Promoting Treatment Access Following Pediatric Primary Care Depression Screening: Randomized Trial of Web-Based, Single-Session Interventions for Parents and Youths

Schleider, Jessica L.; Dobias, Mallory; Fassler, Julia; Shroff, Akash; Pati, Susmita

doi:10.1016/j.jaac.2020.01.025

Cited by 14 publications

(8 citation statements)

References 9 publications

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“…Collaborative treatment planning with patients—discussing pros and cons of treatment options, developing next steps that reflect patients' values, etc.—can be easily shifted to engage family members in the process, thereby enhancing the likelihood of adherence and success ( 59 ). Finally, the BBFM, by promoting specificity and efficiency, may facilitate current movements toward single session mental health care in the context of primary care [e.g., ( 61 )].…”

Section: Application Of the Bbfm In A Family Medicine Residency Programmentioning

confidence: 99%

The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care

et al. 2021

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Engel's biopsychosocial model, based in systems theory, assumes the reciprocal influence of biological, psychological, and social factors on one another and on mental and physical health. However, the model's application to scientific study is limited by its lack of specificity, thus constraining its implementation in training and healthcare environments. The Biobehavioral Family Model (BBFM) is one model that can facilitate specification and integration of biopsychosocial conceptualization and treatment of illness. The model identifies specific pathways by which family relationships (i.e., family emotional climate) impact disease activity, through psychobiological mechanisms (i.e., biobehavioral reactivity). Furthermore, it is capable of identifying positive and negative effects of family process in the same model, and can be applied across cultural contexts. The BBFM has been applied to the study of child health outcomes, including pediatric asthma, and adult health, including for underserved primary care patients, minoritized samples, and persons with chronic pain, for example. The BBFM also serves as a guide for training and clinical practice; two such applications are presented, including the use of the BBFM in family medicine residency and child and adolescent psychiatry fellowship programs. Specific teaching and clinical approaches derived from the BBFM are described in both contexts, including the use of didactic lecture, patient interview guides, assessment protocol, and family-oriented care. Future directions for the application of the BBFM include incorporating temporal dynamics and developmental trajectories in the model, extending testable theory of family and individual resilience, examining causes of health disparities, and developing family-based prevention and intervention efforts to ameliorate contributing factors to disease. Ultimately, research and successful applications of the BBFM could inform policy to improve the lives of families, and provide additional support for the value of a biopsychosocial approach to medicine.

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Section: Application Of the Bbfm In A Family Medicine Residency Programmentioning

confidence: 99%

The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care

et al. 2021

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“…The Program Feedback Scale (PFS) [63], which is routinely used to evaluate acceptability and user perceptions of SSIs [64][65][66][67], asks participants to rate agreement with seven statements indicating perceived acceptability and feasibility of their selected SSI (eg, "I enjoyed the program") on a 5-point Likert scale (1="really disagree"; 5="totally agree"). The scale was adapted from existing, validated acceptability assessments of digital interventions; adaptations from existing scales were necessary in order to exclude items that are inapplicable to web-based SSIs (eg, items referencing frequency of use or interest in continuing to revisit the program).…”

Section: Program Feedback Scalementioning

confidence: 99%

Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health (Preprint)

Schleider¹,

Dobias²,

Sung³

et al. 2020

Preprint

Self Cite

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BACKGROUND Many youths with mental health needs are unable to access care. Single-session interventions (SSIs) have helped reduce youth psychopathology across multiple trials, promising to broaden access to effective, low-intensity supports. Online, self-guided SSIs may be uniquely scalable, particularly if they are freely available for as-needed use. However, the acceptability of online SSI and their efficacy have remained unexamined outside of controlled trials, and their practical utility is poorly understood. OBJECTIVE We evaluated the perceived acceptability and proximal effects of Project YES (Youth Empowerment & Support), an open-access platform offering three online SSIs for youth internalizing distress. METHODS After selecting one of three SSIs to complete, participants (ages 11-17 years) reported pre- and post-SSI levels of clinically relevant outcomes that SSIs may target (eg, hopelessness, self-hate) and perceived SSI acceptability. User-pattern variables, demographics, and depressive symptoms were collected to characterize youths engaging with YES. RESULTS From September 2019 through March 2020, 694 youths accessed YES, 539 began, and 187 completed a 30-minute, self-guided SSI. SSI completers reported clinically elevated depressive symptoms, on average, and were diverse on several dimensions (53.75% non-white; 78.10% female; 43.23% sexual minorities). Regardless of SSI selection, completers reported pre- to post-program reductions in hopelessness (dav=0.53; dz=0.71), self-hate (dav=0.32; dz=0.61), perceived control (dav=0.60; dz=0.72) and agency (dav=0.39; dz=0.50). Youths rated all SSIs as acceptable (eg, enjoyable, likely to help peers). CONCLUSIONS Results support the perceived acceptability and utility of open-access, free-of-charge SSIs for youth experiencing internalizing distress. CLINICALTRIAL Open Science Framework; osf.io/e52p3

