Internet-Based Depression Education for Minority Youth
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University of Illinois at Chicago
Chicago
Depression
FQHCs, school-based health centers and community clinics
African Americans, Latinos |
PROJECT
Patients receive motivational interviews and an Internet-based depression-prevention training program.
African American and Latino youth who show high risk for depressive disorders receive a series of in-person motivational interviews, and are enrolled in an Internet-based self-directed training program. This program includes learning and behavior-change strategies to reduce risk factors for depression, and to increase factors that promote resiliency against depressive symptoms. Components of the program are aimed at the adolescent patients as well as their parents. The program includes exercises that the patient can complete online and print out for later review. Patients also receive telephone coaching to encourage them to complete the training program and its suggested behavior changes. Participating sites include Federally Qualified Health Centers (FQHCs), school-based clinics and community-based clinics.
RATIONALE
Though depression is relatively common and efficacious treatments are available, adolescent patients show low rates of care-seeking, receiving high-quality care, and completing referrals for psychotherapy. As depression has long-term negative health outcomes, prevention of depression may be more cost-effective and less distressing than treatment of a full depressive episode.
This study uses motivational interviewing to engage youth and promote adherence to the Internet-based multimedia component, which targets both adolescents and parents. The prevention program has the potential to reduce both risk factors for a future depressive episode and actual depression incidence, and to enhance resiliency as well as functional outcomes. The training program is tailored to be ethnically and culturally appropriate, and incorporates a variety of learning strategies to improve the acceptance of the information provided. Telephone coaching calls are designed to increase adherence to the prevention training program.
EVALUATION PLAN
Funded by Finding Answers in 2010.
Researchers are conducting a randomized controlled trial: patients are placed in either the intervention group, or a wait-list control group. Patients in the intervention group are receiving motivational interviewing, the Internet training program, and telephone coaching. Wait-list patients are being delayed by four months, before they receive the same intervention. Both groups are being compared to the wait-listed patients during the four-month interval before intervention.
Patient-level outcome measures will include: levels of depressive symptoms, risk for depressive disorder, functional status, and number of depressive episodes. Additionally, the feasibility of larger-scale implementation and its potential public health impact is being evaluated. A cost-benefit analysis is being conducted to inform future intervention efforts. Costs associated with psychiatric illness are being compared to the costs of providing the intervention in order to determine cost effectiveness.
Principal Investigators:
- Karen Taylor-Crawford, MD (Professor of Psychiatry, University of Illinois at Chicago)
- Jennifer C. Froemel, MA, LCPC (Child and Adolescent Program Director, Family Service of Cicero)
- Henry Taylor, MPA (Executive Director, Mile Square Health Center)
- Ben Van Voorhees, MD, MPH (Assistant Professor of Medicine, University of Chicago)
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