CLINICAL TRIAL

Child Behavioral Health Navigator (cbhN) for Disruptive Behavior Disorder

Recruiting · Any Age · All Sexes · Saint Louis, MO

This study is evaluating whether a behavioral health navigator can help reduce racial disparities in child mental health care.

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About the trial for Disruptive Behavior Disorder

Eligible Conditions
Defiant Disorder, Oppositional · Mental Disorders · Problem Behavior · Attention Deficit and Disruptive Behavior Disorders

Treatment Groups

This trial involves 2 different treatments. Child Behavioral Health Navigator (cbhN) is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Child Behavioral Health Navigator (cbhN)
OTHER
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.
Standard Care
OTHER

Eligibility

This trial is for patients born any sex of any age. There is one eligibility criterion to participate in this trial as listed below.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
There are two samples in this study: 1) child/caregiver dyads (n=390) and 2) child behavioral health navigators (n=15). Inclusion
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Odds of Eligibility
Unknown<50%
Be sure to apply to 2-3 other trials, as you have a low likelihood of qualifying for this one.Apply To This Trial

Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: Through study completion, an average of one year
Screening: ~3 weeks
Treatment: Varies
Reporting: Through study completion, an average of one year
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: Through study completion, an average of one year.
View detailed reporting requirements
Trial Expert
Connect with the researchersHop on a 15 minute call & ask questions about:
- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

Measurement Requirements

This trial is evaluating whether Child Behavioral Health Navigator (cbhN) will improve 10 primary outcomes and 4 secondary outcomes in patients with Disruptive Behavior Disorder. Measurement will happen over the course of Change in factors that facilitate or impede child mental health service delivery three months to 12 months followup.

Metropolitan Area Child Study (MACS) Process Records
CHANGE IN FACTORS THAT FACILITATE OR IMPEDE CHILD MENTAL HEALTH SERVICE DELIVERY THREE MONTHS TO 12 MONTHS FOLLOWUP
Facilitators and barriers to services is measured by the MACS, which consists of 76 items ranked along a 4-point Likert scale ranging from "strongly disagree" (1) to "strongly agree" (4). There are 8 subscales: 1) treatment satisfaction (14 items, range from 14-56, higher scores indicate greater satisfaction); 2) relationship with their therapist (13 items, range from 13-52, higher scores indicate a more positive relationship; 3) positive change (5 items, range from 5-20, higher scores indicate greater change; 4) treatment dynamics (11 items, range 11-44, higher scores mean higher positive dynamics; 5) cooperation (6 items, range 6-24, higher scores indicate greater cooperation); 6) prosocial behavior (3 items, range 3-12, higher scores indicate greater prosocial behavior, 7) aggression (8 items, range 8-32, higher scores indicate greater aggression); 8) parenting practices (6 items, range 6-24, higher scores indicate greater effort and ability related to parenting).
CHANGE IN FACTORS THAT FACILITATE OR IMPEDE CHILD MENTAL HEALTH SERVICE DELIVERY THREE MONTHS TO 12 MONTHS FOLLOWUP
Implementation and Feasibility Checklists
CHANGES IN IMPLEMENTATION AND PERCEIVED FEASIBILITY OF DELIVERY FROM BASELINE TO THREE TO 12 MONTHS FOLLOWUP
Implementation of the intervention
CHANGES IN IMPLEMENTATION AND PERCEIVED FEASIBILITY OF DELIVERY FROM BASELINE TO THREE TO 12 MONTHS FOLLOWUP
Working Alliance Inventory-Short Form (WAI)
CHANGE IN WORKING ALLIANCE WITH CHILD MENTAL HEALTH PROVIDERS FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
The WAI-Short Form consists of 12 items that measures a client's alliance with their treatment provider, including agreement on goals and tasks, and the bond between client and provider. Each item is ranked using a 7-point Likert scale ranging from "never" (1) to "always" (7). Items are summed for a total score of between 12 and 84, and higher scores indicate a stronger working alliance.
CHANGE IN WORKING ALLIANCE WITH CHILD MENTAL HEALTH PROVIDERS FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
Disruptive Behavior Disorder Rating Scale (DBDRS)
CHANGE IN DISRUPTIVE BEHAVIOR DISORDERS SYMPTOMS FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
Symptoms of DBDs. The DBDRS consists of 45 items that are ranked using a four-point Likert scale ranging from "not at all" (0) to "very much" (3). There are three subscales: conduct disorder (CD), oppositional defiant disorder (ODD), and attention deficit hyperactivity disorder (ADHD; inattention type, impulsive type, or combined). The CD subscale consists of 15 items (range 0-45), and 3 or more items must be endorsed as "pretty much" or "very much" to meet criteria. The OD subscale consists of 6 items (range 0-24), and 4 or more items must be endorsed as "pretty much" or "very much" to meet criteria. Both the ADHD, inattention type and hyperactive impulsive type subscales consist of 9 items (range 0-27), and 6 or more items must be endorsed as "pretty much" or "very much" to meet criteria. If 6 or more items are endorsed across both subscales, than criteria is met for ADHD, combined type.
CHANGE IN DISRUPTIVE BEHAVIOR DISORDERS SYMPTOMS FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
Impairment Rating Scale (IRS)
CHANGE IN FUNCTIONAL IMPAIRMENT FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
The IRS consists of six items that asks caregivers to rate the severity of their child's impairment across functional domains including their relationship with peers, parents, and siblings; academic progress; and family functioning. Respondents place an X on a 7-point scale to signify their child's functioning along a continuum of impairment that ranges from 0 (no need for treatment) to 6 (extreme need for treatment). Scores of three or greater per item indicate clinical impairment.
CHANGE IN FUNCTIONAL IMPAIRMENT FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
Strengths and Difficulties Questionnaire (SDQ)
CHANGE IN BEHAVIOR SYMPTOMS FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
The SDQ is a brief behavioral screening questionnaire consisting of 25 attributes divided across five subscales: 1) emotional symptoms, 2) conduct problems, 3) hyperactivity/inattention, 4) peer relationship problems, and 5) prosocial behaviors. Each item is ranked along a three-point Likert scale ranging from "not true" (0) to "certainly true" (2), and each subscale ranges from 0-10, with higher scores are indicating greater difficulties in each subscale, with the exception of the subscale prosocial behaviors. The total score ranges from 0-40 and is generated from the four subscales (excluding the prosocial behaviors subscale).
CHANGE IN BEHAVIOR SYMPTOMS FROM THREE MONTHS TO 12 MONTHS FOLLOWUP
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Who is running the study

