Evaluation of a Collaborative Behavioral Health Program Implementation in Primary Care

Evaluation of a Collaborative Behavioral Health Program Implementation in Primary Care

Sponsors

Lead Sponsor: Northwestern University

Collaborator: Northwestern Medicine

Source Northwestern University
Brief Summary

This study will give researchers the opportunity to evaluate implementation of the Collaborative Behavioral Health Program (CBHP), based on the collaborative care model for depression, which aims to improve practice for physicians and staff; improve care for patients; and improve clinic operations through a model that allows for more efficient identification and referral for care for depression.

Detailed Description

This study used a hybrid Type 2 effectiveness-implementation design of a randomized roll-out trial of the Collaborative Care Model for depression (CoCM) in 11 primary care practices in a large healthcare system affiliated with an academic medical center. The Collaborative Behavioral Health Program (CBHP) is supported by leaders in the healthcare system and the primary care steering committee as a means of improving access to effective mental health services. Implementation strategies including hiring and training the necessary staff for CoCM, audit and feedback procedures, and health information technologies to assist with billing and the patient registry, will be provided for all practices. Using a sequential mixed methods measurement approach, we will assess key stakeholders' perspectives of CBHP roll-out, focused on barriers and facilitators of implementation and sustainability. The Stages of Implementation tool will be used to measure the speed and quantity of implementation activities completed across the stages of implementation preparation, implementation, and sustainment over a 30-month period for each practice. Effectiveness of CBHP for patient-level outcomes will be conducted on depressive symptoms, graduation rates for CBHP, and spillover effects on chronic health conditions. With its focus on implementation processes and strategies, this study will elucidate the critical drivers of CoCM implementation that are understudied for a program with such a robust evidence base. This study will also be among the first to conduct economic analyses on a fee-for-service model with the new billing codes for CoCM and can inform ways to improve implementation efficiency with our optimization approach to successive practices in the roll-out design. Changes to the protocol and current status of the study are also discussed.

Overall Status Recruiting
Start Date September 1, 2018
Completion Date December 31, 2024
Primary Completion Date December 31, 2023
Study Type Observational [Patient Registry]
Primary Outcome
Measure Time Frame
Impact of implementation strategies on the speed of CBHP implementation (time, in days) 2 years
Impact of implementation strategies on the quantity of CBHP implementation (number of CBHP participants) 2 years
Acceptability of CBHP 2 years
Effectiveness of CBHP on depressive symptoms (PHQ-9 scores) 2 years
Effectiveness of CBHP on behavioral health service utilization (antidepressant medication prescription, CBHP treatment engagement, and external referrals for behavioral health) 2 years
Enrollment 1900
Condition
Intervention

Intervention Type: Behavioral

Intervention Name: Collaborative Behavioral Health Program

Description: Collaborative care is the delivery of mental health care through a proactive collaboration of primary care providers, behavioral care managers based in primary care practices, and psychiatrists who provide supervision to the behavioral care managers and consultation to the primary care providers.

Eligibility

Sampling Method: Non-Probability Sample

Criteria:

Inclusion Criteria: • PHQ-9 score > 10 Exclusion Criteria: - Current suicidality - Bipolar disorder - Substance abuse disorder - Psychosis - Other severe mental health condition

Gender: All

Minimum Age: 18 Years

Maximum Age: N/A

Overall Contact

Last Name: Allison Carroll, PhD

Phone: 3125031631

Email: [email protected]

Location
Facility: Status: Contact: Contact Backup: Investigator: Northwestern Medicine Allison Carroll, PhD 312-503-1631 [email protected] Justin D Smith, PhD Principal Investigator
Location Countries

United States

Verification Date

March 2020

Responsible Party

Type: Principal Investigator

Investigator Affiliation: Northwestern University

Investigator Full Name: Justin D. Smith

Investigator Title: Associate Professor

Keywords
Has Expanded Access No
Condition Browse
Arm Group

Label: NMG IM 211 E Chicago Ave

Label: NMG IM ARKES

Label: NMG IM 1460 N Halsted St

Label: NMG IM 201 E Huron St

Label: NMG Integrative Medicine 150 E Huron St

Label: NMG IM 1776 N Milwaukee Ave

Label: NMG IM 20 S Clark St

Label: NMG IM FM 1704 Maple Ave

Label: NMG IM 259 E Erie St

Label: NMG IM 1135 S Delano Ct

Label: NMG IM 1333 W Belmont Ave

Acronym WBCBHP
Patient Data Undecided
Study Design Info

Observational Model: Cohort

Time Perspective: Prospective

Source: ClinicalTrials.gov