Primary Care Internet-Based Depression Prevention for Adolescents (CATCH-IT)

Summary

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.

Conditions

• Depression
• Anxiety
• Externalizing Symptoms
• Substance Abuse

Interventions

BEHAVIORAL

CATCH-IT

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).

BEHAVIORAL

AMPE

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.

Sponsors & Collaborators

• Harvard Vanguard Medical Associates

  collaborator OTHER

• University of Chicago

  lead OTHER

Principal Investigators

• Benjamin Van Voorhees, MD · University of Chicago

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

13 Years

Max Age

17 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2010-09-30

Primary Completion

2011-04-30

Completion

2011-04-30

Countries

• United States

Study Locations