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Effectiveness of universal vs. targeted school screening for adolescent major depressive disorder
Investigator (PI): Sekhar, Deepa
Performing Organization (PO): (Current): Penn State University, PennState Health, Milton S. Hershey Medical Center, Penn State Hershey Children's Hospital / (717) 531-7300
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2018
Final Year: 2022
Record Source/Award ID: PCORI/AD-2017C3-8752
Funding: Total Award Amount: $2,029,903
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Suicide is now the second leading cause of adolescent death. The prevalence of annual major depressive disorder (MDD) episodes has increased by greater than 50% from 2008 to 2015 among US adolescents. Unfortunately, despite recommendations for universal MDD screening, screening occurs in less than 2% of office visits. Further, screening is 80% less likely for Hispanic compared to non-Hispanic white adolescents, and both minorities and females are less likely to receive MDD treatment. The primary goal of the proposed study is to compare the effectiveness of universal versus targeted adolescent MDD screening in a school setting. Universal screening was chosen to be conducted in schools because, compared to medical settings, schools are more likely to engage adolescents representing a broad spectrum of race, ethnicity, and socioeconomic status. We hypothesize that universal school-based screening with the validated Patient Health Questionnaire-9 (PHQ-9) will increase the number of adolescents identified with MDD and engaged in treatment, and reduce disparities by race, ethnicity, and sex in adolescent mental health. Our Penn State team brings a breadth of experience in pediatrics, community-engaged research, adolescent health, psychiatry, and engagement with minority populations. We have actively partnered with school staff, parents, and adolescents in designing a randomized controlled trial with eight Pennsylvania (PA) public high schools (letters of commitment obtained) serving an estimated 9,650 predominantly minority, rural, and/or low socioeconomic status 9th- to 12th-grade students to conduct the proposed research. It is anticipated the proposal results will provide clear support for universal or targeted screening as an optimal approach to adolescent depression and inform best practices for management of adolescent MDD. The results have high potential for dissemination from the local to the national level. Results will be shared directly with partnering schools (e.g., school website, newspaper, social media), on the state level with over 1,000 schools across PA utilizing the Penn State Pro Wellness newsletter and our ongoing relationships with the PA Student Assistance Program, Prevent Suicide PA, and the PA Department of Health, and finally on the national level through the investigative team's academic circles as well as through our collaboration with the National Poll on Children's Health.
MeSH Terms:
  • Adolescent
  • Adolescent Medicine /*methods
  • Child Guidance
  • Female
  • Humans
  • Interdisciplinary Communication
  • Major Depressive Disorder /*diagnosis
  • /*therapy
  • Male
  • Mass Screening /*methods
  • Pennsylvania
  • PHQ-9
  • Program Development
  • Randomized Controlled Trials as Topic
  • School Health Services /*organization & administration
  • Socioeconomic Status
  • Suicide /prevention & control
  • United States
  • Universities
Country: United States
State: Pennsylvania
Zip Code: 17033
UI: 20192187
CTgovId: NCT03716869
Project Status: Ongoing