Depression, Suicidal Ideation
Conditions
Keywords
depression, suicidal ideation, treatment, mental health, text message intervention
Brief summary
Text2Connect (T2C) proposes to test a text-based intervention designed to improve engagement with mental health treatment.
Detailed description
To enhance outcomes for transition-age youth with mental health disorders during the vulnerable period that occurs during their first several months of college, the investigators propose an automated TM intervention, Text to Connect (T2C), that aims to increase mental health self-efficacy through psychoeducation, self-monitoring of symptoms and stressors, and cues to action for college-bound youth. Assignment of Interventions: The study will utilize block randomization whereby 2/3 of participants will be randomly assigned to receive T2C, and 1/3 to receive PE. Blocks will balance the groups on site (CCP versus STAR/CABS). A 2:1 randomization scheme will randomize 50 youth to either receive T2C (n=30) or a link to brief psychoeducational videos about mental health (PE; n=20). All participants will then complete a brief battery of self-report assessments online at baseline and again monthly through month 4. Youth randomized to receive PE will receive a text message with the link to the webpage with the psychoeducational videos. Youth randomized to receive T2C will be onboarded and initiate the TM intervention that sends automated prompts at minimum monthly through month 4. Hypothesis: Aim 1. To examine the feasibility of T2C for transition-age youth with psychiatric disorders (n=3 clinics, 50 adolescents). Youth randomized to receive T2C will: Hypothesis 1a. engage with T2C at high rates (\>70% response rate to SMS prompts). Hypothesis 1b. report high levels of satisfaction (\>70% satisfaction) and usability with T2C. Aim 2. To examine the impact of T2C versus PE on mental health self-efficacy, symptoms and functioning, and treatment engagement. Over 4 months, youth who receive T2C, as compared with youth who receive PE, will report: Hypothesis 2a (Primary). Greater mental health self-efficacy Hypothesis 2b (Secondary). Lower symptom severity and greater psychosocial functioning Hypothesis 2c (Secondary). Higher rates of follow-through with mental health services
Interventions
BEHAVIORALText2Connect
The T2C intervention aims to increase mental health self-efficacy though psychoeducation, self-monitoring of symptoms and stressors, and cues to action for college-bound youth.
BEHAVIORALPsychoeducational Videos (PE) Only
Participants in this group will receive psychoeducation through the PE video library.
Sponsors
Kaiser Foundation Research Institute
National Institute of Mental Health (NIMH)
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcomes assessors will be masked to the intervention condition at follow-up assessment time points.
Intervention model description
This study will use a parallel study design, where participants are randomized into two intervention groups (T2C and PE) and will receive interventions in parallel.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Participant engaged in treatment at CC Waterdam, STAR or CABS clinic * Participants have a current psychiatric diagnosis documented in their electronic medical record and/or be in receipt of mental health services within 3 months per self-/ parent- or clinician- report * At least 18 years of age * Recently graduated high school * Planning to attend college or higher education program within 6 weeks * Own a text-capable phone * Be willing and able to provide informed consent
Exclusion criteria
* Participants will be excluded if they have conditions that might impair their ability to effectively engage in Text2Connect * Under the age of 18yo * Non-English speakers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| General Self-Efficacy | 1 month Timepoint | Mental health self-efficacy will be assessed via the General Self-Efficacy Scale (GSE), as the primary outcome of Text2Connect Phase 2. The GSE contains 10 items scored on a 4-point Likert Scale, with scores ranging from 10-40. Higher scores indicate greater self-efficacy. |
| Usability & Satisfaction-PSSUQ | 3 month follow up timepoint | Satisfaction with the technical components of interventions will be assessed through the certain questions from the Post System Satisfaction and Usability Questionnaire (PSSUQ), as the primary outcome of Text2Connect Phase 2. The PSSUQ utilize 16 items w/ response options ranging from 1-7 where 1=strongly disagree and 7=strongly agree. The PSSUQ has sub-scores derived from subsets of the questions which reflect system usefulness, information quality, and interface quality. Scores are added and range from 16-112, with higher score indicating less satisfaction. Questions 1 to 16 result in the Overall score; Questions 1 to 6 result in System Usefulness score; Questions 7 to 12 result in Information Quality score; Questions 13 to 16 result in Interface Quality. |
| Usability & Satisfaction-CSQ | 3 month follow up timepoint | Satisfaction with the technical components of interventions will be assessed through the certain questions from the Client Satisfaction Questionnaire (CSQ8). 8 items are scored on a likert scale of 1 to 4. Item 1 (reverse scored): scale 1(excellent)-4 (poor); Item 2: 1(definitely not)-4(definitely); item 3(reverse scored): 1(none of needs met)-4(all needs met); item 4: 1(definitely not)-4(definitely); item 5: 1(quite dissatisfied)-4(very satisfied); item 6(reverse scored): 1(made things worse)-4(helped a great deal); item 7 (reverse scored): 1(quite dissatisfied)-4(very satisfied); item 8: 1(definitely not)-4(definitely). Higher scores=higher satisfaction (score sum range is 8-32). |
