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Implementation of Problem-Solving Treatment in Community Health Centers (PST-Aid)

Type III Hybrid Effectiveness-Implementation Trial of a Clinical Decision Support System for the Implementation of Problem-Solving Treatment in Community Health Centers

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years and older
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

Not stated in the study description — ask the study team about visits and procedures.

Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests PST-Aid, a web app that helps therapists and clients use problem-solving treatment for depression. The app helps them set goals and plan actions together. The study is for therapists in the OCHIN clinic network and adults with depression.

Although evidence-based clinical interventions (CI) are a preferred treatment option for patients with depression, CIs are rarely available in community primary care settings. When available, CIs are often delivered with poor fidelity and abandoned by practitioners during the initial months post-training. Identifying effective implementation strategies to support the adoption, reach, and sustained use with fidelity of these CIs could enhance the effectiveness of primary care-based treatment of depression, as primary care is where most treatment for this disorder is delivered. Current models of primacy care practitioner training and supervision follow standard formal didactic procedures that might not be sufficient for successful adoption, high-fidelity delivery, and sustainment of CIs. Automated decision support tools and feedback systems embedded in health informatics technology have been found to be effective in supporting the use of best practices and hence might be useful for the transition from training to sustained CI use. In practice, however, these tools are ignored by practitioners, have mixed success on outcomes, and can hinder clinical care owing to poor design. Problem Solving Treatment Aid (PST-Aid), an educate and reorganize implementation strategy, is a web-based app that promotes practitioner-client collaboration in the use of PST for goal setting and action planning. A pilot randomized trial comparing Problem Solving Treatment (PST) training-as-usual to training plus PST-Aid found PST-Aid was deemed to be appropriate and usable to both practitioner and client users with preliminary support for benefits in depression outcomes.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Therapists: Work at a clinic in the OCHIN network and provide talk therapy in that network.
  • Therapists: Have a master's degree in social work, psychology, counseling, or a related field.
  • Therapists: Have no past formal training in problem-solving treatment under University of Washington AIMS rules.
  • Therapists: Are not getting special training outside usual clinic support in a depression-focused talk therapy.
  • Therapists and clients: Speak English.
  • Clients: Are age 18 or older.
  • Clients: Have unipolar depression, meaning depression without manic episodes, as reported by their care provider.
  • Clients: Score 10 or higher on the PHQ-9, a survey that measures depression symptoms.

Who can't join

  • Clients: Have a past or current mental health diagnosis other than anxiety or unipolar depression without psychosis. Psychosis means losing touch with reality.
  • Clients: Currently have thoughts of suicide.
  • Clients: Currently have an alcohol or drug abuse disorder.
  • Clients: Have dementia, a condition that affects memory and thinking.
  • Clients: Their care provider cannot confirm whether all the exclusion rules apply.
  • Therapists: Do not meet all the entry rules listed above.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: * Practitioner Participants. (a) are employed by a clinic that is an OCHIN clinical network member; * Practitioner Participants. (b) hold a master's degree in social work, psychology, counseling, or a related field; * Practitioner Participants. (c) provide psychotherapeutic care in the OCHIN network; * Practitioner Participants. (d) have not previously received formal training in PST as defined by University of Washington Advancing Integrated Mental Health Solutions Center (AIMS) criteria; * Practitioner Participants. (e) are not currently receiving specialized training outside of standard clinic support to implement a depression-specific psychosocial intervention; and * Practitioner Participants. (f) are English-speaking. * Client Participants. a) 18+, * Client Participants. b) English-speaking, * Client Participants. c) have a diagnosis of unipolar depression per provider report, and * Client Participants. d) have a PHQ-9 score ≥ 10, which is above the clinical cutoff for depression symptoms. Exclusion Criteria: * Client Participants. (a) history or presence of psychiatric diagnoses other than unipolar, nonpsychotic depression or anxiety disorders, * Client Participants. (b) active suicidal ideation, * Client Participants. (c) current alcohol or substance abuse disorders, or * Client Participants. (d) have dementia * Client Participants. (e) all exclusion criteria cannot be confirmed via provider report. * Practitioner Participants. Exclusion criteria are those that do not meet the inclusion criteria listed above.

Study sites (1)

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