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This study evaluates the impact of a longitudinal remote consultation (LRC) implementation strategy for collaborative care depression treatment among perinatal women receiving care from federally qualified health centers (FQHCs). All participating FQHCs will receive training in collaborative care. Cluster randomization will be used to assign the addition of LRC to select FQHCs. Differences in implementation success, clinical outcomes, and costs will be compared after a 12 month implementation period and 13-21 month sustainment period.
Depression is a common and serious disorder among pregnant women but few from low income groups receive effective treatment. The highly evidence based collaborative care (CC) model for depression has been shown to work for women in pregnancy but has not been widely implemented in this population. The proposed study targets improving dissemination of the evidence based CC treatment model for pregnant and postpartum women with depression, a common disorder of the perinatal period (pregnancy and the first year following birth). Longitudinal remote consultation (LRC) is an implementation strategy that has been have shown to improve fidelity to evidence-based practices and patient outcomes for mental health innovations. We believe LRC can be used with equal benefit for complex interventions such as CC.
The purpose of this study is to compare two implementation strategies for Collaborative Care depression treatment: 1) standard implementation and 2) standard implementation + Longitudinal Remote Consultation (LRC). This research is being done in order to assess implementation and patient outcomes in sites receiving a standard implementation approach with and without LRC. The results of the proposed study will provide information on the benefits and relative value of ongoing consultation, such as LRC, for implementation of complex interventions like collaborative care.
The proposed study will involve twenty federally qualified health centers (FQHCs) providing prenatal care and which are part of the national OCHIN Network. All sites will receive a standard implementation approach. After pre-implementation training ten of the sites will be randomly selected to receive LRC. Implementation and clinical outcomes as well as costs will be compared between the study conditions after a 12 month implementation period and a 13-21 month sustainment period. The results of the proposed study will provide critical generalizable knowledge regarding the benefits of ongoing consultation for implementation of complex interventions like collaborative care.
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
Longitudinal Remote Consultation, Collaborative Care
Not yet recruiting
University of Washington
Published on BioPortfolio: 2016-11-30T15:45:39-0500
The purpose of this project is to test whether a new model of collaborative care depression treatment adapted to the needs and preferences of low-income, urban mothers with perinatal depre...
Perinatal outcomes in the US rank behind most other developed countries even though women in the US utilize more maternity services. Current approaches to consultation and collaboration am...
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Based on the published evidence, collaborative care for depression is both necessary and sufficient for improving care and outcomes for depressed patients in primary care settings. The Tra...
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To plan and implement an interprofessional collaborative care clinic for women in midwifery care needing a consultation with a maternal-fetal medicine specialist.
Little is known about the reach and impact of collaborative care for depression outside of clinical trials.
Depression is a risk factor for morbidity and mortality in patients with coronary heart disease. Finding effective methods for identifying and treating depression in these patients is a high priority....
Depression is the most common psychiatric disease in older people, often accompanied by co-morbidities and functional limitations. In cross-sectional studies, depression is associated with an increase...
Integrated health care models aim to improve access and continuity of mental health services in general medical settings. STEPS-UP is a stepped, centrally assisted collaborative care model designed to...
Consultation via remote telecommunications, generally for the purpose of diagnosis or treatment of a patient at a site remote from the patient or primary physician.
Transmission and interpretation of tissue specimens via remote telecommunication, generally for the purpose of diagnosis or consultation but may also be used for continuing education.
The care of a fetus or newborn given before, during, and after delivery from the 28th week of gestation through the 7th day after delivery.
Two extensive fibrous bands running the length of the vertebral column. The anterior longitudinal ligament (ligamentum longitudinale anterius; lacertus medius) interconnects the anterior surfaces of the vertebral bodies; the posterior longitudinal ligament (ligamentum longitudinale posterius) interconnects the posterior surfaces. The commonest clinical consideration is OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT. (From Stedman, 25th ed)
Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent DECOMPRESSION SICKNESS. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings.