The Effect of Caregiver Opinion Leaders to Increase Demand for Evidence-Based Practices for Youth Anxiety: A Cluster Randomized Controlled Trial

Abstract

Background: Dissemination initiatives have the potential to increase consumer knowledge of evidence-based treatments (e.g., cognitive behavioral therapy; CBT) and engagement with such treatments. Opinion leaders (OLs) have been used in public health campaigns, but use of OLs has not been examined for the dissemination of mental health treatments. This study uses the theory of planned behavior to test the dissemination strategies of involving an OL in an educational presentation to increase caregiver demand for CBT for youth anxiety. Methods: Participants (N=262; 92% Female; 69% White, 82% non-Hispanic) were caregivers who registered for a virtual presentation on youth anxiety treatment. Caregivers were cluster-randomized by school (N=25; two-arm prospective randomization) to the OL condition (presented by a clinical researcher and local caregiver OL) or the researcher-only condition. Presentations occurred from May 2021-May 2022. Measures were completed pre- and post-presentation, and at three-month follow-up. Results: 109 participants attended the presentations. Relative to the researcher co-presenter, participants rated the OL as significantly more relatable, familiar, similar, and understanding of their community, but less credible than the researcher co-presenter. In both conditions, there was a significant pre-post increase in participants’ (a) knowledge of, (b) subjective norms related to, and (c) intention of seeking CBT for youth anxiety, but not stigma or attitudes about CBT. Presentation conditions did not differ in change on these measures, or on rates of seeking youth anxiety CBT at follow-up.Conclusions: Although involvement of a caregiver OL did not increase caregiver demand for EBT for youth anxiety, the receipt of the outreach presentation was associated with increases in knowledge of, subjective norms related to, and intention to seek CBT for youth anxiety. Involving OLs may not be necessary for all consumer audiences, but may be beneficial for engendering a sense of relatability, similarity, and connection with the disseminators of information.