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

Agency for Healthcare Research and Quality (AHRQ)

Status: Completed

Conditions: Depression

Treatments: Other: Quality Improvement (QI) for depression; Other: Usual Care

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT02030782

HS009908

Details and patient eligibility

About

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.

Enrollment: 418 patients

Sex: All

Ages: 13 to 21 years old

Volunteers: No 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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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418 participants in 2 patient groups

Usual Care

Active Comparator group

Description:

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

Treatment:

Other: Usual Care

Quality Improvement for Depression

Experimental group

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.

Treatment:

Other: Quality Improvement (QI) for depression