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- Title
An Integrated Care Pathway for depression in adolescents: protocol for a Type 1 Hybrid Effectiveness-implementation, Non-randomized, Cluster Controlled Trial.
- Authors
Courtney, Darren B.; Barwick, Melanie; Amani, Bahar; Greenblatt, Andrea T.; Aitken, Madison; Krause, Karolin R.; Andrade, Brendan F.; Bennett, Kathryn; Cleverley, Kristin; Uliaszek, Amanda A.; de Oliveira, Claire; Hawke, Lisa D.; Henderson, Jo; Wang, Wei; Watson, Priya; Gajaria, Amy; Newton, Amanda S.; Ameis, Stephanie; Relihan, Jacqueline; Prebeg, Matthew
- Abstract
Introduction: Our group developed an Integrated Care Pathway to facilitate the delivery of evidence-based care for adolescents experiencing depression called CARIBOU-2 (Care for Adolescents who Receive Information 'Bout OUtcomes, 2nd iteration). The core pathway components are assessment, psychoeducation, psychotherapy options, medication options, caregiver support, measurement-based care team reviews and graduation. We aim to test the clinical and implementation effectiveness of the CARIBOU-2 pathway relative to treatment-as-usual (TAU) in community mental health settings. Methods and analysis: We will use a Type 1 Hybrid Effectiveness-Implementation, Non-randomized Cluster Controlled Trial Design. Primary participants will be adolescents (planned n = 300, aged 13–18 years) with depressive symptoms, presenting to one of six community mental health agencies. All sites will begin in the TAU condition and transition to the CARIBOU-2 intervention after enrolling 25 adolescents. The primary clinical outcome is the rate of change of depressive symptoms from baseline to the 24-week endpoint using the Childhood Depression Rating Scale—Revised (CDRS-R). Generalized mixed effects modelling will be conducted to compare this outcome between intervention types. Our primary hypothesis is that there will be a greater rate of reduction in depressive symptoms in the group receiving the CARIBOU-2 intervention relative to TAU over 24 weeks as per the CDRS-R. Implementation outcomes will also be examined, including clinician fidelity to the pathway and its components, and cost-effectiveness. Ethics and dissemination: Research ethics board approvals have been obtained. Should our results support our hypotheses, systematic implementation of the CARIBOU-2 intervention in other community mental health agencies would be indicated.
- Subjects
DEPRESSION in adolescence; INTEGRATIVE medicine; INSTITUTIONAL review boards; CAREGIVERS; MENTAL depression; PSYCHOACOUSTICS; EVIDENCE-based psychotherapy
- Publication
BMC Psychiatry, 2024, Vol 24, Issue 1, p1
- ISSN
1471-244X
- Publication type
Article
- DOI
10.1186/s12888-023-05297-4