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“…For example, Schleider and Weisz [ 11 ] found that growth mindset SSIs led to more significant improvement in youth depression and perceived behavioral control in a 9-month follow-up than in active control. They also found that enhancing belief-in-change of personality-enhanced treatment access for adolescent depression [ 12 ], but recorded nonsignificant changes in general anxiety, social anxiety, and conduct problems [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Examination of Web-Based Single-Session Growth Mindset Interventions for Reducing Adolescent Anxiety: Study Protocol of a 3-Arm Cluster Randomized Controlled Trial

Zhu¹,

Tse²,

Chan³

et al. 2023

JMIR Res Protoc

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Background Anxiety disorders are the most common mental disorders worldwide. In Hong Kong, 7% of adolescents are diagnosed with anxiety disorders, and 1 in every 4 secondary school students reports clinical-level anxiety symptoms. However, 65% of them do not access services. Long waitlists in public services, the high cost of private services, or the fear of being stigmatized can hinder service access. The high prevalence of anxiety and low intervention uptake indicate a pressing need to develop timely, scalable, and potent interventions suitable for adolescents. Single-session interventions (SSIs) have the potential to be scalable interventions for diagnosable or subclinical psychopathology in adolescents. Providing precise and context-adapted intervention is the key to achieving intervention efficacy. Objective This study aims to compare the effectiveness of three SSIs: single-session intervention of growth mindset on negative emotions (SIGMA), SSI of growth mindset of personality (SSI-GP), and active control, in reducing adolescent anxiety. Methods Adolescents (N=549, ages 12-16 years) from secondary schools will be randomized to 1 of 3 intervention conditions: the SIGMA, SSI-GP, or active control. The implementation of each intervention is approximately 45 minutes in length. Adolescent participants will report anxiety symptoms (primary outcome), perceived control, hopelessness, attitude toward help-seeking, and psychological well-being at preintervention, the 2-week follow-up, and the 8-week follow-up. A pilot test has confirmed the feasibility and acceptability of SIGMA among adolescents. We hypothesized that SIGMA and SSI-GP will result in a larger reduction in anxiety symptoms than the control intervention during the posttest and 8-week follow-up period. We also predict that SIGMA will have a more significant effect than SSI-GP. We will use the intention-to-treat principle and linear regression-based maximum likelihood multilevel models for data analysis. Results This study will be conducted from December 2022 to December 2023, with results expected to be available in January 2024. Conclusions This protocol introduces the implementation content and strategies of growth mindset SSIs (consists of 2 forms: SIGMA and SSI-GP) among school students. The study will provide evidence on the efficacy of different growth mindset SSIs for adolescent anxiety. It will also establish implementation strategies for self-administrative SSIs among school students, which can serve as a pioneer implementation of a scalable and self-accessible brief intervention to improve the well-being of young people. Trial Registration ClinicalTrials.gov NCT05027880; https://clinicaltrials.gov/ct2/show/NCT05027880 International Registered Report Identifier (IRRID) PRR1-10.2196/41758

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Promoting Treatment Access Following Pediatric Primary Care Depression Screening: Randomized Trial of Web-Based, Single-Session Interventions for Parents and Youths

Cited by 14 publications

References 9 publications

The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care

The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care

Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health (Preprint)

Examination of Web-Based Single-Session Growth Mindset Interventions for Reducing Adolescent Anxiety: Study Protocol of a 3-Arm Cluster Randomized Controlled Trial

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