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Youth Partners in Care: Depression and Quality Improvement (YPIC)

Primary Purpose

Depression

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Quality Improvement (QI) for depression
Usual Care
Sponsored by
Agency for Healthcare Research and Quality (AHRQ)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Depression focused on measuring depression, quality improvement, treatment, adolescents

Eligibility Criteria

13 Years - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Met either of two criteria: 1) endorsed "stem items" for major depression or dysthymia from the 12-month Composite International Diagnostic Interview(CIDI-12,2.1) modified slightly to conform to diagnostic criteria for adolescents, 1-week or more of past-month depressive symptoms, and a total Center for Epidemiological Studies- Depression Scale(CES-D)40 score ≥ 16, or 2) CES-D score ≥ 24.
  • Age 13-21
  • Presented at primary care clinic

Exclusion Criteria:

  • not English-speaking
  • provider not in study
  • sibling already in study
  • completed eligibility screener previously

Sites / Locations

  • University of California
  • Kaiser Permanente Los Angeles Medical Center
  • Venice Family Clinic
  • Ventura County Medical Center
  • University of Pittsburgh

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Usual Care

Quality Improvement for Depression

Arm Description

Patients received usual care through primary care, enhanced by provider education regarding depression evaluation and management (1-2 hour training, plus study manual)

Major intervention components included a) expert leader teams who planned and implemented the intervention at each clinic, b) care managers who supported primary care clinicians with depression evaluation and management, c) access to cognitive-behavior therapy for depression within each primary care clinic, and d) patient and provider choice regarding treatment modality.

Outcomes

Primary Outcome Measures

Self-reported depressive symptoms on the CES-D (Center for Epidemiologic Studies Depression Scale)

Secondary Outcome Measures

mental health related quality of life as assessed using self-report on the Medical Outcomes Study Short Form 12 Health Survey.
satisfaction with care
Rates of mental health care, counseling/psychotherapy, and medication treatment.
Youth self report on the study version of the Service Assessment for Children & Adolescents provided measures of rates of mental health care(dichotomous indicator of whether any mental health treatment received), counseling/psychotherapy (dichotomous indicator of whether counseling/psychotherapy was received, number of counseling/psychotherapy sessions), and medication treatment (dichotomous indicator of whether youth received any medication treatment for mental health problems). These measures were obtained using .

Full Information

First Posted
January 19, 2012
Last Updated
January 7, 2014
Sponsor
Agency for Healthcare Research and Quality (AHRQ)
Collaborators
RAND, Kaiser Permanente, University of Pittsburgh, Venice Family Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT02030782
Brief Title
Youth Partners in Care: Depression and Quality Improvement
Acronym
YPIC
Official Title
Youth Partners in Care: Depression & Quality Improvement
Study Type
Interventional

2. Study Status

Record Verification Date
December 2008
Overall Recruitment Status
Completed
Study Start Date
October 1999 (undefined)
Primary Completion Date
December 2003 (Actual)
Study Completion Date
December 2003 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Agency for Healthcare Research and Quality (AHRQ)
Collaborators
RAND, Kaiser Permanente, University of Pittsburgh, Venice Family Clinic

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized effectiveness trial evaluates a quality improvement intervention aimed at providing access to evidence-based depression treatments (particularly cognitive-behavior therapy for depression and or pharmacotherapy) through primary care for youth ages 13-21, as compared to enhanced usual care. The major hypothesis is that the quality improvement intervention will be associated with improved outcomes, relative to enhanced usual care.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression
Keywords
depression, quality improvement, treatment, adolescents

