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Harlem Strong Mental Health Coalition

ConditionsStress-related ProblemDepression, AnxietyMental Health Wellness
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-65
SponsorCity University of New York, School of Public Health

About this trial

Addressing health disparities, especially in the face of coronavirus pandemic, requires an integrated multi-sector equity-focused, community-based approach. This study will examine the impact of Harlem Strong Community Mental Health Collaborative, a community-wide multi-sectoral coalition in which a health insurer works with a network of community-based organizations, medical providers, and behavioral health providers to engage in a network-wide implementation planning process to: (1) problem-solve financing, access, and quality of care barriers, (2) support capacity building for mental health (MH) task-sharing for community health workers, (3) facilitate coordination and collaboration across MH/behavioral health, primary care, and a range of social services, including case management, housing supports, financial education, employment support, and other community resources to improve linkages to services, and (4) identify a set of common MH, social risk, and health metrics and strategies to integrate these metrics into data systems across the network for continuous quality improvement of the system. The long-term goal of our study is to develop sustainable model for task-sharing MH care that will be embedded in a coordinated comprehensive network of services, including primary care, behavioral/MH, social services, and other community resources.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Black and Latino adults between 18 and 65 years

Harlem residents from low-income housing developments or receiving primary care services in Harlem

PHQ-4 Total Score ≥3, moderate risk for depression

Disqualifiers

Those with risk for depression or anxiety who screen positive for severe mental illness (e.g., psychosis, mania, substance abuse, and high suicide risk) using screening items from the Mini-International Neuropsychiatric Interview will be excluded from the study and referred to MH services at higher levels of care

Trial design

Design model

Crossover

Treatments tested in this trial

  • MH task-sharing training

    Behavioral

    Providers will be trained to screen for MH, provide education, refer, and coordinate to range of social services. MH training typically consists of education and resources, such as one-time workshops and toolkits, provided with limited technical assistance.

  • Supervision

    Behavioral

    Additionally, Community Health Workers (CHWs) will receive bi-weekly group supervision for the first 6-months, and monthly supervision for the remaining year on Zoom from a supervisor at Center for Innovation in Mental Health.

  • Learning Collaborative

    Behavioral

    A learning collaborative with multidisciplinary teams from various healthcare organizations will support continuous quality improvement and develop develop structured approach to improve provision of care.

  • Technology Intervention

    Other intervention

    To be determined by community crowdsourcing after the first phase of implementation of the multisector collaborative care for MH task-sharing.

Treatment groups

700 Participants
are divided into 3 treatment groups
Group A: Education and ResourcesActive comparator 1 intervention
Group B: Multisector Collaborative CareExperimental treatment 3 interventions
Group C: Multisector Collaborative Care and TechnologyExperimental treatment 4 interventions

Trial outcomes

Primary outcomes

1

Depression - PHQ-9

Depression symptom severity is assessed using the Patient Health Questionnaire (PHQ-9), which includes nine items on a scale ranging from "0" (Not at all) to "3" (Nearly every day). PHQ-9 scores range from 0 to 27, with higher scores indicating greater severity of depression. The scores are categorized into five levels: minimal (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27).

Time frame
6-12 months
2

Anxiety - GAD-7

Anxiety symptom severity is assessed using the General Anxiety Disorder (GAD-7) scale, which consists of seven items designed to screen and evaluate anxiety symptom severity on a scale ranging from "0" (Not at all) to "3" (Nearly every day). GAD-7 scores range from 0 to 21, with higher scores indicating greater anxiety symptoms. Scores are classified into four levels: minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21).

Time frame
6-12 months
3

Reach of Screening

Number of new consumers screened for depression using the Patient Health Questionnaire (PHQ-4) relative to the total number of low-income housing residents or patients seen at the sites will be used.

Time frame
0-24 months
4

Mental Health Service Linkage

% of successful MH linkages (connecting with MH navigator or MH referrals).

Time frame
0-24 months

Secondary outcomes

1

Program Adoption

% of delivering MH care components during the Supported Implementation when implementation support is provided (% of MH care components delivered - screening, assessment, education, referral).

Time frame
0-12 months
2

Program Sustainment

% of delivering MH care components during the Sustainment Phases when study-funded implementation supports are withdrawn (% of MH care components delivered - screening, assessment, education, referral).

Time frame
24 months
3

Implementation Barriers and Facilitators

The investigators will review the implementation data table before conducting qualitative interviews to construct the "implementation story (themes)" based on the implementation data which is extracted from clinical records/logs and training records.

Time frame
12, 24 months
4

Provider Attitude towards Adopting Evidence-Based Practices (EBPAS)

The Evidence-based Practice Attitude Scale with 15 items is used to assess providers' attitudes including their requirements, appeal, openness, and divergence. Each item is scored from "0" (not at all) to "4" (to a very great extent), with higher scores indicating a more positive attitude towards adopting evidence-based practices.

Time frame
0, 6, 12, 24 months

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

City University of New York, School of Public Health

Lead sponsor

Harlem Congregation for Community Improvement, Inc.

Collaborator

Healthfirst

Collaborator

Source ClinicalTrials.gov
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