Child360/ Center for Innovative Child Health Systems (CICHS)

Dr. Benjamin W. Van Voorhees developed CATCH-IT (Competent Adulthood Transition with Cognitive, Humanistic, and Interpersonal Training), a primary care/internet-based adolescent-depression-prevention intervention in 2002 (N=14), and obtained funding (Centers for Disease Control) for and completed Phase 1 (Centers for Disease control, 2002-2004), Phase 2 multi-site dose/feasibility randomized clinical trials (K-08, NARSAD and RWJ Foundation support, N=83,2006-2011), Phase 3 (NIMH RO-1, N=369, 2011-2018) and Phase 4 (PCORI, 2019-2027, NIMH, 2020-2025, PCORI 2022-2028). This intervention-development has been supplemented by additional work, including the development of ethnically adapted versions of CATCH-IT: Chicago Urban Resiliency Building, (CURB, RWJ Foundation, 2010-2013), Chinese youth “Grasp the Opportunity” (Hong Kong Jockey Club, 2011-2014, phase 3 clinical trial completed), mainline China (trial under way), Arabic (clinical trial underway) and French versions (under development). Dr. Van Voorhees also worked to develop peer-to-peer support and successfully conducted a randomized clinical trial (“Psychobabble,” adapted to primary care, NIMH R-34, 2007-2010, Vets Prevail, 2008-20011). Additional work has included implementation, epidemiology and case studies supporting the development of scalable depression-prevention models in health systems and community settings.

September 2014, 1C1CMS331342-01-00 (Healthcare Innovation Award, Coordination of Healthcare for Complex Kids, $19,500,000, Dr. Benjamin Van Voorhees, Project Director). This project includes a multi-channel approach to reduce costs and improve outcomes in children and emerging adults with chronic diseases. The project eventually incorporated risk stratification and attempted to contact more than 17,000 children, enrolled more than6,300, and provided more than  230,000 services over four years using both technology and human contact.

• Clinical trials sponsored: Dr. Calvin Rusiewski
• Culture, Community and Health: Dr. Kristen Kenan, Ms. Shion Kabasele
• Clinical epidemiology: Dr. Benjamin Van Voorhees
• International Post-Doctoral Fellows: Dr. Fernando Morschel
• US Post-Doctoral Fellows: Pending

Led by Kristen Kenan, MD, MPH, the YOU Matter Lab focuses on improving mental-health outcomes for Black and Latin adolescents through socioecological, culturally grounded, and youth-centered research. The Lab examines how multilevel stressors and protective factors shape depression risk, using mixed-methods approaches and teen–caregiver partnerships to generate actionable insights. Current projects—including YOU Matter and YOU Matter: Disrupted Pathways—advance understanding of racialized stress, resilience, and prevention opportunities. The Lab also produces the YOU Matter Newsletter, a quarterly, plain-language resource co-developed with teens and caregivers to connect families with community support and share research updates.

• Aligned with CICHS, the YOU Matter Lab contributes to:
• CARE: developing community-responsive models to address adolescent mental health.
• LEARN: engaging youth, caregivers, and trainees in collaborative inquiry.
• INNOVATE: building scalable socioecological tools that can inform precision-prevention and digital interventions.

The Lab’s work reflects CICHS’ mission to translate science into equitable, practical strategies that improve long-term outcomes for underserved youth and families.

B.E.S.T. is a Patient Centered Outcomes Research Institute-funded (AD-2020C3-21046), two-arm, randomized clinical trial seeking to examine the impact of care coordination models on the depressive and anxiety symptomology and transition outcomes of youth with intellectual and developmental disabilities (IDD). We want to understand if a care-coordination model that includes integrated mental health programming is better at supporting youth with IDD in feeling healthier and happier than existing care-coordination models that provide youth with IDD and referrals to outside mental health, as needed. B.E.S.T. seeks to recruit 780 youth with IDD, ages 13-20 years, who currently received care-coordination services by 2026. As of May 2024, 269 youth with IDD have been enrolled in the study.

• Read More about BEST Study

Pathway is a NIMH-funded (1R01MH124723-01), multiphase-optimization-strategy (MOST) clinical trial seeking to optimize Competent Adulthood Transition with Cognitive Behavioral, Humanistic, and Interpersonal Training (CATCH-IT) for the prevention of depression in adolescents. While previous studies in the United States and China have been able to demonstrate effectiveness for CATCH-IT, we have encountered tolerability and scalability issues. We will use the MOST design to help prepare CATCH-IT for implementation studies and dissemination. We will be able to identify and eliminate non-contributing factors, while maintaining efficacy and strengthening tolerability and scalability. Pathway seeks to recruit 400 adolescents with mild-moderate symptoms of depressed mood, ages 13-18, by winter of 2024. As of October 2025, we have successfully concluded recruitment, with 400 adolescent participants enrolled.