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
418 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Usual Care
Arm Type
Active Comparator
Arm Description
Patients received usual care through primary care, enhanced by provider education regarding depression evaluation and management (1-2 hour training, plus study manual)
Arm Title
Quality Improvement for Depression
Arm Type
Experimental
Arm Description
Major intervention components included a) expert leader teams who planned and implemented the intervention at each clinic, b) care managers who supported primary care clinicians with depression evaluation and management, c) access to cognitive-behavior therapy for depression within each primary care clinic, and d) patient and provider choice regarding treatment modality.
Intervention Type
Other
Intervention Name(s)
Quality Improvement (QI) for depression
Intervention Description
Major intervention components included a) expert leader teams who planned and implemented the intervention at each clinic, b) care managers who supported primary care clinicians with depression evaluation and management, c) access to cognitive-behavior therapy for depression within each primary care clinic, and d) patient and provider choice regarding treatment modality.
Intervention Type
Other
Intervention Name(s)
Usual Care
Intervention Description
Usual care enhanced by provider education regarding depression evaluation and management
Primary Outcome Measure Information:
Title
Self-reported depressive symptoms on the CES-D (Center for Epidemiologic Studies Depression Scale)
Time Frame
6-months
Secondary Outcome Measure Information:
Title
mental health related quality of life as assessed using self-report on the Medical Outcomes Study Short Form 12 Health Survey.
Time Frame
6 months, with follow up at 12 and 18 months
Title
satisfaction with care
Time Frame
6 months with follow up at 12 and 18 months
Title
Rates of mental health care, counseling/psychotherapy, and medication treatment.
Description
Youth self report on the study version of the Service Assessment for Children & Adolescents provided measures of rates of mental health care(dichotomous indicator of whether any mental health treatment received), counseling/psychotherapy (dichotomous indicator of whether counseling/psychotherapy was received, number of counseling/psychotherapy sessions), and medication treatment (dichotomous indicator of whether youth received any medication treatment for mental health problems). These measures were obtained using .
Time Frame
6-months with follow-up at 12 and 18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
13 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Met either of two criteria: 1) endorsed "stem items" for major depression or dysthymia from the 12-month Composite International Diagnostic Interview(CIDI-12,2.1) modified slightly to conform to diagnostic criteria for adolescents, 1-week or more of past-month depressive symptoms, and a total Center for Epidemiological Studies- Depression Scale(CES-D)40 score ≥ 16, or 2) CES-D score ≥ 24. Age 13-21 Presented at primary care clinic Exclusion Criteria: not English-speaking provider not in study sibling already in study completed eligibility screener previously
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joan R Asarnow, PhD
Organizational Affiliation
University of California, Los Angeles
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90024
Country
United States
Facility Name
Kaiser Permanente Los Angeles Medical Center
City
Los Angeles
State/Province
California
Country
United States
Facility Name
Venice Family Clinic
City
Venice
State/Province
California
Country
United States
Facility Name
Ventura County Medical Center
City
Ventura
State/Province
California
Country
United States
Facility Name
University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
12222079
Citation
Asarnow JR, Jaycox LH, Anderson M. Depression among youth in primary care models for delivering mental health services. Child Adolesc Psychiatr Clin N Am. 2002 Jul;11(3):477-97, viii. doi: 10.1016/s1056-4993(02)00006-8.
Results Reference
background
PubMed Identifier
11430853
Citation
Wells KB, Kataoka SH, Asarnow JR. Affective disorders in children and adolescents: addressing unmet need in primary care settings. Biol Psychiatry. 2001 Jun 15;49(12):1111-20. doi: 10.1016/s0006-3223(01)01113-1.
Results Reference
background
PubMed Identifier
19651711
Citation
Asarnow JR, Jaycox LH, Tang L, Duan N, LaBorde AP, Zeledon LR, Anderson M, Murray PJ, Landon C, Rea MM, Wells KB. Long-term benefits of short-term quality improvement interventions for depressed youths in primary care. Am J Psychiatry. 2009 Sep;166(9):1002-10. doi: 10.1176/appi.ajp.2009.08121909. Epub 2009 Aug 3.
Results Reference
result
PubMed Identifier
15657324
Citation
Asarnow JR, Jaycox LH, Duan N, LaBorde AP, Rea MM, Murray P, Anderson M, Landon C, Tang L, Wells KB. Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: a randomized controlled trial. JAMA. 2005 Jan 19;293(3):311-9. doi: 10.1001/jama.293.3.311.
Results Reference
result
PubMed Identifier
16502131
Citation
Jaycox LH, Asarnow JR, Sherbourne CD, Rea MM, LaBorde AP, Wells KB. Adolescent primary care patients' preferences for depression treatment. Adm Policy Ment Health. 2006 Mar;33(2):198-207. doi: 10.1007/s10488-006-0033-7.
Results Reference
result
PubMed Identifier
16310125
Citation
Asarnow JR, Jaycox LH, Duan N, LaBorde AP, Rea MM, Tang L, Anderson M, Murray P, Landon C, Tang B, Huizar DP, Wells KB. Depression and role impairment among adolescents in primary care clinics. J Adolesc Health. 2005 Dec;37(6):477-83. doi: 10.1016/j.jadohealth.2004.11.123.
Results Reference
result
PubMed Identifier
19797376
Citation
Ngo VK, Asarnow JR, Lange J, Jaycox LH, Rea MM, Landon C, Tang L, Miranda J. Outcomes for youths from racial-ethnic minority groups in a quality improvement intervention for depression treatment. Psychiatr Serv. 2009 Oct;60(10):1357-64. doi: 10.1176/ps.2009.60.10.1357.
Results Reference
result
PubMed Identifier
18937226
Citation
Tang L, Duan N, Klap R, Asarnow JR, Belin TR. Applying permutation tests with adjustment for covariates and attrition weights to randomized trials of health-services interventions. Stat Med. 2009 Jan 15;28(1):65-74. doi: 10.1002/sim.3453.
Results Reference
result
PubMed Identifier
18018807
Citation
Goldstein RB, Asarnow JR, Jaycox LH, Shoptaw S, Murray PJ. Correlates of "non-problematic" and "problematic" substance use among depressed adolescents in primary care. J Addict Dis. 2007;26(3):39-52. doi: 10.1300/J069v26n03_05.
Results Reference
result
PubMed Identifier
17658983
Citation
Fordwood SR, Asarnow JR, Huizar DP, Reise SP. Suicide attempts among depressed adolescents in primary care. J Clin Child Adolesc Psychol. 2007 Jul-Sep;36(3):392-404. doi: 10.1080/15374410701444355.
Results Reference
result

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Youth Partners in Care: Depression and Quality Improvement

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