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Completed

NCT Number: NCT03637478

Enhancing Systems of Care: Supporting Families and Improving Youth Outcomes

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.

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Key information

Conditions

Pediatric Mental Health Services

Age range

0 year–17 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cambridge Health Alliance

Cambridge, Massachusetts, 02141, United States

About this study

This is a quasi-experimental, longitudinal study. Identified youth and families will receive the intervention within the four study site clinic locations. Comparison group families will receive usual care. Each primary care study site will have designated Family Support Specialist, Clinical Care Manager and Child Psychiatry resources. The intervention includes an integrated care consultation which combines diagnostic evaluation, family assessment, and multi-disciplinary, team-based treatment recommendations, with follow-up community linkages and support, as indicated.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

  • 17.6 years or older

Treatment and study plan

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.

Primary outcomes

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

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

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

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

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

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

Secondary outcomes

  1. Family Care Experience

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

    Qualitative assessment of family perceptions of care using the Family Professional Partnership Scale (FPPS). The anchors of items rated on satisfaction are rated on a 5-point likert scale, where 1 = very dissatisfied, 3 = neither satisfied nor dissatisfied, and 5 = very satisfied wherein the higher the value represents a better outcome.

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

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

    Measurement of clinical functioning using Children's Global Assessment Scale (CGAS). Trends from baseline to 6 months and 12 months will be examined to identify improvement, decline, or no change in clinical functioning.The CGAS measure provides a single global rating only, on scale of 0-100, where scores below 60 indicate clinical need.

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

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

    Measurement of clinical functioning using Child and Adolescent Functional Assessment Scale (CAFAS). Trends from baseline to 6 months and 12 months will be examined to identify improvement, decline, or no change in clinical functioning. The CAFAS measure indicates the level of clinical functioning, on a scale of 0-140, where scores above 40 indicate clinical need.

Sponsors and collaborators

Lead sponsor

Cambridge Health Alliance

Other

Registry information

Acronym: E-SOC

Important dates

Study start
2017
Primary completion
2020
Study completion
2020
First posted
Aug 20, 2018
Registry last updated
Oct 20, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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