BackGround

Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic.

Objective

To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used.

Method

Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants’ age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity.

Results

No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians’ poor adherence to feedback conditions.

Conclusions

The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care.

Trial registration Dutch Trial Register NTR4234 .

中文翻译：

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调查青年心理保健中常规结果监测（ROM）反馈的有效成分所面临的挑战

背景

青年精神卫生保健中对反馈的研究很少，并且将反馈实施到临床实践中是有问题的。

目的

为了通过三臂，平行分组，随机对照试验研究荷兰青年心理保健中常规结果监测（ROM）反馈的潜在有效组成部分，该试验采用了基于文献的多方面实施策略。

方法

使用分组随机程序将参与者随机分配到三种情况（有关症状和生活质量的基本反馈；补充有临床支持工具的基本反馈；与同事讨论第二种情况的反馈，同时遵循标准化的病例咨询格式） ，按位置和参与者的年龄分层。青年样本包括225名参与者（平均年龄= 15.08岁；女性为61.8％），父母样本为234名母亲和54名父亲（儿童的平均年龄= 12.50岁；女性为47.2％）。主要结果是症状严重程度。次要结果是生活质量和治疗结束变量。此外，我们评估了“未步入正轨（NOT）”是否缓解了症状与症状严重性变化之间的关联。

结果

条件之间没有显着差异，没有发现NOT的调节作用。这种结果可能归因于有限的功能和实施困难，例如ROM很少，反馈的查看和共享水平不明，以及临床医生对反馈条件的依从性差。

结论

这项研究使我们对ROM反馈的知识有限，并强调了青少年精神卫生保健中ROM的研究和实施的复杂性。

试用注册荷兰试用注册NTR4234。