Enhancing Systems of Care: Supporting Families and Improving Youth Outcomes

NCT03637478 | Completed

• 1 other identifier: CHR-IRB-1062/04/17
• Study Type: interventional
• Target: 171
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to improve access to child mental health and substance abuse (MH/SA) care by expanding primary care screening and increasing availability of timely mental health evaluation and treatment.

Conditions

Pediatric Mental Health Services

Outcome Measures

Primary Outcomes (2)

• Access to child mental health and substance abuse (MH/SA) care

  Service Use Data from Electronic Health Records and Claims for intervention group versus controls

  Comparative analysis of access to care trends (0-6 months)

• Engagement in child mental health and substance abuse (MH/SA) treatment

  Service Use Data from Electronic Health Records and Claims for intervention group versus controls

  Comparative analysis of service use trends (6-12 months)

Secondary Outcomes (3)

• Family Care Experience

  Analysis of baseline and follow-up family perceptions of care (baseline collected at enrollment, follow-up assessments collected at 6 months and 12 months)

• Changes in Children's Global Assessment Scale (CGAS) Score

  Comparative analysis of baseline and follow-up clinical functioning scores (baseline collected at enrollment, follow-up assessments collected at 6 months and 12 months)

• Changes in Child and Adolescent Functional Assessment Scale (CAFAS) Score

  Comparative analysis of baseline and follow-up clinical functioning scores (baseline collected at enrollment, follow-up assessments collected at 6 months and 12 months)

Study Arms (1)

Enhanced Systems of Care Team

EXPERIMENTAL

The four intervention sites have been selected based on their size: taken together, their pediatric populations comprise over 80% of the total number of children receiving care at Cambridge Health Alliance. At the four intervention sites, the study will involve: 1) an integrated child mental health assessment done by the E-SOC team within primary care, 2) active follow-up, collaboration with specialty providers and support to families, 3) School, child welfare and other community linkages as appropriate.

Behavioral: Enhanced Systems of Care Team

Interventions

Enhanced Systems of Care Team BEHAVIORAL

E-SOC team will be increasing connections between clinical care and community partners, such as schools, juvenile justice and child-serving state agencies, to reduce disparities in access to mental health/substance use evaluation and treatment. All aspects of the care continuum will be provided in a culturally and linguistically competent manner, with child and family-driven care planning. Overall goals are: earlier identification of mental health needs including child trauma; increased treatment access and adherence; care delivered in least restrictive settings; care experience reflecting active youth and family engagement; program sustainability and replicability.

Enhanced Systems of Care Team

Eligibility Criteria

• Age: 0 Years - 17 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Must be between ages 0 to 17.5 years
• Referred by primary care physician at one of these Cambridge Health Alliance clinics: Windsor Street Care Center, Broadway Care Center, Everett Care Center, Malden Family Medicine Center
• Referred youth must have a caregiver (a parent of guardian) who agrees to participate in the assessment and treatment process

You may not qualify if:

• years or older

Sponsors & Collaborators

• Cambridge Health Alliance: lead

Study Sites (1)

Cambridge Health Alliance

Cambridge, Massachusetts, 02141, United States

Location

Study Officials

• Katherine E Grimes, MD, MPH

  Cambridge Health Alliance

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director, Children's Health Initiative

Model Details: The E-SOC Model consists of the delivery of intensively integrated clinical care within pediatrics, combined with community-based parent support from family support specialists. Innovations include child mental health specialists joining the pediatrics team for "huddles", psychiatry notes shared with pediatricians via the Electronic Medical Records and active inclusion of pediatricians in pre-evaluation discussions with the E-SOC Team and post-evaluation recommendations for the families. In addition, the E-SOC model includes active communication with school personnel, child welfare, and community-based resources, when needed.

Study Record Dates

• First Submitted: July 19, 2018
• First Posted: August 20, 2018
• Study Start: October 17, 2017
• Primary Completion: July 31, 2020
• Study Completion: September 30, 2020
• Last Updated: October 20, 2020

Record last verified: 2020-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)