186/s12889-024-20026-6.

Reference Type DERIVED
PMID: 39300414 (View on PubMed)

Other Identifiers

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U01OD033245

Identifier Type: NIH

Identifier Source: org_study_id

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