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The goal of this study is first to develop and adapt a digital low-intensity treatment, "VIBE in the Parks", for adolescents and young adults (AYA) who visit programming at the Chicago Park District. A trial will occur at four Park District sites to compare how "VIBE in the Parks" works compared to a control condition (where AYA are given access to a digital workbook).
Amid an unprecedented youth mental health crisis, adolescents and young adults (AYA) have the most barriers to receiving mental healthcare. While digital tools are a scalable and accessible way to provide timely mental health screening and referral options, these tools have failed to engage AYA in their daily lives. This failure is driven by multiple factors, including a lack of: 1) understanding of implementation determinants for digital tools in community spaces; and 2) partnership with AYA, their caregivers, and support staff who work in key community settings where AYA spend their time. The goal of this study is to target AYA engagement in the design and implementation of a digital low-intensity treatment for AYA in Chicago Park District (CPkD) Teen Programming. The CPkD is the largest park district in the country, and more than 40,000 youth are served daily across all 77 Chicago neighborhoods. This project harnesses on a partnership with CPkD and is grounded in the Accelerated Creation-to-Sustainment (ACTS) Model to guide the development of a technology ("VIBE in the Parks"), as well as its service and implementation plans for CPkD sites. Aim 1 follows the first phase of the ACTS Model, Create. Human-centered design and community-engaged research methodologies will be used to collaborate with the existing CPkD Youth Advisory Board and Teen Programming participants, caregivers of AYA served by CPkD, and CPkD staff. Design activities will focus on targeting mechanisms that are believed to influence engagement: 1) individual-level barriers to care; 2) leveraging spaces where youth spend their time, including assessing determinants in these spaces; and 3) elevating key player input throughout design. The products of Aim 1 will include: an initial version of "VIBE in the Parks" that demonstrates usability and acceptability by key players, a service protocol for integration of the "VIBE in the Parks" and potential higher clinical needs reported by AYA as a result of using the tool, and an implementation blueprint for integration into CPkD programming. Additionally, extended usability testing will pilot all trial activities to be conducted in Aim 2. In Aim 2, the second phase of the ACTS Model, Trial, will be followed by conducting a pilot randomized controlled trial in CPkD sites using an Optimization, Effectiveness, and Implementation trial methodology. The "VIBE in the Parks" will be compared to a control condition (digital workbook) across a pragmatic, rollout implementation trial. Primary outcomes include acceptability and feasibility, along with reductions of individual levels to mental healthcare, DMH use, and, secondarily, clinical outcomes (anxiety, depression). Optimization activities will occur across the trial period. In sum, the naturalistic approach of this work addresses multiple barriers to real-world digital tool engagement failures for AYA. It will provide key insights into engagement strategies, adaptations, and both service and implementation practices that will support AYA in community settings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| "VIBE in the Parks" | Experimental | "VIBE in the Parks" developed across Aim 1 activities |
|
| Digital Control | Active Comparator | Access to a digital self-help book |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| "VIBE in the Parks" | Behavioral | "VIBE in the Parks" will be developed across Aim 1 activities and will include screening, feedback, and access to digital resources related to symptoms |
| Measure | Description | Time Frame |
|---|---|---|
| After Scenario Questionnaire | 3-items; 7-point scale (i.e., 1-7), with higher scores indicating greater satisfaction; Assesses satisfaction | Administered three times; baseline, week 2, week 4 |
| Kiddie Computerized Adaptive Tests, Anxiety and Depression Modules | ~1 minute to complete each self-report module, assess anxiety and depressive symptoms; Higher scores indicate greater symptom severity | Administered five times; baseline and at weeks 1, 2, 3, and 4 |
| TeACH System Individual Barriers and Engagement Questionnaire | 4-items; Mental Health Understanding, Confidence to Act, Likelihood to use DMH (5-point Likert Scale, higher scores indicate greater understanding, confidence, likelihood); DMH Use (Y/N/Unsure) | Administered 5 times, at baseline and weeks 1, 2, 3, 4 |
| Twente Engagement with Ehealth Technologies Scale | 9-items on a 5-point scale, with higher scores indicating stronger engagement; Engagement with e-health (behavior, cognition, affect) | Administered five times, at baseline and weeks 1, 2, 3, 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Generalized Anxiety Disorder-7 | 7-items, 4-point scale (i.e., 0-3), with higher scores indicating more anxiety symptoms; Anxiety; Administered to ages 18+ | Administered twice, at baseline and week 4 |
| Patient Health Questionnaire-9 |
| Measure | Description | Time Frame |
|---|---|---|
| WHO Disability Assessment Schedule 2.0 | 12-Items, 5-point scale (i.e., 0-4), with higher scores indicating more severity; health and disability; Administered to ages 18+ | Administered once, at baseline |
| DSM-5 Cross-Cutting Symptom Measure |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Colleen Stiles-Shields, Ph.D. | University of Illinois at Chicago | Principal Investigator |
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IPD will be shared via the NIMH Data Archive (NDA): https://nda.nih.gov/
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D003863 | Depression |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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A pilot randomized controlled trial will be conducted using an Optimization, Effectiveness, and Implementation (OEI) trial methodology. The "VIBE in the Parks" will be compared to a control condition across a pragmatic, rollout implementation trial design. Namely, different sites and activities for Teen Programming will be selected by simple randomization to first offer the control condition for two months, followed by the "VIBE in the Parks".
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| Digital Control | Behavioral | Digital control will include providing participants access to a digital workbook for Cognitive Behavioral Therapy (CBT) |
|
9-items, 4-point scale (i.e., 0-3), with higher scores indicating more depressive symptoms; Depression; Administered to ages 18+
| Administered twice, at baseline and week 4 |
| Revised Children's Anxiety and Depression Scale | 25-items, 4-point scale (i.e., 0-3), with higher scores indicating more symptoms; Anxiety, Low Mood; Administered to ages 13-17, Parents when opted in | Administered twice, at baseline and week 4 |
| Mental Health Implementation Science Tools - Consumer Version | Assess mental health interventions by implementation domains on a 7-point Likert Scale, with higher scores indicating stronger agreement; subscales administered: Acceptability, Appropriateness, Accessibility/Reach | Administered three times, at baseline, weeks 2 and 4 |
| Self-Stigma of Seeking Help Scale | 10-items, 5-point scale (i.e., 1-5), with higher scores indicating more agreement; feelings of stigma around receiving mental health care | Administered three times, at baseline, weeks 2 and 4 |
23 item (adult) or 25 item (child) self-report tool using a 5-point scale (i.e., 0-4), with scores reviewed by domain and not as a total sum; Assesses mental health
| Administered once, at baseline |