• Learn more about the Pathway study

PATH 2 Purpose is a Patient Centered Outcomes Research Institute-funded (IHS-2017C3-9333), two-armed, comparative-effectiveness-randomized-control trial, evaluating the efficacy of two interventions: Teens Achieving Mastery over Stress (TEAMS) and Competent Adulthood Transition with Cognitive Behavioral, Humanistic, and Interpersonal Training (CATCH-IT). We are seeking to compare these two interventions early to prevent depressive illness and, potentially, other common mental health disorders. If effective, CATCH-IT will provide a scalable, culturally acceptable, low-cost preventive intervention for mood disorders in adolescents, allowing health care providers to shift from a “wait until sick enough for treatment” model to a preventative model. PATH 2 Purpose seeks to recruit 634 adolescents with mild to moderate symptoms of depressed mood in the 13-19 age range.  Recruitment was concluded in September 2025 with 636 adolescent participants enrolled.

• Learn more about the Path 2 Purpose

Developing new interventions that incorporate the “diverse needs and circumstances of people with mental illness” – particularly in primary care and community settings – was a key NIMH strategic objective. Prevention of mental disorders had become a priority for the NIMH, which emphasizes the importance of developing “new and better interventions” to “…preempt the occurrence of disease.” These interventions were to (1) work in multiple and diverse settings (e.g. primary care); (2) be suitable for delivery outside of traditional mental health systems; (3) use new technologies; (4) build on previous clinical trials; (5) reduce identified disorders/enhance functional outcomes; (6) include families; and (7) be tailored to the individual. Despite these NIMH guidelines – with primary care physicians remaining the first line providers for at-risk adolescents – there was no widely available, low-cost and culturally acceptable preventive approach that targets depression in primary care settings.

To address this gap and specified NIMH priority, Dr. Van Voorhees developed and conducted a Phase 2 clinical trial of a primary care, Internet-based, depression-prevention intervention (CATCH-IT, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training). In this study, the high-intensity arm (i.e., motivational interview + internet site referral) demonstrated significant reductions in depressed mood and increases in protective factors (social support, motivation) and lower incidence of depressive episodes over 12 months (7% versus 28%), compared with the low-intensity arm (physician brief advice + internet site referral + ).

We now propose the next step study, a Phase 3 efficacy study. In this 4-year, two-site randomized clinical trial, we propose to test the efficacy of the CATCH-IT primary care, Internet-based, depression-prevention intervention against an Active Monitoring Psych-education (AMPE) treatment in preventing the onset of depressive episodes in an intermediate to high-risk group of adolescents ages 13-18. We plan to (a) identify high-risk adolescents based on elevated scores on the PHQ-A, a screening measure of depressive symptoms; (b) recruit 400 (200 per site) of these at-risk adolescents to be randomized in either the CATCH-IT or the AMPE group; (c) assess outcomes at 2, 8, 12, 18, and 24 months post-intake on measures of depressive symptoms, depressive diagnoses, other mental disorders, and on measures of role impairment in education, quality of life, attainment of educational milestones, and family functioning; and (d) conduct exploratory analyses to examine the effectiveness of this intervention program, moderators of protection, and potential ethnic and cultural differences in intervention response.

CHECK was designed as a model that improves care for populations with specialized needs, with a focus on the specific priority area of high-cost pediatric and young-adult populations. In addition, CHECK was designed to fit with a second Innovation category: models that test approaches for specific types of providers to transform their financial and clinical models (primarily pediatric providers who provide services to children with complex medical needs).

• Proposal goals:
  Our proposal aims were specified in the supplemental materials: 1) to reduce both inpatient admissions and emergency room visits, 2) to reduce missed school days and, 3) to increase patient satisfaction, activation, and engagement. By implementing early intervention approaches that focus on the prevention of disease and the preemption of exacerbations of chronic disease (Aim 1), we aimed to reduce hospital admissions and emergency room visits, garnering significant cost savings. CHECK’s cost savings were to pay for themselves while also yielding savings for the Medicaid agency. Over and above these benefits, CHECK was to improve patients’ overall health while also reducing missed school days and strengthening current and future productivity and quality of life (Aim 2). Aim 3 focused on building a population of satisfied, connected, engaged and activated patients who will experience greater health and well-being now and in the future, potentially reducing future healthcare costs.
• Target Population:
  Our target population was children and young adults with chronic health conditions. This was defined as patients under age 25 years who have either 1) a specific diagnosis of asthma, diabetes mellitus, sickle cell disease, or depression, or 2) two or more ongoing conditions from the following list: infectious diseases, diabetes mellitus, disorders of metabolism, sickle cell, splenic sequestration, depressive disorder, developmental delays, epilepsy, asthma, acute chest syndrome, intestinal malabsorption, other congenital anomalies of the heart, cleft palate, or perinatal disorders of the digestive system. The four specific targeted conditions were selected because of their prevalence in the population (including asthma, diabetes, and depression) or their complexity and cost (sickle cell), as well as the capacity and expertise within UI Health to address these conditions.

The 14 additional conditions were selected because internal data analysis had demonstrated that these were the most expensive disorders among this patient cohort (resulting from higher hospital admission and emergency room visit rates). We had expanded the age range to 25 years to include young adults with chronic diseases as this allows the case coordination to focus on improving the transition process for adolescents and young adults with special healthcare needs, a particularly disenfranchised population in Chicago (17% of young adult population). This transitional period proved critical in establishing patient use behaviors, and indeed effective health care during the transition to adulthood is essential for future health and productivity outcomes, including stable workforce participation, family formation, education, and peer relationships.

