Adolescent Depression Screening and Treatment in Mozambican Primary Care
Pilot Implementation of Depression Screening and Treatment for Adolescents in Mozambican Primary Care
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Palmira Dos Santos, PhD
- Phone Number: 00258825944524
- Email: palmira_fortunato@yahoo.com.br
Study Contact Backup
- Name: Kathryn Lovero, PhD
- Phone Number: (858)2542979
- Email: kll2153@cumc.columbia.edu
Study Locations
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Maputo, Mozambique
- Centro de Saude Alto Mae
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Maputo, Mozambique
- Centro de Saude Chamaculo
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Maputo, Mozambique
- Centro de Saude Magoanine Tendas
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Maputo, Mozambique
- Centro de Saude Primeiro de Maio
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Providers:
- IPT-AG Arm: YFHS staff will be included in the study if they (a) conduct screening for depression and/or group IPT-AG and (b) provide consent to participate in the study.
- TAU Arm: YFHS staff will be included in the study if they (a) provide referrals for adolescents suspected of having mental illness or seeking mental health services and (b) provide consent to participate in the study. Treatment providers (Psychiatric Technicians and psychologists) will be included in the study if they (a) treat adolescents referred from participating YFHS for depression and (b) provide consent to participate in the study.
Patients: In both study arms, adolescents attending one of the four study YFHS will be included in the study if they:
- are between the ages of 12-19 years;
- screen positive for depression;
- provide informed consent (ages 16 -19) or if their guardian provides informed consent and they provide assent (if ages 12-15).
- Study centers: must be clinics that have YFHS.
Exclusion Criteria:
In both study arms, adolescents will be excluded if they:
- are unable to participate in treatment due to acute illness; and/or
- are unable to communicate sufficiently in Portuguese to answer inclusion questions.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Active Comparator: TAU
Psychologists or PsyTechs in mental health services of primary care clinics will provide individual psychotherapy to depressed adolescents in the TAU arm.
Local mental health professionals providing depression treatment in the TAU arm will not have been trained on IPT for adults or adolescents.
Also, the two Ministry of Health psychologists trained as trainers of IPT-AG will not provide treatment in the TAU Arm.
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Adolescents will be administered unstructured psychotherapy in individual sessions with a trained mental health specialist (i.e., psychologist or psychiatric technician).
Other Names:
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Experimental: IPT-AG
Group IPT-AG will be facilitated by the trained providers at each YFHS using the IPT-AG manual adapted to the Mozambican context.
Adolescents will participate in 12 weekly sessions.
The first and last sessions will be one-on-one with the provider.
The first session is used for the participant and provider to develop a treatment plan and the last session is to prepare for treatment termination.
All other sessions will be conducted in groups of 6-8 adolescents.
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IPT-AG is a ten session, group therapy for adolescents.
Each group contains 6-8 adolescents who attend weekly sessions together.
The goals of IPT-AG are: 1) to reduce depression symptoms, and 2) to improve interpersonal relationships.
Another aim of the group format is to increase adolescents' experience with positive social interactions and to reduce social isolation.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in PHQ-A Score From Baseline to 6 Months Post-intervention
Time Frame: Baseline, 6 months
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The Patient Health Questionnaire (PHQ)-A is a 9-item severity measure of depression for adolescents adapted from the PHQ-9.
Questions ask how often an adolescent has been bothered by different depression symptoms in the past week, and responses of "not at all," "several days," "more than half the days," and "nearly every day" are given scores of 0 to 3. A total score is calculated by summing the value of all items and ranges from 0 (better outcome) to 27 (worse outcome).
The change in PHQ-A score will be reported as a percent change.
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Baseline, 6 months
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IPT-AG Fidelity
Time Frame: 6 months post-intervention
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The Group IPT-AG Fidelity Checklist is a 14-item scale that measures provider fidelity to group interpersonal therapy for adolescents.
Providers are scored for superior (1), satisfactory (2), or needs improvement (3) adherence to each item on the checklist, which each represent and essential element of treatment (e.g., gives hope that depression is treatable, links depression to interpersonal problems).
The score of the 14-items is averaged to compute the IPT-AG Fidelity rating (1=superior, 2=satisfactory, 3=needs improvement).
The total score range is 1 to 14, with a lower score indicating a better outcome.
This outcome was only assessed in participants who received the study intervention.
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6 months post-intervention
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Kathryn Lovero, PhD, Columbia University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- AAAU3060
- K01MH120258 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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