Evaluation of a primary care/Internet-based depression prevention program for at-risk adolescents and their families.
Funded by the National Institute on Mental Health
This multi-site study was designed to evaluate a primary care/Internet-based depression prevention program for at-risk adolescents and their families. The intervention approach, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training (CATCH-IT), is based on face-to-face interventions of demonstrated efficacy. It combines a sustained motivational program delivered to adolescents by their pediatricians with an Internet-based intervention that aims to help teens understand the connection between their thoughts and moods, the importance of activity scheduling, and the relation between depression and interpersonal functioning. In addition, a parent program is designed to educate parents about youth depression, treatment options, and ways to promote resilience in their teens. Pilot work with this intervention suggests that is associated with significant reductions in depressed mood, increased social support, and reduced depressive episodes at 3 and 12 month follow-up in a diverse population.
In the current 5-year, two-site (Chicago and Boston) randomized clinical trial, the efficacy of the CATCH-IT intervention will be compared to an educational control condition in preventing the onset of depressive episodes in an intermediate to high risk, geographically representative sample of adolescents aged 13-18. We plan to: (a) identify high risk adolescents based on elevated scores on a screening measure of depressive symptoms that is delivered in primary care; (b) recruit 400 (200 per site) of these at-risk adolescents to be randomized into either the CATCH-IT or the Educational group; and (c) assess outcomes at 2, 6, 12, 18 and 24 months post intake on measures of depressive symptoms, depressive diagnoses, other mental disorders, and on measures of role impairment in education, quality of life, attainment of educational milestones, and family functioning; and to examine predictors of intervention response, and potential ethnic and cultural differences in intervention response.