Depression Screening in Primary Care: Using HIT for Patients With Limited English

NCT03191929 | Completed

• 1 other identifier: 2011-8343
• Study Type: interventional
• Target: 410
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study assessed the potential of Health Information Technology (HIT) to improve the screening, diagnosis, and treatment of depression and post-traumatic stress among LEP Southeast Asians. Should this intervention be found to be effective, the principles of the HIT technology could be easily adapted for screening in other languages to increase the recognition and treatment of depression and PTSD in primary care settings.

Conditions

Depression; Post-Traumatic Stress Disorder

Keywords

Depression; Post-traumatic Stress Disorder; Health Information Technology (HIT); Primary Care Provider; Mental Health Screening

Outcome Measures

Primary Outcomes (1)

• Appropriate clinical detection of depression and/or PTSD

  The appropriate presence or absence of provider diagnosis of depression and/or PTSD in the patient electronic medical record.

  12 weeks

Secondary Outcomes (6)

• Provider initiation of guideline mental health treatment and trauma informed care

  12 weeks

• Patient outcomes (at 12 weeks post-baseline visit) for depression and/or PTSD

  12 weeks

• Patients' evaluation of the overall quality of care

  12 weeks

• Patients' level of involvement in decision-making related to their care

  12 weeks

• Patients' trust in their provider

  12 weeks

Study Arms (2)

HIT Intervention Arm

EXPERIMENTAL

The Health Information Technology Intervention Study Arm consisted of: 1) web-based tutorial on delivering trauma-informed care, 2) Multi-media mental health risk assessment, 3) Immediate provider notification, which included flagging patients' scores that met criteria for symptoms of depression and/or PTSD, 4) subsequent integration into the patient electronic medical record, and 5) Clinical decision support adapted from the Harvard Program in Refugee Trauma.

Other: HIT Intervention

Minimal Intervention Control Arm

ACTIVE COMPARATOR

The Minimal Intervention Control Arm consisted of: 1) web-based tutorial on delivering culturally competent health care in general, 2) Multi-media mental health risk assessment, 3) Provider notification only in the event that patients' scores evidenced symptoms of being at risk to harm either themselves or others.

Other: Minimal Intervention Control Arm

Interventions

HIT Intervention OTHER

Patients in the HIT intervention completed a multi-media, culturally adapted, mental health risk assessment tool in their preferred language prior to their baseline health care visit with their primary care provider. Patients' scores were transmitted to the provider prior to their clinic visit. Providers in the HIT intervention received a web-based training developed by the Harvard Program in Refugee Trauma to train providers in delivering culturally competent, trauma-informed care to address mental health problems and other trauma-related medical issues in patients who experienced extreme war trauma. Providers also received ongoing clinical decision support through a mobile application to support the diagnosis and initiation of treatment for depression and/or PTSD.

HIT Intervention Arm

Minimal Intervention Control Arm OTHER

Patients in the Minimal Intervention Control Arm completed a multi-media, culturally adapted, mental health risk assessment tool in their preferred language prior to their baseline health care visit with their primary care provider; however, patients' scores in the Minimal Intervention Control Arm were only transmitted to the provider prior to their clinic visit if they showed evidence of being at risk to harm either themselves or others. Providers in the Minimal Intervention Control Arm completed the online tutorial, "A physician's practical guide to culturally competent care," which was provided by The Office of Minority Health, US Department of Health and Human Services Website.

Minimal Intervention Control Arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Cambodian patients over age 18 were included.

You may not qualify if:

• Patients with severe visual/hearing impairments, major psychiatric disorders such as bipolar disorder or schizophrenia, and/or life-threatening illness, which limited their ability to consent to the study were excluded.

Sponsors & Collaborators

• Dara Sorkin: lead

Related Publications (1)

• Sorkin DH, Rizzo S, Biegler K, Sim SE, Nicholas E, Chandler M, Ngo-Metzger Q, Paigne K, Nguyen DV, Mollica R. Novel Health Information Technology to Aid Provider Recognition and Treatment of Major Depressive Disorder and Posttraumatic Stress Disorder in Primary Care. Med Care. 2019 Jun;57 Suppl 6 Suppl 2(Suppl 6 2):S190-S196. doi: 10.1097/MLR.0000000000001036.

  PMID: 31095060 DERIVED

MeSH Terms

Conditions

Depression; Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Officials

• Dara H. Sorkin, Ph.D.

  University of California, Irvine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: June 9, 2017
• First Posted: June 19, 2017
• Study Start: August 1, 2011
• Primary Completion: June 1, 2015
• Study Completion: June 1, 2015
• Last Updated: July 3, 2023

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share