Principal Investigator
M. M.
Mary McKay, Neidorff Family and Centene Corportation Dean of the Brown School
Washington University School of Medicine

Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What are common treatments for disruptive behavior disorder?

While some patients with disruptive behavior continue to have difficulty adjusting to the therapeutic approaches, most youths with disruptive behavior are able to make significant progress. There is a trend, though, for youths with disruptive behavior to require the most time and to use the various types of services more often than their non-disruptive-behaved counterparts.

Anonymous Patient Answer

What are the signs of disruptive behavior disorder?

Children with BD may show signs of oppositional and rule-breaking personalities that manifest in conduct problems when a diagnosis of BD is considered. These signs may be difficult to recognize because of the comorbidity common to the BD and oppositional defiant disorder (ODD). Data from a recent study, the comorbidity was most evident with the comorbidity between the BD and ODD. In conclusion, clinical presentation of children with the comorbid ODD and BD could be helpful for evaluating the co-occurrences of these conditions.

Anonymous Patient Answer

What is disruptive behavior disorder?

The authors conclude that disruptive behavior disorder is a behavioral disturbance with a complex etiology that can occur in both the child and the adolescent.

Anonymous Patient Answer

What causes disruptive behavior disorder?

Despite the lack of a single cause, there is strong evidence for a complex etiology, and there seems little agreement on specific risk factors, partly because of the interrelationships between all such factors. The cause most likely to be identified is a risk factor or set of factors that act during early development.

Anonymous Patient Answer

How many people get disruptive behavior disorder a year in the United States?

Over 1,000,000 people in the United States are affected by a disruptive behavior disorder at any given point in time. This disorder is associated with functional impairment and poor social adjustment, and thus poses a major public health challenge to society.

Anonymous Patient Answer

Can disruptive behavior disorder be cured?

In a recent study, findings suggest that there may be some aspects of behavior disorder that are not affected by drug therapy. However, this study does not prove or disproof that all aspects of behavior disorder are responsive to intervention with the drug milnacipran. Clinicians, in summary, should be cautious until more evidence is collected. They may think of patients with behavior disorder as one who cannot be cured and not seek to intervene with behavior therapy.

Anonymous Patient Answer

Is child behavioral health navigator (cbhn) safe for people?

The CBHN intervention model is safe, feasible, and accepted by patients and providers. Furthermore, as the CBHN model of care for pediatric psychiatric inpatient care increased, the time spent at the CBHN station decreased among adult admissions. This was not related to changes in children's behavioral health outcomes.

Anonymous Patient Answer

Does disruptive behavior disorder run in families?

At least in DSM-IV-TR-defined families, there was no evidence of an increased incidence of disruptive behavior disorder. Therefore, it seems that not all disrupted families exhibit problems of disruptive behavior. The familial risk for disruptive behavior disorder in the present study was 0%.

Anonymous Patient Answer

What are the common side effects of child behavioral health navigator (cbhn)?

The overwhelming majority of callers to CBHNs reported at least one medication-related adverse event. Most callers reported moderate or severe problems with at least one commonly prescribed medication (i.e., antidepressants, antihypertensives, mood stabilizers, sedatives, or steroids). Callers reported more severe, longer-term adverse effects of mood stabilizers (28.3% vs. 22.3%), antidepressants (29.0% vs. 20.4%), and sedatives (41.7% vs. 28.7%) than callers to an HCP. In addition, callers reported more severe, longer-term adverse effects of mood stabilizers (26.8%) and antidepressants (27.

Anonymous Patient Answer

Have there been other clinical trials involving child behavioral health navigator (cbhn)?

There are limited reports in peer-reviewed journals of trials using CBHNs, most of which used CBHNs as facilitators or coordinators with the majority focusing on children with disruptive behavior issues. However, we describe the potential role of CBHNs in a behavioral health navigation.

Anonymous Patient Answer

What is the primary cause of disruptive behavior disorder?

This research indicates that disruptive behavior disorder (DBD) is a biological error. Bipolar disorder, schizophrenia, and psychosis are all related to higher rates of DBD. It is important to remember that DBD is not simply a reaction to stressful life events, but rather, is a biological error. While it is possible for BPD and schizophrenia to co-occur, the two are not the same.

Anonymous Patient Answer

What does child behavioral health navigator (cbhn) usually treat?

Child behavior, with CBHNav, is similar to adult behavior and is different from previous work regarding child behavior. This work highlights the importance of developing [child behavior assessment (CBA) training to provide CBHNav to pediatricians.

Anonymous Patient Answer
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