• Number of beneficiaries served:
  We proposed to enroll 6,000 Cook County children and young adults in the CHECK program to have a real, measurable impact on pediatric health in our region.
• Number of participating providers:
  Including our FQHC partners, our network included about 250 total providers.

Summary: TIKES will create a unified system of clinical care, education and research focused on maximizing healthy developmental progress and social capital formation for the children in the state of Illinois. TIKES will be the medical home model that harnesses the power of information technology to identify and then deploy interventions to assist families and children at-risk for diminished social capital and thus at risk for future health and educational disparities. Building on existing cultural and family strengths, TIKES will be longitudinal, developmentally focused, cost-effective, and culturally relevant. Advances in research, generated by already funded grants (Table 1) and future funded projects (potential collaborators, Table 2), will accelerate improvements in practice and create new opportunities for undergraduate and graduate medical education (Timeline Table 3 below, page 12; Table 4, page 14, provides summary of resources needed to execute this vision).

Key Goals Summary

(Timeline Table 3 below, Years 1-5): A TIKES Research Center focused on increasing social capital and reducing disparities in health and educational outcomes will be established. The Center will house research program collaborations and supporting database analytics for the medical home. Research will be conducted using clinical trials, public-use data sets, and data mining of existing clinical data in electronic medical records to evaluate risk stratification and intervention strategies that enhance social-capital formation and reduce health and educational disparities. Recruited faculty will be closely related to social-capital formation and disparities-reduction in areas such as obesity prevention, developmental delay, attention deficit treatment, effective parenting, oppositional defiant behavior prevention, and medical home model implementation.

A TIKES medical home model will be built as a program of excellence for Illinois Health Connect. The model will Increase covered lives by 100% and outpatient visits by 60%. The model will implement key components of medical-home-model-dependent information technology (patient registry and tracking, care management, and quality improvement) as a medical-home demonstration project for Illinois Health Connect. TIKES-related educational programs will be established for all levels of trainees to gain experience with technology, the medical home model, database analysis, and research to develop medical home/social capital disparities-focused programming, including related quality improvement and intervention projects for resident and summer medical student research internships.

The abilities and skills developed over childhood and adolescence are critical at reducing health and educational disparities. Unfortunately, social capital may be lost and disparities actually engendered when children experience sub-optimal developmental progress across time. Children, families, and communities experience this ‘lost” social capital in the form of poverty, early school leaving, lost productivity and wages, poor health, and problems with family formation. Preventable problems in key developmental domains of (1) general health, such as vaccination adherence, obesity prevention and treatment, and sexually transmitted diseases, (2) cognitive and academic delay because of learning disorders and attentional deficits, (3) relational-emotional consequences of neglect and abuse and associated depression and anxiety, and (4) conduct or civic disorders associated with delinquency or oppositional-defiant disorder often result in lost social capital and increased disparities. The current episode-of-care focused pediatric practice has limited the impact of pediatric practice on these key developmental domains. To address these limitations, the medical-home model seeks to integrate several functions, including patient registry and tracking, care management, and quality improvement into routine practice. Thus, the medical-home model will perform essential functions such as risk stratification and early intervention to change developmental trajectories. Consequently, a data-driven medical-home model offers the prospect of intervening during key periods of development to improve outcomes. Unfortunately, no such model currently exists in general pediatric care.

TIKES will leverage progress in health services research, from the medical-home model to information technology, to promote major improvements in child health and advances in disparities research.  TIKES will be (1) longitudinal, (2) developmentally focused, (3) cost-effective and (4) culturally relevant, building on existing cultural and family strengths to address key barriers and optimize developmental progress. Specifically, a longitudinal approach is necessary to move beyond an episode-based treatment-care system to one that tracks progress across time and predicts future risk. Developmental surveillance employed with the best tools available will be used to gather data across time and in all of the developmental domains. TIKES will track milestone achievement within developmental pathways across time as the critical goal. Given the cost pressures on the health care system, TIKES will make use of safe, low-cost, and technology-delivered interventions to advance developmental progress. Where useful, TIKES will deploy and develop/adapt interventions that are both culturally relevant and also harness existing family and community strengths to effect behavioral change, using a patient tracking/registry, care management, and quality improvement methods. The TIKES medical-home model will link research to clinical practice.

TIKES will address the need for an interdisciplinary effort focused on the development, implementation, and evaluation of strategies and interventions to optimize social-capital formation from fetal life to emerging adulthood. TIKES will focus on the high-value domains of: (1) general health (vaccination adherence, obesity and sexually transmitted disease), (2) cognitive/academic (delay/learning disorders/attention), (3) relational-emotional (neglect, abuse and depression/anxiety) and (4) conduct/civic (delinquency/oppositional defiant). TIKES will be composed of clinical, educational, research and economic development functions that relate directly to the core missions of the College of Medicine.