Team Communication Training for Children's Depression

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Diego

Disqualifiers: Not employed at Rady Children's

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to enhance communication among medical teams during depression screenings in children, ensuring quicker access to necessary help. It tests a special program called Team Communication Training, which improves collaboration among medical staff, resulting in faster and more effective depression screenings and treatment connections. The trial seeks medical staff or health providers at Rady Children's Hospital in San Diego with experience in children's and teens' mental health care. The goal is to improve patient engagement and outcomes in addressing the youth mental health crisis. As an unphased trial, this study offers a unique opportunity to contribute to innovative solutions for this crisis.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this team communication training is safe for improving pediatric depression screening?

Research has shown that team communication training is generally manageable for participants. This training helps healthcare team members communicate and collaborate more effectively. No evidence of negative effects suggests it is safe for participants.

The training includes activities such as role-playing and feedback sessions, which are common in many workplaces and do not involve physical procedures. The trial's "Not Applicable" phase indicates safety, as it does not involve new drugs or medical treatments. Overall, the training aims to enhance teamwork and patient care without known risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Team Communication Training for children's depression because it focuses on enhancing how healthcare teams work together, which is different from typical treatments like medication and individual therapy. This training involves practical sessions, feedback from real clinical cases, and regular coaching to improve team communication, which isn't usually a focus in standard care. By improving how teams communicate, the goal is to provide faster, more coordinated, and effective care for children facing depression, potentially leading to better outcomes than traditional methods alone.

What evidence suggests that team communication training is effective for improving pediatric depression screening?

Research shows that training healthcare teams to communicate better can improve their collaboration. This trial will compare two approaches: Team Communication Training, which enhances team interactions, and Early Identification Universal Depression Screening, which emphasizes early detection of depression. Studies find that effective communication among teams enables faster and more efficient patient service connections. This is especially important for treating depression in children, where prompt care is crucial. The training teaches teams to share information and coordinate care, leading to better patient outcomes. ^{1 2 3 4 6}

Who Is on the Research Team?

Nicole A Stadnick, PhD, MPH

Principal Investigator

UCSD Associate Professor

Are You a Good Fit for This Trial?

This trial is for healthcare teams within pediatric settings. It's designed to help improve how they talk and work together after a child screens positive for depression. The goal is to make sure kids get the right follow-up care quickly.

Inclusion Criteria

Employed as medical staff and/or a medical or health provider at Rady Children's Hospital San Diego

Experience providing or supporting care to children and adolescents with mental health care needs

Exclusion Criteria

Any individual that does not meet the inclusion criteria will be excluded from study participation.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Team Communication Training

Participants undergo team communication training, including didactic sessions, simulation exercises, and performance feedback.

6 months

Biweekly supervision meetings

Early Identification Universal Depression Screening

Providers and staff receive training in the depression screening tool and orientation to the clinical pathway.

6 months

Regular medical visits

Follow-up

Participants are monitored for safety and effectiveness after training and screening interventions.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Team Communication Training

Trial Overview The study tests a team communication training program aimed at bettering the use of existing depression screening protocols in children. By enhancing teamwork, it hopes to increase regular screenings and ensure timely mental health services.

How Is the Trial Designed?

Group I: Team-Enhanced Condition Experimental Treatment 1 Intervention

The team-enhanced condition will include: 1. Two initial 1-hour didactic sessions to develop the team charter. 2. Biweekly check-ins (15-30 minutes) where the research team will review ongoing use of the team charter with participants and explore any necessary revisions.

Group II: Standard Condition Active Control 1 Intervention

In the comparison condition, staff will continue to use multiple discrete strategies already implemented as apart of the depression screening pathway. These existing strategies include: 1. Training in the depression screening tool (Patient Health Questionnaire) 2. Orientation to the clinical pathway (i.e., screening conducted at every urgent care or emergency department visit and every 30 days for all other medical visits) 3. Expectations for handoff to the next step in the care cascade

Who Is Running the Clinical Trial?

University of California, San Diego

Lead Sponsor

Trials

1,215

Recruited

1,593,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

The Brazilian Portuguese version of the Pediatric Trigger Toolkit was successfully translated and adapted for use in Brazilian hospitals, involving a thorough validation process that included expert consensus and cultural adaptation.

The toolkit demonstrated a positive predictive value of 13.51% for identifying adverse drug events in pediatric patients, with antihistamine triggers being the most effective, indicating its potential utility in improving patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Brazilian Portuguese version of the Pediatric Trigger Toolkit is applicable to measure the occurrence of adverse drug events in Brazilian pediatric inpatients. Silva, LT., Modesto, ACF., Martins, RR., et al.[2020]

Family-Focused Treatment for Childhood Depression (FFT-CD) is a 15-session program that effectively addresses depression in children by enhancing family support and teaching cognitive-behavioral skills, showing positive outcomes in three case studies.

