Promoting Treatment Access Following Pediatric Primary Care Depression Screening
5 de março de 2020 atualizado por: Jessica Schleider, Stony Brook University
Promoting Treatment Access Following Pediatric Primary Care Depression Screening: Evaluation of Web-based, Single-session Interventions for Parents and Youths
Major depression (MD) in youth is a serious psychiatric illness with extensive morbidity and mortality.
The American Academy of Pediatrics recently released practice guidelines promoting primary care (PC)-based youth MD screening; however, even when diagnosed by PC providers, <50% of youth with MD access treatment.
Thus, a need exists for interventions that are feasible for youths and parents to access and complete-and that may strengthen parents' likelihood of pursuing longer-term services.
Single-session interventions (SSIs) may help forward these goals.
SSIs include elements of comprehensive treatments, but their brevity makes them easier to disseminate at scale.
Meta-analytic evidence suggests SSIs can reduce youth psychopathology, including self-administered (e.g., online) SSIs.
One computer-based SSI, teaching growth mindset (GM; viewing personal traits as malleable), has reduced adolescent depressive symptoms in multiple RCTs; GM-SSIs have also improved parents' expectancies that psychotherapy could benefit their children's mental health.
This project will test whether these online, youth- and parent-directed GM-SSIs-designed to reduce youth depressive symptoms and improve parents' mental health treatment expectancies, respectively-may increase mental health service access, reduce youth depressive symptoms, and relieve parental stress following PC-based youth MD screening.
Youths reporting elevated MD symptoms at PC visits (N = 200) will receive either Information/Psychoeducation/Referral (IPR) or IPR plus parent- and youth-directed GM-SSIs (IPR+SSI).
The investigators will examine whether IPR+SSI, versus IPR alone, increases MD service access; reduces parental stress; and reduces youth depressive symptoms across three months.
Results may yield a disseminable model for promoting youth treatment access after PC-based depression screening.
Visão geral do estudo
Status
Desconhecido
Condições
Tipo de estudo
Intervencional
Inscrição (Antecipado)
246
Estágio
- Não aplicável
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Locais de estudo
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New York
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Stony Brook, New York, Estados Unidos, 11794-2500
- Recrutamento
- Stony Brook University
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Contato:
- Jessica L Schleider, PhD
- Número de telefone: 631-632-4131
- E-mail: jessica.schleider@stonybrook.edu
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
11 anos a 16 anos (Filho)
Aceita Voluntários Saudáveis
Não
Gêneros Elegíveis para o Estudo
Tudo
Descrição
Inclusion Criteria:
- Youth is between the ages of 11 and 16, inclusive, at the time of study recruitment
- Youth reports a Pediatric Symptom Checklist 'Internalizing' score of 5 or higher (out of 10) at her/his most recent pediatric primary care visit at 1 of the 9 Stony Brook University-affiliated clinics participating in this study
- Parent and youth are comfortable with reading and writing in English
- Parent and youth are comfortable with online activity
Exclusion Criteria:
- Parent or youth is not comfortable reading and/or writing in English
- Parent or youth is not comfortable with online activity
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador Ativo: Online Programs + Information/Psychoeducation/Referral (IPR)
Includes 2 online, one-session programs (one for youths; one for parents) and Primary Care-based IPR.
The 30-min, self-administered YOUTH PROGRAM includes: An introduction to the brain and a lesson on neuroplasticity; Testimonials from older youths who describe their views that traits are malleable, due to the brain's plasticity; Further stories by older youths, describing times when they used "growth mindsets" to persevere during social/emotional setbacks; Study summaries noting how/why personality can change; And an exercise in which youths write notes to younger students, using scientific information to explain people's capacity for change.
In the 15-min Qualtrics-based PARENT PROGRAM, parents read 2 scientific passages on (1) the notion that emotions are flexible in youth and adults, and (2) that failure promotes personal growth.
After each passage, parents write a persuasive summary of its main arguments, directed to fellow parents who may benefit from the information.
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Online, 15-minute self-administered program for parents
Online, 30 minute self-administered program for youths
Outros nomes:
Usual care at pediatric primary care clinics participating in this study
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Comparador de Placebo: Information/Psychoeducation/Referral (IPR; usual care control)
Information, Psychoeducation and Referral (IPR) represents usual care in the Stony Brook University Hospital's Pediatric Primary Care Division.
Families of a youth with elevated MD symptoms during a PC visit receive a folder containing informational materials about the nature of depression and referrals to providers in their area.
