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Supporting Our Valued Adolescents Pilot Randomized Controlled Trial

Not Applicable
Completed
Conditions
Depression
Anxiety
Interventions
Behavioral: Supporting Our Valued Adolescents (SOVA)
Other: Enhanced Usual Care
Registration Number
NCT03318666
Lead Sponsor
University of Pittsburgh
Brief Summary

The purpose of this pilot study is to provide preliminary findings testing the Supporting Our Valued Adolescents (SOVA) intervention, two social media sites (one for adolescents, one for parents) aiming to address negative health beliefs, knowledge about depression or anxiety, parent-adolescent communication, in a moderated online peer community, with the goal of increasing adolescent use of mental health services.

Detailed Description

Although recent evidence shows integrated care models increase service use, implementing these models is resource intense. Even in primary care settings with access to services and routine screening for depression and anxiety, patient engagement is low. This can be explained by a low perceived need for services present in both adolescents and parents. Key target mechanisms which may increase service use include: (1) parents' and adolescents' health beliefs and knowledge, (2) emotional/informational support, and (3) communication about mental health with each other. The "SOVA" or "Supporting Our Valued Adolescents" intervention aims to address these key mechanisms through two moderated social media websites (one for parents, one for adolescents) which include daily blog posts, online peer to peer interactions, and discussion guides. SOVA had undergone an iterative process of design - using stakeholder-engagement and human computer interaction techniques (PCOR K12 HS 22989-1). The goal of this process was to build a usable intervention which is stakeholder-informed. Preliminary work has found that 100 adolescents/young adults with a history of depression or anxiety symptoms and parents find the SOVA websites to have good usability. The investigators will use a pilot randomized controlled trial of SOVA to refine recruitment and retention strategies, measure implementation outcomes and investigate potential mechanisms of action in depressed and/or anxious adolescents not currently engaged in treatment and their parents; and examine parent-adolescent communication factors about mental health and relationship quality in the context of a web-based intervention.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
38
Inclusion Criteria

Adolescent:

  • Ages 12-19
  • AHCP identifies depressive and/or anxiety symptoms
  • Scores at least 5 or greater on the PHQ-9 (depression) and/or GAD-7 (anxiety) consistent with at least mild symptoms
  • AHCP recommends adolescent to initiate a new treatment episode (no treatment in past 3 months)
  • Can read and write in English
  • Have completed the 6th grade
  • Assent (<18 y/o)/Consent to study (18 or 19 y/o)

Parent:

  • Adolescent child meets inclusion/exclusion criteria and agrees to enroll in the study
  • Can read and write in English
  • Have completed the 6th grade
  • Consent to study

Adolescent Healthcare Provider:

  • Healthcare provider (physician, nurse practitioner, physician assistant) providing clinical services in the Center for Adolescent and Young Adult Health
  • Consents to study
Exclusion Criteria

Adolescent:

  • Actively suicidal requiring crisis/hospitalization defined as: currently having suicidal thoughts and a plan AND AHCP recommends immediate crisis services and/or evaluation for hospitalization
  • History of receiving a psychiatric medication and/or psychotherapy for depression and/or anxiety in the past 3 months
  • No access to internet
  • No active email account

Parent:

  • No access to internet
  • No active email account

Adolescent Healthcare Provier:

• None

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Supporting Our Valued Adolescents (SOVA)Enhanced Usual CareThis arm will receive the SOVA intervention in addition to Enhanced Usual Care
Enhanced Usual Care (EUC)Enhanced Usual CareBoth arms will receive this intervention
Supporting Our Valued Adolescents (SOVA)Supporting Our Valued Adolescents (SOVA)This arm will receive the SOVA intervention in addition to Enhanced Usual Care
Primary Outcome Measures
NameTimeMethod
Study retention6 weeks

proportion of dyads accessing 6-week to those who access baseline surveys

Secondary Outcome Measures
NameTimeMethod
Parent Help Seeking (for Parent themselves)6 weeks

Actual Help Seeking Questionnaire, a list of individuals help may have been sought from with indication of whether this person was seen for an emotional problem in the past 2 weeks yes or no

Parent perception of Adolescent Functioning6 weeks

Columbia Impairment Scale, Parent rates on a 0-4 scale how much of a problem different aspects of adolescent functioning have been, 13 item questionnaire, higher score indicates greater problems with functioning

Health Beliefs: Beliefs About Therapy - Adolescents6 weeks

Barriers to Adolescents Seeking Help Scale (Wilson 2005/Kuhl 1997) measures perceptions about seeking treatment from a mental health provider. The total score ranges from 1 to 11, a higher score indicated greater barriers.

Health Beliefs: Beliefs About Therapy - Parents6 weeks

The Parental version of the Barriers to Help Seeking Scale (Bates, 2010) measures parental perceptions about their child seeking treatment from a mental health provider. The total score ranges from 1 to 11, a higher score indicated greater barriers.

Actual Receipt of Mental Health Services6 weeks and 3 months

Combined measure using Electronic Health Record Chart Review and parent/adolescent self-report as well as the Actual Help Seeking Questionnaire (Rickwood 2005) which does not involve scoring.

