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Homelessness is associated with a multitude of negative consequences including an increased risk for mental health problems. Once homeless, these individuals face significant barriers to mental health care and are therefore less likely to receive the treatment they need. Mobile technology may offer a novel platform for increasing access to mental health care in this population. Thus, the primary goals of this pilot study are to (1) establish the feasibility and acceptability of delivering a brief cognitive-behavioral intervention to homeless youth via smartphone technology, (2) examine the extent to which brief cognitive-behavioral interventions delivered via mobile technology improve mental health and trauma-related psychological symptoms in homeless youth, and (3) establish smartphone usage patterns among homeless youth to inform future interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mobile mental health intervention | Experimental | Participants will receive emotional support and problem-solving / stress-management skills via over-the-phone coaching sessions and mobile applications. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Coaching sessions | Behavioral | Participants receive three 30-minute phone sessions with a doctorate-level therapist over the course of one month. These sessions are skills-based and focus on improving participants' problem solving through cognitive-behavioral techniques. Participants are allowed to text the therapist between sessions for information and support. |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment adherence | Adherence will be assessed based on number of coaching sessions attended over the course of the 1 month treatment period (range of 0 to 3). | Baseline (week 0) to Endpoint (week 4) |
| Treatment satisfaction | Participants will be asked to report the extent to which they were satisfied with the study, the extent to which they thought the study was helpful, and whether they would recommend the study to someone else. These responses are recorded on 5-point likert type scales with higher ratings indicating higher satisfaction. | Treatment endpoint (week 4) |
| Measure | Description | Time Frame |
|---|---|---|
| Depression symptoms | Depression symptoms will be assessed using the Patient Health Questionnaire-9 (PHQ-9). The range is from 0-27. Higher values represent worse depression symptoms. | Baseline (week 0) to Endpoint (week 4) |
| Posttraumatic Stress Disorder symptoms |
| Measure | Description | Time Frame |
|---|---|---|
| Acceptability of mental health treatment | Attitudes toward the mental health system will be assessed using an author-developed measure. | Baseline (week 0) to Endpoint (week 4) |
| Positive and negative affect |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alyson K Zalta, PhD | Rush University Medical Center | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31267980 | Derived | Schueller SM, Glover AC, Rufa AK, Dowdle CL, Gross GD, Karnik NS, Zalta AK. A Mobile Phone-Based Intervention to Improve Mental Health Among Homeless Young Adults: Pilot Feasibility Trial. JMIR Mhealth Uhealth. 2019 Jul 2;7(7):e12347. doi: 10.2196/12347. |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 24, 2018 | Aug 6, 2018 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| D001519 | Behavior |
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|
| Mobile applications | Behavioral | Participants will have access to 3 mobile apps for the duration of the study, and after it ends. One app will push participants a daily, self-reflective survey to complete, and a daily motivational or instructional tip to rate. Other apps will provide education and exercises on various aspects of mental health and wellness, such as sleep and relaxation. |
|
PTSD symptoms will be assessed using the PTSD Checklist for DSM-5 (PCL-5). The range is from 0-80. Higher values represent worse PTSD symptoms. |
| Baseline (week 0) to Endpoint (week 4) |
| Emotion Regulation | Ability to regulate emotion will be assessed using the Difficulties in Emotion Regulation Scale (DERS). Range is from 36 to 180. Higher scores suggest greater problems with emotion regulation. | Baseline (week 0) to Endpoint (week 4) |
| Anxiety symptoms | Current symptoms of anxiety will be assessed using the State Anxiety scale of the State Trait Anxiety Inventory. Scores range from 20 to 80. Higher scores indicate greater anxiety. | Baseline (week 0) to Endpoint (week 4) |
| Risky sexual behavior and substance use | Risky sexual behaviors and substance use will be assessed using the Centers for Disease Control and Prevention's Youth Risk Behavior Survey (2011). | Baseline (week 0) to Endpoint (week 4) |
| Acceptability of treatment components | At the end of the treatment period, participants will rate the extent to which they liked each of the different treatment components (coaching sessions, text messages, apps, tips). Participants will also be asked to report the extent to which they used the skills that they learned in the coaching sessions. | Endpoint (week 4) |
Current positive and negative emotions will be assessed using the Positive and Negative Affect Schedule.
| Baseline (week 0) to Endpoint (week 4) |