Improving Problem-Solving Treatment for Depression in Community Health Centers

Type III Hybrid Effectiveness-Implementation Trial of a Clinical Decision Support System for the Implementation of Problem-Solving Treatment in Community Health Centers

This study is testing a new way to deliver Problem Solving Treatment for depression in community health centers to see if it helps people feel better and function well compared to the standard approach.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 410 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Washington (Academic / other)
• Locations: 1 site (Portland, Oregon)
• Trial ID: NCT06494384 on ClinicalTrials.gov

What this trial studies

This study evaluates the effectiveness of an enhanced implementation strategy called PST-Aid for Problem Solving Treatment (PST) in community health centers. It compares standard PST delivery with PST-Aid, which incorporates automated decision support tools and feedback systems to improve the fidelity, adoption, and sustainability of treatment. The trial aims to determine if PST-Aid leads to better outcomes in reducing depressive symptoms and enhancing patient functioning. By focusing on both implementation and clinical effectiveness, the study seeks to address the gap in delivering evidence-based interventions in primary care settings.

Who should consider this trial

Good fit: Ideal candidates include English-speaking adults aged 18 and older with a diagnosis of unipolar depression and a PHQ-9 score of 10 or higher.

Not a fit: Patients who do not meet the eligibility criteria, such as those without a diagnosis of depression or those not part of the OCHIN clinical network, may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly improve the treatment of depression in community health settings, leading to better patient outcomes.

How similar studies have performed: Other studies have shown promise in using technology-assisted implementation strategies for improving mental health treatment, suggesting that this approach may be effective.

Eligibility criteria

Inclusion Criteria:

* Practitioner Participants. (a) are employed by a clinic that is an OCHIN clinical network member;
* Practitioner Participants. (b) hold a master's degree in social work, psychology, counseling, or a related field;
* Practitioner Participants. (c) provide psychotherapeutic care in the OCHIN network;
* Practitioner Participants. (d) have not previously received formal training in PST as defined by University of Washington Advancing Integrated Mental Health Solutions Center (AIMS) criteria;
* Practitioner Participants. (e) are not currently receiving specialized training outside of standard clinic support to implement a depression-specific psychosocial intervention; and
* Practitioner Participants. (f) are English-speaking.
* Client Participants. a) 18+,
* Client Participants. b) English-speaking,
* Client Participants. c) have a diagnosis of unipolar depression per provider report, and
* Client Participants. d) have a PHQ-9 score ≥ 10, which is above the clinical cutoff for depression symptoms.

Exclusion Criteria:

* Client Participants. (a) history or presence of psychiatric diagnoses other than unipolar, nonpsychotic depression or anxiety disorders,
* Client Participants. (b) active suicidal ideation,
* Client Participants. (c) current alcohol or substance abuse disorders, or
* Client Participants. (d) have dementia
* Client Participants. (e) all exclusion criteria cannot be confirmed via provider report.
* Practitioner Participants. Exclusion criteria are those that do not meet the inclusion criteria listed above.

Where this trial is running

Portland, Oregon

• OCHIN, Inc. — Portland, Oregon, United States (Recruiting)

Study contacts

• Principal investigator: Patrick Raue, PhD — University of Washington
• Study coordinator: Katie Osterhage, MMS

Conditions Depression