Prevention of Adolescent Depression in Primary Care

Barriers and Relational Work Solutions

  • Nicholas Mahoney Department of Psychiatry, University of Wisconsin Hospital and Clinics, Madison, Wisconsin & Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois
  • Tracy Gladstone The Robert S. and Grace W. Stone Primary Prevention Initiatives, Wellesley Centers for Women, Wellesley College
  • Daniela DeFrino Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois
  • Allison Stinson Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois
  • Jennifer Nidetz Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois
  • Jason Canel Northshore University Health Systems, Evanston, Illinois
  • Eumene Ching Harvard Vanguard, Boston, Massachusetts
  • Anita Berry Advocate Children’s Hospital, Downers Grove, Illinois
  • James Cantorna Franciscan Medical Specialists, Munster, Indiana
  • Joshua Fogel Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois & Department of Business Management, Brooklyn College, New York
  • Milton Eder Access Community Health Network, Chicago, Illinois
  • Megan Bolotin Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois
  • Benjamin W. Van Voorhees Department of General Pediatrics, College of Medicine, University of Illinois at Chicago, Illinois
DOI: https://doi.org/10.32398/cjhp.v15i2.1895

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.

Published
2017-08-01
How to Cite
Mahoney, N., Gladstone, T., DeFrino, D., Stinson, A., Nidetz, J., Canel, J., Ching, E., Berry, A., Cantorna, J., Fogel, J., Eder, M., Bolotin, M., & Van Voorhees, B. W. (2017). Prevention of Adolescent Depression in Primary Care: Barriers and Relational Work Solutions. Californian Journal of Health Promotion, 15(2), 01-12. https://doi.org/10.32398/cjhp.v15i2.1895
Issue
Vol. 15 No. 2 (2017): CJHP 2017 August
Section
Articles