Primary Care Internet-Based Depression Prevention for Adolescents (CATCH-IT)
In this 5-year, two-site randomized clinical trial, we propose to test the efficacy of the CATCH-IT primary care/Internet based depression prevention intervention against Attention Monitoring Psychoeducation (AMPE) in preventing the onset of depressive episodes in an intermediate to high risk group of adolescents aged 13-17. 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 into 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.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Treatment
|Official Title:||Primary Care Internet-Based Depression Prevention for Adolescents (CATCH-IT)|
- To determine whether the CATCH-IT 2-R depression prevention intervention prevents or delays major depressive episodes, as well as non-affective disorder episodes, compared to AMPE. [ Time Frame: 49-60 months from beginning of trial ] [ Designated as safety issue: No ]
- To determine if participants in the CATCH-IT 2-R group exhibit more rapid favorable changes of depressive symptoms/and or vulnerability/protective factors compared with the AMPE group. [ Time Frame: 49-60 months from beginning of the trial ] [ Designated as safety issue: No ]
- To determine if participants in the CATCH-IT 2-R program report lower perceived educational impairment, greater quality of life, greater health-related quality of life, and lower incidence of other mental disorders (anxiety, substance/alcohol use). [ Time Frame: 49-60 months from beginning of trial ] [ Designated as safety issue: No ]
- To determine for whom (moderators) and how (mediators) the CATCH-IT 2-R program works in this population. [ Time Frame: 49-60 months from beginning of trial ] [ Designated as safety issue: No ]
|Study Start Date:||September 2010|
|Study Completion Date:||April 2011|
|Primary Completion Date:||April 2011 (Final data collection date for primary outcome measure)|
Experimental: CATCH-IT 2-R Arm
Primary care/Internet based depression prevention intervention (CATCH-IT 2-R) with a family component.
The CATCH-IT 2-R intervention has a motivational (3 PCP motivational interviews at time 0, 1.5 months and 12 months and 3 coaching phone calls at 2 and 4 weeks and 18 months) and an Internet component (with separate adolescent [14 modules] and parent [5 modules] programs). This revised and expanded intervention will include a comprehensive approach to reducing modifiable risk factors and enhancing resiliency factors associated with increased or decreased risk of depression, respectively, proposed by Spence and Reinecke.148 The revised CATCH-IT "Tracker" will monitor time in study and deploy elements of the intervention based on time since enrollment, including computer and human elements (e.g. calls, doctor visits).
|Active Comparator: Attention Monitoring Psycho-education (AMPE) Arm||
The AMPE components are similar to those employed in previous primary care based quality improvement/Chronic Care Model Interventions (patient education [psycho-education described below], provider training [described in Case Finding and Recruitment], active monitoring and referral [case management, discussed under assessments], physician and nurse education and routine contact with PCP [study design rationale]). This Internet site will focus on assisting parents and adolescents in early identification of need for treatment and will also target stigma and negative attitudes toward treatment of mental disorders we have previously identified as barriers to seeking and adhering to treatment.
|United States, Illinois|
|University of Chicago|
|Chicago, Illinois, United States, 60637|
|Access Community Health Network|
|Chicago, Illinois, United States|
|Northshore University Health Systems|
|Evanston, Illinois, United States|
|United States, Massachusetts|
|Harvard Vanguard Medical Associates|
|Boston, Massachusetts, United States|
|Principal Investigator:||Benjamin Van Voorhees, MD||University of Chicago|