The majority of mental, emotional, and behavioral disorders have an initial onset before age 24, with 20% annual incidence, and with major depressive disorder being the most common one. Health systems may be able to reduce costs by transitioning from the current treatment-focused model for major depressive disorder to a prevention model. However, evidence is needed for (1) the comparative effectiveness of a “scalable intervention” and (2) an implementation model for such a scalable intervention in the primary care setting.
This paper describes a comparative effectiveness trial evaluating the efficacy of two evidence-based cognitive-behavioral prevention programs: Teens Achieving Mastery over Stress (TEAMS), the “gold standard” group therapy model, and Competent Adulthood Transition with Cognitive Behavioral, Humanistic and Interpersonal Training (CATCH-IT), a scalable, self-directed, technology-based model.
Eligible adolescents, age 13–19, are offered one of these two depression prevention programs across five health systems (30 clinics) in urban and suburban Chicago, rural western Illinois, and Louisville, Kentucky. The research team is comprehensively evaluating patients’ outcomes at two, six, 12, and 18-month assessment points. Using a hybrid clinical trial design that simultaneously examines the implementation process, the study is also assessing adolescents', parents', and providers' experiences (e.g., efficacy, time commitment, cultural acceptability) of each intervention approach.