The treatment led to significant reductions in depressive symptoms for the children involved, with improvements maintained for up to 9 months after completing the program, highlighting its potential long-term efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-Focused Treatment for Childhood Depression: Model and Case Illustrations. Tompson, MC., Langer, DA., Hughes, JL., et al.[2020]

An Integrated Care Pathway (ICP) for treating adolescents with Major Depressive Disorder (MDD-A) was developed based on high-quality clinical guidelines, ensuring that treatment reflects the best available evidence.

The ICP includes multi-family psychoeducation, a 16-session Group Cognitive Behaviour Therapy, and regular team reviews, aiming to improve treatment consistency and outcomes for adolescents with depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Way through the woods: Development of an integrated care pathway for adolescents with depression. Courtney, D., Bennett, K., Henderson, J., et al.[2021]

A systematic review of 130 studies on muscle strengthening training (MST) in youth revealed that only 33.8% reported on adverse events (AEs), highlighting a significant gap in safety monitoring during these interventions.

Among the studies that did report AEs, 40.1% documented at least one adverse event, with over half of the reported events (59.1%) linked directly to the training or testing, indicating a need for better definitions and reporting practices in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting of Adverse Events in Muscle Strengthening Interventions in Youth: A Systematic Review. Mack, DE., Anzovino, D., Sanderson, M., et al.[2023]

Family-Focused Treatment for Childhood Depression (FFT-CD) was found to be more effective than individual supportive psychotherapy, with 77.7% of children in FFT-CD showing significant improvement in depression symptoms compared to 59.9% in the other group during treatment.

Both treatment groups had similar recovery rates from depressive episodes (around 76-77%), but FFT-CD showed a lower rate of depressive recurrences and suicide attempts at the 9-month follow-up, highlighting the potential long-term benefits of family interventions in managing childhood depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and efficacy of a family-focused treatment for depression in childhood. Tompson, MC., Langer, DA., Asarnow, JR.[2021]

The comprehensive body system review (BSR) in the Safety Monitoring Uniform Report Form (SMURF) identified 129 additional adverse events (AEs) in pediatric patients, significantly more than the 48 AEs from the general inquiry and 16 from the drug-specific inquiry, highlighting its effectiveness in capturing important safety data.

Parents found the detailed BSR acceptable and satisfactory, while clinicians did not share the same level of acceptance, indicating a potential gap in the perceived utility of detailed adverse event reporting methods in pediatric psychopharmacology.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology. Greenhill, LL., Vitiello, B., Fisher, P., et al.[2007]

The Integrated Care Pathway (ICP) developed for treating adolescents with depression aims to improve treatment response by following a Clinical Practice Guideline and a measurement-based care framework, with outcomes assessed using the Childhood Depression Rating Scale - Revised (CDRS-R) over a 20-week period.

The study plans to recruit 30 participants at two outpatient sites, with the hypothesis that the ICP will lead to greater reductions in depressive symptoms compared to standard treatment, and if successful, will pave the way for a larger multi-center randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of an Integrated Care Pathway for Adolescents with Depression: A Pilot Clinical Trial Protocol. Courtney, DB., Cheung, A., Henderson, J., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39425229

Cluster randomized trial of a team communication training ... However, team effectiveness interventions have been shown to improve team processes and outcomes and can be applied in healthcare settings.

2. implementationsciencecomms.biomedcentral.com implementationsciencecomms.biomedcentral.com/articles/10.1186/s43058-024-00641-5

Cluster randomized trial of a team communication training ... This project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression ...

3. clinicaltrials.gov clinicaltrials.gov/show/NCT06527196

TEAMS R34 #3: Team Communication Training for ... Team communication training is hypothesized to lead to improved, efficient, and effective decision-making to increase the frequency of depression ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11487972/

Cluster randomized trial of a team communication training ... Data from the National Survey of Children's Health indicates a 3.2% prevalence rate for pediatric depression in the US and 14.3% among youths ...

5. researchgate.net researchgate.net/publication/385049321_Cluster_randomized_trial_of_a_team_communication_training_implementation_strategy_for_depression_screening_in_a_pediatric_healthcare_system_a_study_protocol

Cluster randomized trial of a team communication training ... Methods This project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression ...

6. frontiersin.org frontiersin.org/journals/child-and-adolescent-psychiatry/articles/10.3389/frcha.2024.1328527/full

Depression symptoms, communication and cooperation ... In the present study, we examined depression symptoms in preschool age (4 years) in relation to social skills (communication and cooperation), and friendships.