Intervention acceptabilityat study completion, an average of 1year

interviews with adolescent healthcare providers

Health beliefs: Stigma6 weeks

The Depression Stigma Scale (Griffiths 2004) measurizes stigmatizing attitudes toward depression treatment. It is a continuous measure and the total score ranges from 0-36. There are two subscales: the personal stigma subscale which totals 0-18 and the perceived stigma subscale which totals 0-18. These two are summed for the total stigma score. A higher score indicates a worse outcome.

Health Beliefs: Beliefs about Antidepressants - Resistance6 weeks

The Resistance to Antidepressant Use Questionnaire (Cohane, 2008) measures an individual's resistance toward taking antidepressant medication if prescribed. It is a continuous measure and the total score ranges from 0 to 18, with a higher score indicating greater resistance.

Depression Knowledge6 weeks

The Depression literacy questionnaire (Gulliver 2012) measures knowledge about depression diagnosis and treatment. The total score ranges from 0-22, with a higher score indicating greater knowledge of depression.

Peer social support6 weeks

Actual/Observed emotional/informational support from online coding of peer and moderator comments for types of social support

Parent-Adolescent Communication Quality-Parent Form-Extent of Problems Subscale6 weeks

The Parent-Adolescent Communication Scale measures two subscales of parent communication. This measure obtains this information from the parent perspective. The extent of communication problems subscale has a range from 10 through 50 - higher scores indicating greater extent of problems with communication.

Parent-Adolescent Communication Quality-Adolescent Form-Extent of Problems Subscale6 weeks

The Parent-Adolescent Communication Scale measures two subscales of parent communication. This measure obtains this information from the adolescent perspective. The extent of communication problems subscale has a range from 10 through 50 - higher scores indicating greater extent of problems with communication.

Perceived Need for Treatment - Open ended question6 weeks

Open-ended question about whether adolescent/child needs any mental health service

Perceived Need for Treatment - Survey Measure6 weeks

The General-Practice Users Perceived-Need Inventory (McNab, 2004) will be used to measure perceived need for treatment. There is no scoring.

Depressive Symptoms6 weeks

Patient Health Questionnaire-9 measures depression severity with a score ranging from 0 to 27, a higher score indicating greater severity.

Anxiety Symptoms6 weeks

Generalized Anxiety Disorders 7-item Questionnaire measures extent of anxiety symptoms. The total score ranges from 0 to 21 with a higher score indicating greater severity.

Functioning6 weeks

The Multidimensional Adolescent Functioning Scale (Wardennar 2013) has 3 subscales of functioning for adolescents - in general, related to family, and related to peers. The total score subscales for general are 0-40; for family are 0-28; and for peer are 0-24 with a higher score indicating higher functioning. The subscales can be totalled for a range of 0-92.

Relationship Quality6 weeks

Parent-child connectedness scale, 5 questions on a 5-point Likert scale, higher scores indicated greater connectedness

Adolescent Help Seeking - Parent Perception of Adolescent Help Seeking6 weeks

Actual Help Seeking Questionnaire, a list of individuals help may have been sought from with indication of whether this person was seen for an emotional problem in the past 2 weeks yes or no

Health Beliefs: Beliefs about Antidepressants - Meanings6 weeks

The Antidepressant Meanings Scale (Cohane, 2008) measures an individual's level of negative attitudes toward taking an antidepressant medication if prescribed. It is a continuous measure and the total score ranges from 0 to 24, with a higher score indicating more negative attitudes.

Anxiety Knowledge6 weeks

The Anxiety literacy questionnaire (Gulliver 2012) measures knowledge about depression diagnosis and treatment. The total score ranges from 0-22, with a higher score indicating greater knowledge of anxiety.

Peer emotional/informational support6 weeks

The Medical Outcome Study Social Support Scale (Sherbourne, 1991) has a single subscale named the Emotional/informational subscale which measures types of social support which either provide emotional support or provide information. This subscale ranges from 0-100, with higher levels associated with greater support.

Parent-Adolescent Communication Quality-Parent Form-Openness Subscale6 weeks

The Parent-Adolescent Communication Scale measures two subscales of parent communication. This measure obtains this information from the parent perspective. The degree of openness subscale has 10 questions with a range from 10 through 50 - higher scores indicating more openness in communication.

Parent-Adolescent Communication Quality-Adolescent Form-Openness Subscale6 weeks

The Parent-Adolescent Communication Scale measures two subscales of parent communication. This measure obtains this information from the adolescent perspective. The degree of openness subscale has 10 questions with a range from 10 through 50 - higher scores indicating more openness in communication.

Adolescent Help Seeking - Adolescent Perception6 weeks

Actual Help Seeking Questionnaire, a list of individuals help may have been sought from with indication of whether this person was seen for an emotional problem in the past 2 weeks yes or no

Trial Locations

Locations (1)

Center for Adolescent and Young Adult Health

🇺🇸

Pittsburgh, Pennsylvania, United States

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