All families in this study will receive PC-based IPR.
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Usual care at pediatric primary care clinics participating in this study
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Mental Health Treatment-Seeking Behavior Checklist
Prazo: Baseline to 3-month follow-up
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At baseline and 3-month follow-up, parents will indicate whether they have engaged in each of four treatment-seeking behaviors for their child: researched local mental healthcare providers/agencies for their child; contacted a mental healthcare provider or agency about treatment for their child; contacted child's school regarding mental health supports for their child; and scheduled an appointment OR placed child on a waiting-list with a mental healthcare provider/agency.
Total number of treatment-seeking behaviors between baseline and 3-month follow-up may range from 0 to 4. Individual behaviors are self-reported by parents on as 'yes' or 'no' (noting whether they engaged in the behavior during the study period).
At baseline, parents will report on whether they engaged in these behaviors 'since the child's last doctor's appointment.'
At follow-up, parents will report whether they have engaged in these behaviors 'since their past survey, 3 months ago.'
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Baseline to 3-month follow-up
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Change in Children's Depression Inventory 2 - Youth Report Total Score
Prazo: Baseline to 3-month follow-up.
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Change in youth reported depressive symptoms, total score derived from 28-item CDI-2.
Scores range from 0-56, with higher scores indicating higher levels of depression.
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Baseline to 3-month follow-up.
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in Pediatric Symptom Checklist - Youth-Report Total score
Prazo: Baseline to 3-month follow-up.
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Youth-report measure of overall youth psychopathology.
Youth rate 35 items on a 0-2 scale reflecting internalizing, externalizing, and attention-related symptoms.
Scores range from 0 - 70.
Higher scores indicate higher overall symptom severity.
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Baseline to 3-month follow-up.
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Change in Pediatric Symptom Checklist- Parent Report Total score
Prazo: Baseline to 3-month follow-up.
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Youth-report measure of overall youth psychopathology.
Youth rate 35 items on a 0-2 scale reflecting internalizing, externalizing, and attention-related symptoms.
Scores range from 0 - 70.
Higher scores indicate higher overall symptom severity.
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Baseline to 3-month follow-up.
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Change in Pediatric Symptom Checklist- Youth Internalizing Score (parent report)
Prazo: Baseline to 3-month follow-up.
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Parent-report measure of overall youth psychopathology.
Parents rate 5 items on a 0-2 scale reflecting internalizing symptoms in their child.
Scores range from 0-10.
Higher scores indicate higher overall symptom severity.
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Baseline to 3-month follow-up.
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Change in Beck Hopelessness Scale - 4 (Youth Report)
Prazo: Baseline to immediate post-online-intervention (in active intervention group only) and 3-month follow-up (between groups).
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Respondents (youths) report agreement with 4 items indicating levels of hopelessness about the future.
Higher summed scores reflect greater levels of hopelessness, and scores range from 0-12.
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Baseline to immediate post-online-intervention (in active intervention group only) and 3-month follow-up (between groups).
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Change in Beck Hopelessness Scale - 4 (Parent Report)
Prazo: Baseline to immediate post-online-intervention (in active intervention group only) and 3-month follow-up (between groups).
|
Respondents (parents) report agreement with 4 items indicating levels of hopelessness about the future.
Higher summed scores reflect greater levels of hopelessness, and scores range from 0-12.
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Baseline to immediate post-online-intervention (in active intervention group only) and 3-month follow-up (between groups).
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Change in Brief Symptom Inventory - 18
Prazo: Baseline to 3-month follow-up
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The Brief Symptom Inventory-18 (BSI-18) assesses self reported parent psychopathology and distress.
Adult respondents rate endorsement of 18 physical and emotional complaints on a 0-4 Likert scale.
The total sum score yields an additional total distress score (range: 0-72).
Higher scores indicate higher levels of overall psychological distress.
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Baseline to 3-month follow-up
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Change in Barriers to Accessing Care Evaluation (BACE)
Prazo: Baseline to 3-month follow-up
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Parents rate the 30 items on a 0-3 scale indicating the degree to which various beliefs, concerns, circumstances, and logistical difficulties have stopped, delayed or discouraged them from getting professional care for their child's mental health problem.
Higher total scores indicate greater perceived barriers to care.
Scores range from 0-90, with higher scores indicating more overall barriers to accessing mental health care for their child.
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Baseline to 3-month follow-up
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Change in Attitudes Toward Therapy Scale - Parent
Prazo: Baseline to immediate post-online-intervention (in active intervention group only) and 3-month follow-up (between groups).
