Remote Supervision for Implementing Collaborative Care for Perinatal Depression (MInD-I)
|Perinatal Depression||Other: Longitudinal Remote Consultation Other: Collaborative Care|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Remote Supervision for Implementing Collaborative Care for Perinatal Depression|
- Clinical depression outcomes [ Time Frame: 12 months post-initiation of collaborative care ]Patient Health Questionnaire-9 (PHQ-9); level of depression symptomatology and functional impairment
- Implementation Outcomes [ Time Frame: 12 month post implementation of collaborative care ]To assess the degree to which sites in the two conditions complete implementation we will use the Stages of Implementation Completion tool tailored for collaborative care, SIC-CC
- Cost and cost-effectiveness [ Time Frame: 12-month post-implementation of collaborative care ]For a cost-benefit analysis, we will use of the Cost of Implementing New Strategies (COINS) method to assess costs in the two conditions. This methodology takes advantage of the SIC-CC instrument as a costing template to map the use of resources and associated costs to these to study conditions. Costs associated with implementation in each of these conditions will be carried out for all 20 health centers included in the study.
|Study Start Date:||January 2017|
|Estimated Study Completion Date:||March 2021|
|Estimated Primary Completion Date:||June 2020 (Final data collection date for primary outcome measure)|
Experimental: Longitudinal Remote Consultation
This is the active treatment arm consisting of 10 cluster randomized federally qualified health centers receiving both training in collaborative care and longitudinal remote consultation (LRC) support.
Other: Longitudinal Remote Consultation
Longitudinal Remote Consultation utilizes video conferencing to efficiently link providers to consultants who provide timely feedback and training in collaborative care. LRC will be provided in addition to standard collaborative care training and support
Other Name: LRC
Active Comparator: Collaborative Care
This comparator arm will consist of 10 cluster randomized federally qualified health centers who receive training in collaborative care.
Other: Collaborative Care
Standard collaborative care implementation training and support
Other Name: CC
Depression is a common and serious disorder among pregnant women but few from low income groups receive effective treatment. The highly evidence based collaborative care (CC) model for depression has been shown to work for women in pregnancy but has not been widely implemented in this population. The proposed study targets improving dissemination of the evidence based CC treatment model for pregnant and postpartum women with depression, a common disorder of the perinatal period (pregnancy and the first year following birth). Longitudinal remote consultation (LRC) is an implementation strategy that has been have shown to improve fidelity to evidence-based practices and patient outcomes for mental health innovations. We believe LRC can be used with equal benefit for complex interventions such as CC.
The purpose of this study is to compare two implementation strategies for Collaborative Care depression treatment: 1) standard implementation and 2) standard implementation + Longitudinal Remote Consultation (LRC). This research is being done in order to assess implementation and patient outcomes in sites receiving a standard implementation approach with and without LRC. The results of the proposed study will provide information on the benefits and relative value of ongoing consultation, such as LRC, for implementation of complex interventions like collaborative care.
The proposed study will involve twenty federally qualified health centers (FQHCs) providing prenatal care and which are part of the national OCHIN Network. All sites will receive a standard implementation approach. After pre-implementation training ten of the sites will be randomly selected to receive LRC. Implementation and clinical outcomes as well as costs will be compared between the study conditions after a 12 month implementation period and a 13-21 month sustainment period. The results of the proposed study will provide critical generalizable knowledge regarding the benefits of ongoing consultation for implementation of complex interventions like collaborative care.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02976025
|Contact: Perry Foleyfirstname.lastname@example.org|
|Principal Investigator:||Ian Bennett||University of Washington|