METRIC: Measurement, Education and Tracking in Integrated Care


The proposed study seeks to establish the feasibility of universal screening for depression in an adult primary care safety net setting, measure the effectiveness of a culturally appropriate depression education intervention to reduce stigma and increase uptake in depression treatment among Hispanics, and implement a Measurement-Based Integrated Care (MBIC) model with collaborative, multi-disciplinary treatment and culturally tailored care management strategies.

Full Title of Study: “METRIC: Measurement, Education and Tracking in Integrated Care: Strategies to Increase Patient Engagement and Reduce Mental Health Disparities Among Hispanics”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: January 15, 2019

Detailed Description

Specific Aim 1: Examine the specific effects of a Depression Education Fotonovela (DEF) to increase knowledge of depression, reduce stigma and increase engagement in depression treatment among Hispanic patients.

Specific Aim 2: Evaluate the impact of Measurement-Based Integrated Care (MBIC) for the treatment of depression in one community-based Federally Qualified Health Centers (FQHC) in North Texas whose patient population is majority Hispanic.

Specific Aim 3: Examine the feasibility of universal screening and accurate detection of depression among adult primary care patients utilizing innovative iPad Depression Screening technology.


  • Other: Measurement-Based Integrated Care
    • Measurement-Based Integrated Care (MBIC) synthesizes the science of integrated health care and incorporates the strategies of measurement-based care. concept of MBIC for the treatment of depression includes: systematic assessment of symptoms, antidepressant treatment side effects and medication adherence and incorporation of a Depression Care Manager (DCM) to track patients and keep them engaged in care using behavioral interventions
  • Behavioral: Depression Education Fotonovela
    • Depression education that uses a unique, culturally adapted depression fotonovela titled “Secret Feelings” developed by Cabassa, Molina and Baron (2012). The fotonovela is a popular comic-book style pamphlet that portrays a dramatic story using photographs and dialogue bubbles, which has become an effective tool for engaging Hispanic audiences and increasing knowledge about specific health issues
  • Behavioral: Standard Education
    • The the use of a pamphlet to educate people about depression.

Arms, Groups and Cohorts

  • Experimental: MBIC + DEF
    • Measurement-Based Integrated Care with Depression Education Fotonovela
  • Experimental: MBIC + SE
    • Measurement-Based Integrated Care + Standard Education

Clinical Trial Outcome Measures

Primary Measures

  • Number of participants who engage in depression treatment
    • Time Frame: baseline to one month post education session
  • Change in PHQ-9 (depressive symptoms) scores
    • Time Frame: baseline compared to one year post enrollment

Secondary Measures

  • Number of primary care patients screened for depression using the iPad technology
    • Time Frame: two year participant enrollment period

Participating in This Clinical Trial

Inclusion Criteria

  • Adult primary care patients
  • Hispanic
  • Meets diagnostic criteria for depression

Exclusion Criteria

  • currently in treatment for depression

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • The University of Texas at Arlington
  • Collaborator
    • National Institute on Minority Health and Health Disparities (NIMHD)
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Katherine Sanchez, PhD, Principal Investigator, University of Texas at Arlington

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