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Effectiveness of Telepsychiatry-based Culturally Sensitive Collaborative Treatment of Depressed Chinese Americans

2016年11月30日 更新者:Albert Yeung、Massachusetts General Hospital

Hypothesis 1. Telepsychiatry consultations will be acceptable and well-received by depressed Chinese Americans and by their primary care clinicians.

Hypothesis 2. Depressed Chinese Americans in remote primary care clinics receiving T-CSCT will have improved outcomes compared to patients who receive Usual Care by primary care physicians.

研究概览

详细说明

Telepsychiatry-based CSCT (T-CSCT):

Live and interactive Telepsychiatry (using videoconferencing) brings tremendous opportunities to clinical care, education, research, and administration. In the U.S. to date, telepsychiatry has been implemented in rural areas where people lack access to psychiatrists (Baer et al, 1997), in the Prison System with service users constrained from traveling (Brecht et al., 1996), in rural native American resettlement areas (Shore & Spero, 2005), and in Alaska where residents are faced with both distance and a shortage of mental health professionals. In this proposed study, we plan to investigate the effectiveness of telepsychiatry-based CSCT (T-CSCT) to provide culturally sensitive collaborative management of MDD to monolingual Chinese Americans. For this group of patients, telepsychiatry consultation could be a necessity both in urban as well as rural primary care clinics that are not staffed with bilingual psychiatrists. T-CSCT plans to utilize the advanced telemedicine technology in major academic centers to connect the scarce resource of bilingual and bicultural mental health professionals to underserved Chinese Americans to improve their access to treatment of MDD.

T-CSCT will explore the usefulness and effectiveness of recognizing MDD subjects through consumer-initiated depression self-screening using the validated CB-PHQ-9, which will be made available in community newspapers, journals, and on the internet. To facilitate care management for Chinese Americans, a Depression Toolkit for Chinese Americans will be developed, which will include information on the nature and treatment of MDD, the CB-PHQ-9 for depression self-screening, a bilingual instrument to monitor progress of depressive symptoms, strategies for patients to negotiate with health professionals for individually tailored treatment for depression, and answers to frequently asked questions (FAQs) by Asian American immigrants on MDD and its treatment. If shown to be effective, the T-CSCT can be the prototype of a telemedicine-based Multiracial Mental Health Resource Center to provide services to other minority populations to reduce disparities in mental health treatment.

研究类型

介入性

注册 (实际的)

241

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Massachusetts
      • Boston、Massachusetts、美国、02111
        • South Cove Community Health Center

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

Inclusion Criteria:

  1. Individuals with Chinese ethnicity, defined as people who self-identify as being Chinese based upon having either one or both parents being ethnic Chinese.
  2. Monolingual Chinese American immigrants, defined as people who require or prefer to be interviewed in Chinese (including Cantonese, Taiwanese, Mandarin, and Toisanese dialects).
  3. Men or women age 18 or older, who live in the greater Boston area.
  4. Individuals who are competent to consent and have completed a written consent form.
  5. Individuals who have a PCP.
  6. Patients who screen positive for MDD, current according to the fourth version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) as diagnosed by the Mini International Neuropsychiatric Interview (MINI; Sheehan et al, 1998)
  7. Individuals who are willing to receive phone interviews for monitoring of symptoms and for additional support (care management) if available.

Exclusion Criteria:

  1. Patients with serious suicidal risk.
  2. Patients with unstable medical illnesses requiring imminent hospitalization or rendering patients unsuitable for clinical interview.

d. Patients with comorbid severe mental disorders including:

  1. Organic mental disorders.
  2. Alcohol or substance abuse disorders active within the last year.
  3. Schizophrenia.
  4. Delusional disorder.
  5. Psychotic disorders not elsewhere classified.
  6. Bipolar disorder. e. Patients with history of treatment by a psychiatrist in the past 4 months.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:双倍的

武器和干预

参与者组/臂
干预/治疗
安慰剂比较:日常护理
T-CSCT: Patients in Group A will receive T-CSCT, which consists of Telepsychiatry-based Culturally Sensitive Psychiatry Assessment using the Engagement Interview Protocol (EIP) plus Care Management.
有源比较器:TCSCT
T-CSCT: Patients in Group A will receive T-CSCT, which consists of Telepsychiatry-based Culturally Sensitive Psychiatry Assessment using the Engagement Interview Protocol (EIP) plus Care Management.

研究衡量的是什么?

主要结果指标

结果测量
大体时间
Hamilton Rating Scale for Depression
大体时间:Screen, Week 9, 17, 24
Screen, Week 9, 17, 24

次要结果测量

结果测量
大体时间
Clinical Global Impressions (Severity of Depression and Global Improvement)
大体时间:Screen, Week 9, 17, 24
Screen, Week 9, 17, 24

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Albert Yeung, MD、Massachusetts General Hospital

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2009年1月1日

初级完成 (实际的)

2014年1月1日

研究完成 (实际的)

2015年4月1日

研究注册日期

首次提交

2009年2月27日

首先提交符合 QC 标准的

2009年3月2日

首次发布 (估计)

2009年3月3日

研究记录更新

最后更新发布 (估计)

2016年12月1日

上次提交的符合 QC 标准的更新

2016年11月30日

最后验证

2016年11月1日

更多信息

与本研究相关的术语

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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