Prevention of Adolescent Depression in Primary Care: Barriers and Relational Work Solutions

. 2017 Aug;15(2):1-12.

Prevention of Adolescent Depression in Primary Care: Barriers and Relational Work Solutions

Nicholas Mahoney^{1

2}, Tracy Gladstone³, Daniela DeFrino², Allison Stinson², Jennifer Nidetz², Jason Canel⁴, Eumene Ching⁵, Anita Berry⁶, James Cantorna⁷, Joshua Fogel^{2

8}, Milton Eder⁹, Megan Bolotin², Benjamin W Van Voorhees²

Affiliations

¹ Department of Psychiatry, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
² Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois.
³ The Robert S. and Grace W. Stone Primary Prevention Initiatives, Wellesley Centers for Women, Wellesley College.
⁴ Northshore University Health Systems, Evanston, Illinois.
⁵ Harvard Vanguard, Boston, Massachusetts.
⁶ Advocate Children's Hospital, Downers Grove, Illinois.
⁷ Franciscan Medical Specialists, Munster, Indiana.
⁸ Department of Business Management, Brooklyn College, New York.
⁹ Access Community Health Network, Chicago, Illinois.

PMID: 30393470
PMCID: PMC6214481

Prevention of Adolescent Depression in Primary Care: Barriers and Relational Work Solutions

Nicholas Mahoney et al. Calif J Health Promot. 2017 Aug.

. 2017 Aug;15(2):1-12.

Authors

Affiliations

¹ Department of Psychiatry, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
² Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois.
³ The Robert S. and Grace W. Stone Primary Prevention Initiatives, Wellesley Centers for Women, Wellesley College.
⁴ Northshore University Health Systems, Evanston, Illinois.
⁵ Harvard Vanguard, Boston, Massachusetts.
⁶ Advocate Children's Hospital, Downers Grove, Illinois.
⁷ Franciscan Medical Specialists, Munster, Indiana.
⁸ Department of Business Management, Brooklyn College, New York.
⁹ Access Community Health Network, Chicago, Illinois.

PMID: 30393470
PMCID: PMC6214481

Abstract

Background and purpose: Depression affects millions of adolescents in the United States each year. This population may benefit from targeted preventive interventions. We sought to understand the internal factors that affect the ability of healthcare organizations to implement an intervention that involves mental health screening and depression prevention treatment of at-risk adolescents in primary care settings.

Methods: From November 2011 to July 2016 we conducted a study of the implementation of a multisite (N=30) phase 3 randomized clinical trial of an Internet-based depression prevention intervention program (CATCH-IT). We describe the prevalence of internal barriers on the screening and enrollment process by reporting REACH (the proportion of target audience exposed to the intervention).

Results: A total of 369 adolescents were randomized into the intervention or control program. Mean REACH values for the study clinics were 0.216 for screening and 0.181 for enrollment to CATCH-IT. Mean REACH enrollment lost due to internal barriers was 0.233. This translated to 4,691 adolescents lost at screening and 2,443 adolescents lost at enrollment due to internal barriers.

Conclusion: We propose a model of the implementation process that emphasizes the importance of positive relational work that assists in overcoming internal barriers to REACH. We also provide implications for policy and practice.

Keywords: adolescent; delivery of health care; health care reform; mental health; primary health care.

PubMed Disclaimer

Figures

**Figure 1:**
The Relational Work Implementation Model is based on a participant-centered approach to the research process

See this image and copyright information in PMC

Cited by

Screening for depression in children and adolescents in primary care or non-mental health settings: a systematic review update.
Beck A, Dryburgh N, Bennett A, Shaver N, Esmaeilisaraji L, Skidmore B, Patten S, Bragg H, Colman I, Goldfield GS, Nicholls SG, Pajer K, Meeder R, Vasa P, Shea BJ, Brouwers M, Little J, Moher D. Beck A, et al. Syst Rev. 2024 Jan 31;13(1):48. doi: 10.1186/s13643-023-02447-3. Syst Rev. 2024. PMID: 38291528 Free PMC article.
Randomized Clinical Trial of an Internet-Based Adolescent Depression Prevention Intervention in Primary Care: Internalizing Symptom Outcomes.
Gladstone T, Buchholz KR, Fitzgibbon M, Schiffer L, Lee M, Voorhees BWV. Gladstone T, et al. Int J Environ Res Public Health. 2020 Oct 22;17(21):7736. doi: 10.3390/ijerph17217736. Int J Environ Res Public Health. 2020. PMID: 33105889 Free PMC article. Clinical Trial.
24-Month Outcomes of Primary Care Web-Based Depression Prevention Intervention in Adolescents: Randomized Clinical Trial.
Van Voorhees B, Gladstone TRG, Sobowale K, Brown CH, Aaby DA, Terrizzi DA, Canel J, Ching E, Berry AD, Cantorna J, Eder M, Beardslee W, Fitzgibbon M, Marko-Holguin M, Schiffer L, Lee M, de Forest SA, Sykes EE, Suor JH, Crawford TJ, Burkhouse KL, Goodwin BC, Bell C. Van Voorhees B, et al. J Med Internet Res. 2020 Oct 28;22(10):e16802. doi: 10.2196/16802. J Med Internet Res. 2020. PMID: 33112254 Free PMC article. Clinical Trial.
Internet-based cognitive behavioral therapy intervention for youth with type 1 diabetes and depressive symptoms: a pilot and feasibility study.
Singh P, Otero JM, Howe C, Feinstein RT, Gupta K, Gladstone TRG, Van Voorhees BW, Gupta OT. Singh P, et al. Mhealth. 2023 Dec 11;10:6. doi: 10.21037/mhealth-23-33. eCollection 2024. Mhealth. 2023. PMID: 38323145 Free PMC article.
PATHway: Intervention optimization of a prevention program for adolescents at-risk for depression in the primary care setting.
Gladstone TRG, Zhong C, Lowther M, Feinstein RT, Fitzgibbon ML, Gussin HA, Schiffer L, Diviak K, Berbaum ML, Rusiewski C, Ramirez P, Lefaiver C, Canel J, Mitchell J, Buchholz KR, Van Voorhees BW. Gladstone TRG, et al. Contemp Clin Trials. 2024 Feb;137:107413. doi: 10.1016/j.cct.2023.107413. Epub 2023 Dec 17. Contemp Clin Trials. 2024. PMID: 38114047 Free PMC article.

