- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT01773629
Care Managers for Perinatal Depression (CMPD) (CMPD)
The investigators will evaluate effects of introducing the care manager on:
- Patient receipt of timely diagnosis and initiation of treatment for major depression (diagnosis within 2 weeks of screening and treatment within 1 month of diagnosis); and
- Patient continuity of care for depression across the transition of care from pregnancy to postpartum (within 4 months postpartum).
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
The first two specific research aims of this proposed randomized study will evaluate the benefits of introducing site specific care managers into established multi-component enhancements of perinatal depression care. The four study sites are members of the IMPLICIT perinatal quality improvement network and provide prenatal care to a diverse population of low income minority women using a common set of care processes within diverse practice models including Obstetric, Family Medicine, and Nurse Practitioner/Midwifery settings. The established processes of care include evidence based screening, diagnosis, treatment protocols and quality improvement care teams.
The investigators will evaluate effects of introducing the care manager on:
- Patient receipt of timely diagnosis and initiation of treatment for major depression (diagnosis within 2 weeks of screening and treatment within 1 month of diagnosis); and
- Patient continuity of care for depression across the transition of care from pregnancy to postpartum (within 4 months postpartum).
For the third and fourth specific research aims we will conduct supplementary econometric and qualitative analyses to aid in understanding the provider and system context in which this intervention is implemented across the four study sites. Results of this evaluation will be used to understand for whom and in which systems of care this model is most successful as well as the costs of delivering this intervention.
Specifically the investigators will:
- Employ econometric techniques to quantify the costs of implementing and maintaining the IMPLICIT collaborative care maternal depression intervention; and
- Develop institutional ethnographies of the four study sites and identify factors associated with relative success in implementing perinatal depression care managers and improving timely diagnosis, initiation, and continuity of depression care.
Achieving these aims will provide the foundation for dissemination of this innovative approach to perinatal depression care delivery throughout the entire growing IMPLICIT network which now extends across the northeast and mid-Atlantic regions of the US; sites which provide perinatal care for low income minority women in urban, rural, and suburban communities. These sites include prenatal practices in the Robert Wood Johnson Foundation Aligning Forces for Quality initiative, the Healthy York County Coalition which is partnering with us to disseminate this work in their region.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
-
-
Pennsylvania
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Lancaster, Pennsylvania, Stati Uniti, 17604
- Downtown Family Medicine
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Lancaster, Pennsylvania, Stati Uniti, 17608
- Southeast Lancaster Health Services
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Philadelphia, Pennsylvania, Stati Uniti, 19122
- Broad Street Health Center
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Philadelphia, Pennsylvania, Stati Uniti, 19139
- Haddington Health Center
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-
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Female
- Current pregnancy or experienced pregnancy in the past 6 weeks
- Score >= 12 on PHQ9
Exclusion Criteria:
- < age 13
- Mental illness
- Primary language other than English or Spanish
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Ricerca sui servizi sanitari
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
---|---|
Sperimentale: Intervention
Participants in the intervention arm will receive standard care plus the addition of a care manager.
Care managers will function to provide culturally competent and linguistically appropriate support for the care of women identified as being at high risk for depression in pregnancy.
Working with both the care providers and these study participants care managers will serve as connectors, coaches, collaborators, and negotiators working to overcome barriers to depression care delivery.
|
Participants in the intervention arm will receive standard care plus the addition of a care manager.
Care managers will function to provide culturally competent and linguistically appropriate support for the care of women identified as being at high risk for depression in pregnancy.
Working with both the care providers and these study participants care managers will serve as connectors, coaches, collaborators, and negotiators working to overcome barriers to depression care delivery.
|
Altro: Control
Standard of care: within the current care processes, a woman initiating prenatal care completes a depression risk assessment using a two-step approach.
Women with high risk of depression are then scheduled for a separate visit with a member of the care team (a physician, psychologist, or other mental health provider) referred to as a "perinatal depression champion" for a timely formal diagnostic interview.
|
Standard of care: within the current care processes, a woman initiating prenatal care completes a depression risk assessment using a two-step approach.
Women with high risk of depression are then scheduled for a separate visit with a member of the care team (a physician, psychologist, or other mental health provider) referred to as a "perinatal depression champion" for a timely formal diagnostic interview.
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
Diagnosis of major depression within 2 weeks of screening
Lasso di tempo: 2 weeks after screening
|
Patient receipt of timely diagnosis for major depression during perinatal period.
|
2 weeks after screening
|
Treatment of major depression within 1 month of diagnosis
Lasso di tempo: 1 month
|
Patient receipt of timely initiation of treatment for major depression during the perinatal period.
|
1 month
|
Transition of care from pregnancy to postpartum
Lasso di tempo: 4 months
|
Patient continuity of care for depression across the transition of care from pregnancy to postpartum within 4 months postpartum.
|
4 months
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
Quantify the costs of implementing a care manager
Lasso di tempo: 3 years
|
Employ econometric techniques to quantify the costs of implementing and maintaining the care manager for managing perinatal depression.
|
3 years
|
Qualitative assessment of success in implementation of perinatal depression care management process.
Lasso di tempo: 3 years
|
Develop institutional ethnographies of the study sites and identify factors associated with relative success in implementing perinatal depression care managers and improving timely diagnosis, initiation, and continuity of depression care.
Qualitative measures include efficacy of core implementation group, commitment of implementation group, commitment of user group and readiness to change.
|
3 years
|
Collaboratori e investigatori
Sponsor
Investigatori
- Investigatore principale: Stephen Ratcliffe, MD, MSPH, Lancaster General Hospital
- Investigatore principale: Ian M Bennett, MD, PhD, University of Pennsylvania
- Investigatore principale: Donna Cohen, MD, MS, Lancaster General Hospital
- Investigatore principale: Michael A Horst, PhD, MPHS, MS, Lancaster General Hospital
Studiare le date dei record
Studia le date principali
Inizio studio
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Stima)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- 2010-38-LGH
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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