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One-item measure used to assess parents' perceptions that therapy/counseling would be useful in reducing their child's emotional or behavioral difficulties, rated on a 0-10 scale (total score range: 0-10).
Higher scores indicate stronger beliefs that therapy may help reduce mental health problems, whereas lower scores indicate weaker beliefs that therapy may help reduce mental health problems.
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Baseline to immediate post-online-intervention (in active intervention group only) and 3-month follow-up (between groups).
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Mental Health Treatment Access at 3-month follow-up
Prazo: 3-month follow-up
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Parents will indicate (yes/no) whether their child has received (a) new and/or (b) continuing school-based, outpatient, or other mental health-related services since the child's recent PC appointment (at baseline) and since the baseline assessment (at 3-month follow-up).
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3-month follow-up
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Change in Perceived Stress Scale
Prazo: Baseline to 3-month follow-up
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The PSS is a well-validated measure of the degree to which situations in one's life are appraised as stressful, unpredictable, and uncontrollable.
Higher total scores indicate greater overall perceived stress.
The scale includes 10 items rated on a 0-4 scales, and scores range from 0-40.
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Baseline to 3-month follow-up
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Change in Pediatric Symptom Checklist - Youth-Report Internalizing Score
Prazo: Baseline to 3-month follow-up.
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Youth-report measure of youth depressive symptoms.
Youth rate 5 items reflecting internalizing symptoms on a scale from 0-2.
Total scores range from 0 to 10. Higher scores indicate higher internalizing symptom severity.
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Baseline to 3-month follow-up.
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Change in Children's Depression Inventory 2 - Parent Report total score
Prazo: Baseline to 3-month follow-up.
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Parent reported youth depressive symptoms, total score derived from 17-item parent-report version of CDI-2.
Scores range from 0-54, and higher scores indicate greater youth depression severity.
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Baseline to 3-month follow-up.
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in implicit theories of emotion scale, parent-report
Prazo: Baseline to immediate-post-online intervention (active intervention group only)
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This measure will be used as a manipulation check for parents assigned to the active intervention condition.
Parents will be asked to report the degree to which they view emotions as malleable (versus immutable) at pre- and post-intervention using a previously validated, 4-item assessment of emotion mindsets in adults.
Four items are rated using a 1-to-6 Likert scale.
Higher mean scores on these items indicate a stronger fixed emotion mindset, a lower scores, a stronger growth emotion mindset (range: 1-).
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Baseline to immediate-post-online intervention (active intervention group only)
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Change in Implicit Theories of Personality Questionnaire, youth-report
Prazo: Baseline to immediate-post-online intervention (active intervention group only)
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This measure will be used as a manipulation check for youths assigned to the active intervention condition.
Respondents rate the extent of their agreement with three statements linked to the malleability of personality, using a 1-to-6 Likert scale (e.g.
"Your personality is something about you that you can't change very much").
Higher mean scores on these three items indicate a stronger fixed personality mindset, a lower scores, a stronger growth personality mindset (range: 1-6).
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Baseline to immediate-post-online intervention (active intervention group only)
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Colaboradores e Investigadores
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Patrocinador
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Publicações e links úteis
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Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Real)
15 de janeiro de 2020
Conclusão Primária (Antecipado)
30 de abril de 2021
Conclusão do estudo (Antecipado)
30 de agosto de 2021
Datas de inscrição no estudo
Enviado pela primeira vez
20 de julho de 2019
Enviado pela primeira vez que atendeu aos critérios de CQ
23 de julho de 2019
Primeira postagem (Real)
24 de julho de 2019
Atualizações de registro de estudo
Última Atualização Postada (Real)
6 de março de 2020
Última atualização enviada que atendeu aos critérios de controle de qualidade
5 de março de 2020
Última verificação
1 de março de 2020
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- IRB2019-00241
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
SIM
Descrição do plano IPD
De-identified individual-level participant data will be made publicly available on Open Science Framework upon completion of the grant period (August 2021).
Prazo de Compartilhamento de IPD
Study protocol and a statistical analysis plan have been uploaded with this pre-registration.
Critérios de acesso de compartilhamento IPD
Materials will be publicly available on clinicaltrials.gov.
IPD will be made publicly available on Open Science Framework upon completion of the grant period (August 2021)
Tipo de informação de suporte de compartilhamento de IPD
- PROTOCOLO DE ESTUDO
- SEIVA
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Não
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Não
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .