PATHway: Intervention optimization of a prevention program for adolescents at-risk for depression in the primary care setting

Tracy R. Gladstone, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI 02903, USA. Electronic address: tracy_gladstone@brown.edu.
Cordelia Zhong, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI 02903, USA.
Matthew Lowther, Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL 60612, USA.
Rebecca T. Feinstein, Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois, Chicago, IL 60612, USA.
Marian L. Fitzgibbon, Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL 60612, USA; Institute for Health Research and Policy, University of Illinois, Chicago, IL 60608, USA; Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois, Chicago, IL 60612, USA.
Hélène A. Gussin, Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL 60612, USA.
Linda Schiffer, Institute for Health Research and Policy, University of Illinois, Chicago, IL 60608, USA.
Kathleen Diviak, Institute for Health Research and Policy, University of Illinois, Chicago, IL 60608, USA.
Michael L. Berbaum, Institute for Health Research and Policy, University of Illinois, Chicago, IL 60608, USA; University of Illinois, Cancer Center, Chicago, Il 60612, USA.
Calvin Rusiewski, Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL 60612, USA.
Paula Ramirez, Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL 60612, USA.
Cheryl Lefaiver, Advocate Aurora HealthFollow
Jason Canel, NorthShore University Health System, Evanston, IL 60201, USA.
James Mitchell, Department of Pediatrics, Comer Children's Hospital, University of Chicago, Chicago, IL 60637, USA.
Katherine R. Buchholz, Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA.
Benjamin W. Van Voorhees, Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL 60612, USA.

Abstract

With as many as 13% of adolescents diagnosed with depressive disorders each year, prevention of depressive disorders has become a key priority for the National Institute of Mental Health (NIMH). Currently, we have no widely available interventions to prevent these disorders. To address this need, we developed a multi-health system collaboration to develop and evaluate the primary care based technology "behavioral vaccine," Competent Adulthood Transition with Cognitive-Behavioral Humanistic and Interpersonal Therapy (CATCH-IT). The full CATCH-IT program demonstrated evidence of efficacy in prevention of depressive episodes in clinical trials. However, CATCH-IT became larger and more complex across trials, creating issues with adherence and scalability. We will use a multiphase optimization strategy approach to optimize CATCH-IT. The theoretically grounded components of CATCH-IT include: behavioral activation, cognitive-behavioral therapy, interpersonal psychotherapy, and parent program. We will use a 4-factor (2x2x2x2) fully crossed factorial design with N = 16 cells (25 per cell, after allowing 15% dropout) to evaluate the contribution of each component. Eligible at-risk youth will be high school students 13 through 18 years old, with subsyndromal symptoms of depression. The study design will enable us to eliminate non-contributing components while preserving efficacy and to optimize CATCH-IT by strengthening tolerability and scalability by reducing resource use. By reducing resource use, we anticipate satisfaction and acceptability will also increase, preparing the way for an implementation trial.

Type

Article

PubMed ID

38114047

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