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Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives

Jeffrey C. Eisen, MD, MBA; Monika Marko-Holguin, MSS; Joshua Fogel, PhD; Alonso Cardenas, BA; My Bahn, PhD; Nathan Bradford, MD; Blake Fagan, MD; Peggy Wiedmann, MD; and Benjamin W. Van Voorhees, MD, MPH

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ABSTRACT

Objective: To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007.

Method: The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention).

Results: While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses.

Conclusion: Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings.

Trial Registration: ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912

Prim Care Companion CNS Disord 2013;15(6):doi:10.4088/PCC.10m01065

Submitted: August 10, 2010; accepted October 2, 2013.

Published online: December 19, 2013.

Corresponding author: Benjamin W. Van Voorhees, MD, MPH, University of Illinois at Chicago, 840 South Wood St M/C 856, Chicago, IL 60612 (bvanvoor@uic.edu).