Cluster randomized trial of a team communication training implementation strategy for depression screening in a pediatric healthcare system: a study protocol.

Autor: Stadnick NA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. nstadnic@health.ucsd.edu.; University of California San Diego Altman Clinical and Translational Research Center Dissemination and Implementation Science Center, La Jolla, CA, USA. nstadnic@health.ucsd.edu.; Child and Adolescent Services Research Center, San Diego, CA, USA. nstadnic@health.ucsd.edu.; Implementation Science and Team Effectiveness in Practice Children's Mental Health Research Center, San Diego, USA. nstadnic@health.ucsd.edu., Aarons GA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.; University of California San Diego Altman Clinical and Translational Research Center Dissemination and Implementation Science Center, La Jolla, CA, USA.; Child and Adolescent Services Research Center, San Diego, CA, USA.; Implementation Science and Team Effectiveness in Practice Children's Mental Health Research Center, San Diego, USA., Edwards HN; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.; Child and Adolescent Services Research Center, San Diego, CA, USA.; Implementation Science and Team Effectiveness in Practice Children's Mental Health Research Center, San Diego, USA., Bryl AW; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.; Rady Children's Hospital, San Diego, CA, USA., Kuelbs CL; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.; Rady Children's Hospital, San Diego, CA, USA., Helm JL; Department of Psychology, San Diego State University, San Diego, CA, USA.; Implementation Science and Team Effectiveness in Practice Children's Mental Health Research Center, San Diego, USA., Brookman-Frazee L; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.; University of California San Diego Altman Clinical and Translational Research Center Dissemination and Implementation Science Center, La Jolla, CA, USA.; Child and Adolescent Services Research Center, San Diego, CA, USA.; Rady Children's Hospital, San Diego, CA, USA.; Implementation Science and Team Effectiveness in Practice Children's Mental Health Research Center, San Diego, USA.
Jazyk: angličtina
Zdroj: Implementation science communications [Implement Sci Commun] 2024 Oct 18; Vol. 5 (1), pp. 117. Date of Electronic Publication: 2024 Oct 18.
DOI: 10.1186/s43058-024-00641-5
Abstrakt: Background: Pediatric depression is a global concern that has fueled efforts for enhanced detection and treatment engagement. As one example, the US Preventive Services Task Force recommends depression screening for adolescents ages 12-18 years. While many health systems have implemented components of depression screening protocols, there is limited evidence of effective follow-up for pediatric depression. A key barrier is timely team communication and coordination across clinicians and staff within and across service areas for prompt service linkage. However, team effectiveness interventions have been shown to improve team processes and outcomes and can be applied in healthcare settings.
Methods: This project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression screening protocol in a large pediatric healthcare system. The team will be defined as part of the study but is expected to include medical assistants, nurses, physicians, and behavioral health clinicians within and across departments. The implementation strategy will target team mechanisms at the team-level (i.e., intra-organizational alignment and implementation climate) and team member-level (i.e., communication, coordination, psychological safety, and shared cognition). First, the project will use mixed methods to refine the team training strategy to fit the organizational context and workflows. Next, a hybrid type 3 implementation-effectiveness pilot trial will assess the initial effectiveness of the team communication training (implementation strategy) paired with the current universal depression screening protocol (clinical intervention) on implementation outcomes (i.e., feasibility, acceptability, appropriateness, workflow efficiency) and clinical/services outcomes (increased frequency of needed screening and reduced time to service linkage). Finally, the study will assess mechanisms at the team and team member levels that may affect implementation outcomes.
Discussion: Team communication training is hypothesized to lead to improved, efficient, and effective decision-making to increase the compliance with depression screening and timely service linkage. Findings are expected to yield better understanding and examples of how to optimize team communication to improve efficiency and effectiveness in the pediatric depression screening-to-treatment cascade. This should also culminate in improved implementation outcomes including patient engagement critical to address the youth mental health crisis.
Trial Registration: NCT06527196. Trial Sponsor: University of California San Diego.
(© 2024. The Author(s).)
Databáze: MEDLINE
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