PDF(Pubmed)
Abstract：
BACKGROUND: Our group developed an Integrated Care Pathway to facilitate the delivery of evidence-based care for adolescents experiencing depression called CARIBOU-2 (Care for Adolescents who Receive Information \'Bout OUtcomes, 2nd iteration). The core pathway components are assessment, psychoeducation, psychotherapy options, medication options, caregiver support, measurement-based care team reviews and graduation. We aim to test the clinical and implementation effectiveness of the CARIBOU-2 pathway relative to treatment-as-usual (TAU) in community mental health settings.
METHODS: We will use a Type 1 Hybrid Effectiveness-Implementation, Non-randomized Cluster Controlled Trial Design. Primary participants will be adolescents (planned n = 300, aged 13-18 years) with depressive symptoms, presenting to one of six community mental health agencies. All sites will begin in the TAU condition and transition to the CARIBOU-2 intervention after enrolling 25 adolescents. The primary clinical outcome is the rate of change of depressive symptoms from baseline to the 24-week endpoint using the Childhood Depression Rating Scale-Revised (CDRS-R). Generalized mixed effects modelling will be conducted to compare this outcome between intervention types. Our primary hypothesis is that there will be a greater rate of reduction in depressive symptoms in the group receiving the CARIBOU-2 intervention relative to TAU over 24 weeks as per the CDRS-R. Implementation outcomes will also be examined, including clinician fidelity to the pathway and its components, and cost-effectiveness.
BACKGROUND: Research ethics board approvals have been obtained. Should our results support our hypotheses, systematic implementation of the CARIBOU-2 intervention in other community mental health agencies would be indicated.
METHODS: We will use a Type 1 Hybrid Effectiveness-Implementation, Non-randomized Cluster Controlled Trial Design. Primary participants will be adolescents (planned n = 300, aged 13-18 years) with depressive symptoms, presenting to one of six community mental health agencies. All sites will begin in the TAU condition and transition to the CARIBOU-2 intervention after enrolling 25 adolescents. The primary clinical outcome is the rate of change of depressive symptoms from baseline to the 24-week endpoint using the Childhood Depression Rating Scale-Revised (CDRS-R). Generalized mixed effects modelling will be conducted to compare this outcome between intervention types. Our primary hypothesis is that there will be a greater rate of reduction in depressive symptoms in the group receiving the CARIBOU-2 intervention relative to TAU over 24 weeks as per the CDRS-R. Implementation outcomes will also be examined, including clinician fidelity to the pathway and its components, and cost-effectiveness.
BACKGROUND: Research ethics board approvals have been obtained. Should our results support our hypotheses, systematic implementation of the CARIBOU-2 intervention in other community mental health agencies would be indicated.
摘要：
背景：我们的团队开发了一种综合护理路径，以促进为患有抑郁症的青少年提供循证护理，称为CARIBOU-2（对接收信息的青少年的护理，第二次迭代）。核心途径组件是评估，心理教育,心理治疗选择,药物选择,护理人员支持,基于测量的护理团队审查和毕业。我们旨在测试CARIBOU-2途径在社区心理健康环境中相对于常规治疗（TAU）的临床和实施有效性。
方法：我们将使用1型混合有效性-实施，非随机集群对照试验设计。主要参与者将是有抑郁症状的青少年（计划n=300，年龄13-18岁），向六个社区精神卫生机构之一介绍。所有站点将在TAU条件下开始，并在招募25名青少年后过渡到CARIBOU-2干预。主要临床结果是使用儿童抑郁量表修订（CDRS-R）的抑郁症状从基线到24周终点的变化率。将进行广义混合效应建模，以比较干预类型之间的结果。我们的主要假设是，根据CDRS-R，接受CARIBOU-2干预的组的抑郁症状相对于TAU在24周内的减少率更高。还将审查执行结果，包括临床医生对通路及其组成部分的忠诚，和成本效益。
背景：已获得研究伦理委员会的批准。如果我们的结果支持我们的假设，将指出在其他社区精神卫生机构中系统地实施CARIBOU-2干预措施。
方法：我们将使用1型混合有效性-实施，非随机集群对照试验设计。主要参与者将是有抑郁症状的青少年（计划n=300，年龄13-18岁），向六个社区精神卫生机构之一介绍。所有站点将在TAU条件下开始，并在招募25名青少年后过渡到CARIBOU-2干预。主要临床结果是使用儿童抑郁量表修订（CDRS-R）的抑郁症状从基线到24周终点的变化率。将进行广义混合效应建模，以比较干预类型之间的结果。我们的主要假设是，根据CDRS-R，接受CARIBOU-2干预的组的抑郁症状相对于TAU在24周内的减少率更高。还将审查执行结果，包括临床医生对通路及其组成部分的忠诚，和成本效益。
背景：已获得研究伦理委员会的批准。如果我们的结果支持我们的假设，将指出在其他社区精神卫生机构中系统地实施CARIBOU-2干预措施。
