title: Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial.
abstract: OBJECTIVE
  A randomized cluster controlled trial tested the hypothesis that weekly feedback to clinicians would improve the effectiveness of home-based mental health treatment received by youths in community settings.
  
  
  METHODS
  Youths, caregivers, and clinicians at 28 sites in ten states completed assessments of the youths' symptoms and functioning every other week. Clinicians at 13 sites were provided with weekly feedback about the assessments, and clinicians at 15 sites received feedback every 90 days. Data were collected from June 1, 2006, through December 31, 2008. Intent-to-treat analyses were conducted with hierarchical linear modeling of data provided by youths, caregivers, and clinicians.
  
  
  RESULTS
  Assessments by youths, caregivers, and clinicians indicated that youths (N=173) treated at sites where clinicians could receive weekly feedback improved faster than youths (N=167) treated at sites where clinicians did not receive weekly feedback. A dose-response analysis showed even stronger effects when clinicians viewed more feedback reports.
  
  
  CONCLUSIONS
  Routine measurement and feedback can be used to improve outcomes for youths who receive typical home-based services in the community.
authors.affiliation: Vanderbilt University, Nashville, TN 37203-5721, USA. leonard.bickman@vanderbilt.edu
authors.forename: Leonard
authors.initials: L
authors.lastname: Bickman
authors.forename: Susan Douglas
authors.initials: SD
authors.lastname: Kelley
authors.forename: Carolyn
authors.initials: C
authors.lastname: Breda
authors.forename: Ana Regina
authors.initials: AR
authors.lastname: de Andrade
authors.forename: Manuel
authors.initials: M
authors.lastname: Riemer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000592:standards; D005246:Feedback; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057194:Intention to Treat Analysis; D007721:Knowledge of Results, Psychological; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D058996:Quality Improvement; D016896:Treatment Outcome