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| ID | Type | Description | Link |
|---|---|---|---|
| R34MH129771 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute of Mental Health (NIMH) | NIH |
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The objective of this proposal is to develop and pilot a systems-level strategy in pediatric primary care to enhance identification and management of suicidal ideation and behavior in Latinx youth, particularly those in immigrant families with parents who have limited English proficiency (LEP). The investigators will focus on the use of trained community health workers (CHWs) to increase clinic capacity and quality of suicide risk screening and early intervention, with a focus on safety planning, parent psychoeducation and care coordination.
Specific aims are 1: To develop site-specific implementation protocols for the integration of CHWs into SIB screening and safety planning for Latinx youth and the youths families; 2: To pilot the implementation of the program in a six-month open trial in four pediatric primary care practices representing a range of usual practice settings; and 3: To engage a stakeholder network to explore barriers and facilitators, including costs and billing strategies, to implementation of this approach across a broad range of pediatric primary care settings.
Parents/guardians of youth who have been referred to and agree to participate in the intervention by the child's primary care provider will participate in a 2-month program consisting of 6-8 phone sessions with a community health worker focusing on safety planning, information/education, program solving and self-care. Research participants will be asked to complete a survey via phone at the beginning of the program and another at the end of the program. The participants may also be asked to participate in an additional interview about the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PALOMA | Experimental | Parents/guardians of youth who have been referred to and agree to participate in the intervention by the child's primary care provider will participate in a 2-month program consisting of 5-7 phone sessions with a community health worker focusing on safety planning, information/education, program solving and self-care. Research participants will be asked to complete a survey via phone at the beginning of the program and another at the end of the program. The participants may also be asked to participate in an additional interview about the participants experience during the study. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PALOMA | Behavioral | Partnering with Parents of Adolescent Latinos on Mental Health Assistance |
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| Measure | Description | Time Frame |
|---|---|---|
| Percent of Participants Screened | Percent of patients 10-18 years old screened for depression and suicidal ideation and behavior at clinic level | Monthly for 9 months |
| Feasibility as assessed by percent of sessions completed | Percent of eligible patients receiving a CHW session | Monthly for 9 months |
| Quality as assessed by percent of CHW visits | Percent of CHW visits that include delivery of one or more intervention components | Monthly for 9 months |
| Engagement as assessed by number of follow-up visits | number of follow-up mental health visits with PCP or specialty provider among youth identified as having suicidal ideation or behavior. | Monthly for 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Family Functioning as assessed by the SCORE-15 Index of Family Functioning and Change (SCORE-15) | SCORE-15 Index of Family Functioning and Change: Score range 5-15, higher total means worse functioning. | Baseline and 3 months |
| Parent Self Efficacy as assessed by Brief Parenting Self Efficacy Scale (BPSES) Questionnaire |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sarah Polk, MD | Johns Hopkins School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| BMS at Yard 56 | Baltimore | Maryland | 21224 | United States |
Data will be made available while safeguarding the privacy of participants, & protecting confidential & proprietary data. Investigators will have access to results free from personal identifiers & PHI. Investigators will fill out a request form that specifies the purpose of the request, the data requested & the qualifications of the requestor. Final research data will include recorded factual material necessary to document & support research findings, including final data sets (w/ identifiers redacted), data collection protocols data, & database documentation. Users must agree to the conditions of use governing access to the publicly released data, including restrictions against attempting to identify study participants, destruction of the data after analyses are completed, reporting responsibilities, restrictions on redistribution of the data to third parties, restrictions on use for commercial purposes, & proper acknowledgement of the data resource.
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| ID | Term |
|---|---|
| D059020 | Suicidal Ideation |
| ID | Term |
|---|---|
| D013405 | Suicide |
| D016728 | Self-Injurious Behavior |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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Brief Parenting Self Efficacy Scale (BPSES) Questionnaire: Total score ranges from 5 to 25, higher scores indicate higher levels of parental self-efficacy. |
| Baseline and 3 months |
| Depression as assessed by the Patient Health Questionnaire - Adolescent (PHQ-A) | Patient Health Questionnaire - Adolescent (PHQ-A): Each item on the PHQ-A is scored as follows: Not at all = 0 Several Days = 1 More than half the days = 2 Nearly every day = 3. A weighted score of 5 or more means a positive screen for depressive symptoms. A weighted score of 0-4 means a negative screen for depressive symptoms. | Baseline and 3 months |
| Suicidal Ideation and Behavior as assessed by the Ask Suicide-Screening Questionnaire (ASQ) | Ask Suicide-Screening Questionnaire (ASQ): 4 Yes or No Questions. "Yes" to questions 1 through 4, or refuses to answer is considered a positive screen. "Yes" to question 5 = acute positive screen (imminent risk identified); "No" to question 5 = non-acute positive screen. | Baseline and 3 months |
| Parental Self-Efficacy to Support Teens During a Suicidal Crisis survey | 9 items. Answer choices ranged from 0 (not at all confident) to 10 (completely confident), with an anchor of 5 (somewhat confident); score range 0-90; higher score higher confidence. | Baseline and 3 months |
| Parent expectations of adolescents' risk survey | 3 items. Answer choices ranged from 0 (not at all confident) to 10 (completely confident), with an anchor of 5 (somewhat confident). Score range 0-30; higher score higher confidence. | Baseline and 3 months |