RECRUITINGINTERVENTIONAL

SKIP for PA Study: Team and Leadership Level Implementation Support for Collaborative Care

Care Team and Practice Level Implementation Strategies to Optimize Pediatric Collaborative Care: A Cluster-Randomized Trial

About This Trial

In a prior application (MH064372), the investigators' treatment research program (Services for Kids In Primary-care, SKIP) developed and tested a chronic care model-based intervention, called Doctor Office Collaborative Care (DOCC), that was found to be effective in the management of childhood behavior problems and comorbid ADHD. In the "SKIP for PA Study", the investigators propose to conduct a randomized clinical trial to evaluate the effects of team- and practice leadership-level implementation strategies designed to enhance the use and uptake of DOCC in diverse pediatric primary care offices.

Who May Be Eligible (Plain English)

The investigators propose to recruit 4 types of practice provider participants (PCP = primary care provider, CM = care manager, SL = Senior Leader, PM = practice manager) as well as caregiver participants. Who May Qualify: - PCP Participants: - Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. - Identified by the practice as a Primary Care Provider - CM Participants: - Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. - Identified by the practice as a Behavioral Health Resource who delivers and coordinates behavioral health care in the practice, who will function in the study as a care manager. - SL Participants: - Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. - Identified by the practice as the Senior Leader. - Have a practice-level leadership role such as Medical Director or a clinical/practice leader - Have administrative responsibilities related to patient care and/or the operations/management of the practice - PM Participants: - Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. - Identified by the practice as the Practice Manager or equivalent position - Are responsible for day-to-day practice operations, such as personnel management, billing, and compliance with regulations, in the pediatric practice. - Caregiver Participants: - Have a child age 5-12 years old who exhibits at least a modest level of behavior problems (Caregiver Participants) - Are at least 18 years of age (Caregiver participants) ...See full criteria on ClinicalTrials.gov Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

The investigators propose to recruit 4 types of practice provider participants (PCP = primary care provider, CM = care manager, SL = Senior Leader, PM = practice manager) as well as caregiver participants. Inclusion Criteria: * PCP Participants: * Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. * Identified by the practice as a Primary Care Provider * CM Participants: * Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. * Identified by the practice as a Behavioral Health Resource who delivers and coordinates behavioral health care in the practice, who will function in the study as a care manager. * SL Participants: * Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. * Identified by the practice as the Senior Leader. * Have a practice-level leadership role such as Medical Director or a clinical/practice leader * Have administrative responsibilities related to patient care and/or the operations/management of the practice * PM Participants: * Employed at one of the up to twenty-four (24) pediatric primary care practices identified by the PA Medical Home Program at the PA AAP or by the University of Pittsburgh research team. * Identified by the practice as the Practice Manager or equivalent position * Are responsible for day-to-day practice operations, such as personnel management, billing, and compliance with regulations, in the pediatric practice. * Caregiver Participants: * Have a child age 5-12 years old who exhibits at least a modest level of behavior problems (Caregiver Participants) * Are at least 18 years of age (Caregiver participants) * Have parental rights for this child (Caregiver participants) Exclusion Criteria: * Caregivers * Already enrolled in the study as the caregiver to a different child (e.g., sibling) (Caregiver participants)

Treatments Being Tested

BEHAVIORAL

DOCC: Evidence-based treatment for disruptive behavior and ADHD

Practices will learn and then deliver DOCC in treatment sessions with caregivers and/or children. The content covers key topics related to the treatment of behavior problems (e.g., self-management, positive parenting) and ADHD (e.g., psychoeducation, medication).

BEHAVIORAL

TEAM: Implementation support strategies at the care team level following standard implementation of DOCC

Practices will learn and then deliver DOCC in treatment sessions with caregivers and/or children. Coaching and consultation will be provided to the provider care team to support the use of collaborative care for behavior problems and ADHD. The TEAM intervention includes regular virtual meetings or calls with the providers (about once/month, on average) that cover core chronic care model functions, including registry use, case-finding, collaborative care team roles, and workflows outlining how DOCC is delivered in the practice.

BEHAVIORAL

Implementation support strategies at the leadership level following standard implementation of DOCC

Practices will learn and then deliver DOCC in treatment sessions with caregivers and/or children. Practice facilitation will be provided to practice leaders to help them support the care team's use of collaborative care for behavior problems and ADHD. The LEAD intervention includes regular virtual meetings or calls with practice leaders (about once/month, on average) that cover the assessment of practice capacity/barriers, ways to overcome organizational barriers and support staff use of DOCC, promoting innovation, and leveraging practice resources to support DOCC delivery and maintenance in the practice.

Locations (2)

Drexel University

Philadelphia, Pennsylvania, United States

University of Pittsburgh

Pittsburgh, Pennsylvania, United States