- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT01407783
Systems of Care for New Moms: Integrating Depression Treatment (NUMOMS)
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
NUMOMS involves collaboration between Nurses for Newborns Foundation and Washington University in St. Louis. This study explores the co-location of depression treatment within nurse home visitation and the organizational changes needed to maintain access to evidence-based treatment. Problem Solving Tools (PST) was chosen as the depression treatment because it is well suited for use by non-mental health specialists and for in-home treatment. It is also a brief treatment (4-8 sessions) takes a non-pathologizing approach.
In the first part of the study we will gather information from women and their providers to determine what system and treatment modifications are needed to effectively deliver acceptable depression treatment in home visitation programs. Based on this information, a panel of local and national experts will provide advice on decisions regarding the intervention adaptation. Once these adaptation decisions are made a small group of experts will adapt a PST manual for use in home visitation.
In the second phase of the NUMOMS study we will carry out a small two-arm randomized trial comparing the effectiveness, acceptability, and practicality of PST provided by home visitation RNs versus usual care (referral to mental health specialty care).
Significantly, NUMOMS has the potential to provide home visitation agencies with a viable means of access to effective and acceptable depression treatment for mothers in the face of policy mandates for depression screening.The specific aims are to:
Adapt PST for implementation in nurse home visitation programs.
- Examine internal (organization and client level) and external (community and policy level) factors that may impact upon PST adaptation and delivery in nurse home visitation.
- Build protocols for targeting depression treatment to the woman's symptom severity and patient preferences.
- Develop and routinize protocols for supervision, clinical consultation, and risk assessment for PST provided by nurse home visitors.
- Modify protocols and systems for client tracking and outcomes.
Implement a two-arm randomized pilot study comparing: PST provided by non-mental health home visitation nurses and referral for treatment (Care as Usual).
- Compare outcomes on the Beck Depression Inventory, the Patient Health Questionnaire-9, and Parenting Stress Index for women treated with PST by non-specialty RNs and Care as Usual.
- Track pathways and barriers to care for women referred to mental health specialty care or primary care for medications.
- Develop an R01 for a full scale randomized controlled trial using data on effect sizes and addressing organizational issues, infrastructure needs, and treatment refinements.
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
Missouri
-
Saint Louis, Missouri, Förenta staterna, 63105
- Washington University and Nurses for Newborns Foundations
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Depressed as indicated by Edinburgh Postpartum Depression Scale or Clinical Checklist
- NFNF client from a certain zip code
- Either pregnant or have a child under the age of 12 months in the home
Exclusion Criteria:
- Under the age of 18
- Severe Mental Illness
- Chemical Dependency
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Experimentell: Problem Solving Tools
The home visitation nurse will teach and utilize the problem solving tools to help low-income depressed mothers.
It is a brief treatment with the a non-pathologizing intervention being done in 4-8 sessions.
|
The problem solving tools was chosen as the depression treatment because it is well suited for use by non-mental health professionals and for in-home treatment.
It is also a brief treatment (4-8 sessions) that takes a non-pathologizing approach.
Andra namn:
|
Inget ingripande: Enhanced Referral
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
PHQ-9
Tidsram: baseline, 6months and 12 months post treatment
|
Measure the reduction of post partum depression after intervention at 6 months and 12 months post treatment.
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baseline, 6months and 12 months post treatment
|
BDI-II
Tidsram: baseline, 6months &12 months post treatment
|
Measure the reduction of post partum depression after intervention at 6 months and 12 months post treatment.
|
baseline, 6months &12 months post treatment
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Qualitative Interview
Tidsram: 1 month post treatment
|
Questions asking the participants their feelings about the intervention.
|
1 month post treatment
|
Samarbetspartners och utredare
Samarbetspartners
Utredare
- Huvudutredare: Luis H Zayas, Ph.D., Washington University School of Medicine
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- 5R34MH083085-02 (U.S.S. NIH-anslag/kontrakt)
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