See all "Cited by" articles

References

1. Angold A, Erkanli A, Farmer EMZ, Fairbank JA, Burns BJ, Keeler G, & Costello EJ (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59(10), 893–901. doi:10.1001/archpsyc.59.10.893 - DOI - PubMed
1. Arnberg FK, Linton SJ, Hultcrantz M, Heintz E, & Jonsson U (2014). Internet-delivered psychological treatments for mood and anxiety disorders: A systematic review of their efficacy, safety, and cost-effectiveness: E98118. PLoS One, 9(5). doi:10.1371/journal.pone.0098118 - DOI - PMC - PubMed
1. Asarnow JR, Jaycox LH, & Anderson M (2002). Depression among youth in primary care: Models for delivering mental health services. Child and Adolescent Psychiatric Clinics of North America, 11(3), 477–497. - PubMed
1. Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, & Robertson N (2010). Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 3(3), CD005470. doi:10.1002/14651858.CD005470.pub2 - DOI - PMC - PubMed
1. Becker MH, & Maiman LA (1980). Strategies for enhancing patient compliance. Journal of Community Health, 6(2), 113–135. doi:10.1007/BF01318980 - DOI - PubMed

Grants and funding

LinkOut - more resources

Full Text Sources
- Europe PubMed Central
- PubMed Central

[1] Angold A, Erkanli A, Farmer EMZ, Fairbank JA, Burns BJ, Keeler G, & Costello EJ (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59(10), 893–901. doi:10.1001/archpsyc.59.10.893 - DOI - PubMed

[2] Angold A, Erkanli A, Farmer EMZ, Fairbank JA, Burns BJ, Keeler G, & Costello EJ (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59(10), 893–901. doi:10.1001/archpsyc.59.10.893 - DOI - PubMed

[3] Arnberg FK, Linton SJ, Hultcrantz M, Heintz E, & Jonsson U (2014). Internet-delivered psychological treatments for mood and anxiety disorders: A systematic review of their efficacy, safety, and cost-effectiveness: E98118. PLoS One, 9(5). doi:10.1371/journal.pone.0098118 - DOI - PMC - PubMed

[4] Arnberg FK, Linton SJ, Hultcrantz M, Heintz E, & Jonsson U (2014). Internet-delivered psychological treatments for mood and anxiety disorders: A systematic review of their efficacy, safety, and cost-effectiveness: E98118. PLoS One, 9(5). doi:10.1371/journal.pone.0098118 - DOI - PMC - PubMed

[5] Asarnow JR, Jaycox LH, & Anderson M (2002). Depression among youth in primary care: Models for delivering mental health services. Child and Adolescent Psychiatric Clinics of North America, 11(3), 477–497. - PubMed

[6] Asarnow JR, Jaycox LH, & Anderson M (2002). Depression among youth in primary care: Models for delivering mental health services. Child and Adolescent Psychiatric Clinics of North America, 11(3), 477–497. - PubMed

[7] Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, & Robertson N (2010). Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 3(3), CD005470. doi:10.1002/14651858.CD005470.pub2 - DOI - PMC - PubMed

[8] Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, & Robertson N (2010). Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 3(3), CD005470. doi:10.1002/14651858.CD005470.pub2 - DOI - PMC - PubMed

[9] Becker MH, & Maiman LA (1980). Strategies for enhancing patient compliance. Journal of Community Health, 6(2), 113–135. doi:10.1007/BF01318980 - DOI - PubMed

[10] Becker MH, & Maiman LA (1980). Strategies for enhancing patient compliance. Journal of Community Health, 6(2), 113–135. doi:10.1007/BF01318980 - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Prevention of Adolescent Depression in Primary Care: Barriers and Relational Work Solutions

Affiliations

Prevention of Adolescent Depression in Primary Care: Barriers and Relational Work Solutions

Authors

Affiliations

Abstract

Figures

Similar articles

Cited by

References

Grants and funding

LinkOut - more resources

Full Text Sources

Abstract

Figures

Similar articles

Cited by

References

Related information

Grants and funding

LinkOut - more resources

Full Text Sources