PATH 2 Purpose

Primary Care and Community-Based Prevention of Mental Disorders in Adolescents

WHY IS THIS STUDY IMPORTANT?

The Intervention Programs

POD

The Prevention of Depression (POD) intervention is an 8-session, group depression prevention program teaching teens how to deal with stress and negative moods, and ways to manage low mood based on cognitive behavioral therapy (CBT) principles and strategies. Efficacy has been demonstrated by several trials over time. These groups have been shown to be effective in preventing depression in several research studies.

CATCH-IT

Competent Adulthood Transition with Cognitive-behavioral & Interpersonal Training (CATCH-IT) is an internet-based depression prevention program that targets decreasing modifiable risk factors while enhancing protective factors in at-risk adolescents, and that includes a parent program.  It has been shown to be safe, feasible, and efficacious.

Study Aims

  • Aim 1: Evaluate the willingness and ability of our community partners to implement two depression early intervention/prevention models in primary care: POD and CATCH-IT
  • Aim 2: Evaluate the efficacy of each intervention in decreasing symptoms of depression in adolescents ages 13-19 identified through primary care, and decrease the percentage of individuals falling above an accepted clinical diagnostic threshold on the scales that measure these illnesses.
  • Aim 3: Evaluate the comparative effectiveness of each intervention for African Americans, Latinos, sexual/gender minority youth, males and females, rural youth and for individuals above and below the accepted diagnostic thresholds for these illnesses.
  • Secondary Aim 1: Evaluate the efficacy of each intervention in decreasing symptoms of substance abuse, anxiety disorder, and conduct disorders in adolescents ages 13-19.
  • Secondary Aim 2: Examine possible mediators and moderators of intervention response, including demographic variables, family history, treatment expectations, life events, and trauma history.

Study Design:

The study is a two-arm comparative effectiveness research trial to that will evaluate the ability of the interventions, POD and CATCH-IT, to intervene early to prevent depressive illness, accessibility, time commitment, cultural acceptability, and implementation costs. Using cluster randomization, 564 Participants eligible for the study will be offered one of two different depression prevention programs in multiple sites in Chicagoland, Rockford, IL; Dixon, IL; and Louisville, KY. The study will also assess teens’, parents’ and providers’ experiences with each intervention approach.

Inclusion: Who is eligible?

Adolescents ages 13-19 years, all genders, English speaking, and have elevated symptoms of depression, or depression and anxiety, as indicated by PHQ-9 score. Recruitment sites will be diverse in socio-economic status and racial/ethnic representation.

Exclusion: Who is ineligible?

Adolescents who currently use psychotropic medication, medication or therapy for depression or bipolar affective disorder, are currently experiencing psychosis or extreme substance abuse, read below a fifth grade level, or have a developmental disorder. Teens will be screened for participation at the recruitment site and/or can contact the study call center directly.

This study is funded by:

Patient-Centered Outcomes Research Institute (www.pcori.org)

OUR TEAM

Principal Investigators:

Benjamin VanVoorhees, MD, MPH, Department of Pediatrics, UI Health; bvanvoor@uic.edu

Tracy Gladstone, PhD, Wellesley University, tgladsto@wellesley.edu

 

Project Director:

Rebecca Feinstein, MPH, MSW, PhD, Department of Pediatrics, UI Health, rfeinst@uic.edu

 

Co-Investigator Partners:

University of IL, Chicago

Melishia Bansa, MPH, bansa@uic.edu

Mike Berbaum, PhD, mberbaum@uic.edu

Jon Klein, MD, MPH, jonklein@uic.edu

Daniela Terrizzi, PhD, RN, ddefrino@uic.edu

University of IL, Rockford (rockford.medicine.uic.edu)

John Plescia, MD, plescia@uic.edu

Michael Glasser, PhD, michaelg@uic.edu

Katherine Shaw Bethea Hospital, Dixon, IL (ksbhospital.com)

Pratip Nag, MD, PhD, pnag@ksbhospital.com

University of Louisville, KY (http://louisville.edu/education)

Patrick Pössel, PhD, Patrick.possel@louisville.edu

Advocate Health Care (www.advocatehealth.com)

Cheryl LeFavier PhD, RN, CCRP, Cheryl.lefaiver@advocatehealth.com

Cathy Joyce, MD, cathy.joyce@advocatehealth.com

Jericho Walk Chicago (www.jerichowalk.com)

Bishop Connie Bansa and Sabrina King