| Mental Health Self-Efficacy | 1 month timepoint | Mental health self-efficacy will be assessed via the Mental Health Self-Efficacy Scale (MHSES), as the primary outcome of Text2Connect Phase 2. The MHSES contains 6 items that are scored on a 10-point Likert Scale. Scores range from 6-60 with higher scores indicating greater confidence in participant's mental health self-efficacy. |
| Engagement With Intervention: Text Message Check-ins | Over 3 months after baseline | Participant's engagement with the T2C intervention will be assessed via their response rate to SMS prompts, as the primary outcome of Text2Connect Phase 2. High engagement with T2C will be rated as \>70% response rate. All Intervention participants (n=34) received text-message check-ins with question: How would you rate your emotional health this past week? on a likert scale of: 1=excellent; 2=very good; 3=good;4=fair; 5=poor. Participants who did not respond to this message initially were sent a reminder with the same content each week of the intervention. |
| Engagement With Intervention: Web-based Check Ins | Over 3 months after baseline | Participant's engagement with the T2C intervention will be assessed via their response rate to prompts, as the primary outcome of Text2Connect Phase 2. High engagement with T2C will be rated as \>70% response rate. Participants received 1 text How would you rate our emotional health this last week on a likert scale of: 1 (excellent), 2 Very good, 3 good 4 fair 5 poor. If respondents answered fair or Poor they were routed to a website with psychoeducational videos and additional questions called a web-based check in. The questions inquired what type of stressors the participant experienced contributing to the Fair or Poor ratings, what types of symptoms the participants noticed as a result of the indicated stressor and if participants felt they could manage their stress. |
| Engagement With Intervention: Drop Out Rate | Over 3 months after baseline | Participant's engagement with the T2C intervention will be assessed via their response rate to prompts, as the primary outcome of Text2Connect Phase 2. High engagement with T2C will be rated as \>70% response rate. Participants are considered dropped out if they requested to be removed from the T2C intervention and all texts to be stopped. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Symptom Severity | 1 month timepoint | Symptom severity will be assessed via the CCAPS Mental Health Symptoms. The CCAPS is a 62-item instrument with 8 subscales (depression, general anxiety, social anxiety, academic distress, eating concerns, family distress, hostility, substance abuse) related to psychological symptoms & distress in college students. Scores are on a 5 point likert scale for each subscale: 0 (not at all like me), 1,2,3,4 (Extremely like me). Lower scores indicate greater severity of symptoms. Some items are reverse-scored. To score, average the items scores for each subscale to create the subscale raw score. |
| Mental Health Service Follow-through | 1 month timepoint | Mental health service follow-through will be assessed via the Client Service Receipt Inventory (CSRI). Ratings of 4 questions are Yes or No indicating if participants received the type of service. Scores described below are count of participants indicating Yes on the scale. |
| Psychosocial Functioning | 1 month timepoint | Psychosocial functioning will be assessed via the College Adjustment Questionnaire (CAQ) The CAQ contains 14 questions & 3 subscales (Educational, Relational, & Psychological functioning) embedded within. Each subscale is scored on 1(very inaccurate)-5 (very accurate) likert scale. Educational Functioning items include: 1, 5, 7, 12, 13; Relational Functioning items include: 2, 4, 9, 10, 14; Psychological Functioning items include: 3, 6, 8, 11. Items 2 & 9 from Relational subscale, 13 from Educational subscale, & 8 & 11 from Psychological subscale are reversed scored on 5 (very inaccurate)-1(very accurate) likert scale. The Educational functioning subscale score can be summed range from 5-25; the Relational functioning subscale score can be summed range from 5-25; the Psychological subscale can be summed range from 4-20. Total scores across all 3 subscales can be summed & range from 14-70. Higher scores indicate better functioning on each scale and across the total measure. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Text2Connect Intervention Participants receiving Text2Connect (T2C) personalized messages will receive a monthly check-in text prompt. Based on their response, the participants then receive either general psychoeducational videos and prompts to continue to monitor mental health or are then prompted to endorse stressors and symptoms they are experiencing to prompt awareness of treatment targets in daily life.
Text2Connect: The T2C intervention aims to increase mental health self-efficacy though psychoeducation, self-monitoring of symptoms and stressors, and cues to action for college-bound youth. | 34 |
| Usual Care-Psychoeducational Videos (PE) Only Participants will receive a web link to a library of 4 PE videos. These brief 2-minute videos include general information about self-care during college.
Psychoeducational Videos (PE) Only: Participants in this group will receive psychoeducation through the PE video library. | 18 |
| Total | 52 |
Baseline characteristics
| Characteristic | Text2Connect Intervention | Total | Usual Care-Psychoeducational Videos (PE) Only |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 34 Participants | 52 Participants | 18 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 3 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 32 Participants | 49 Participants | 17 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| General self-efficacy | 29.5 score on a scale STANDARD_DEVIATION 3.9 | 28.8 score on a scale STANDARD_DEVIATION 3.8 | 27.5 score on a scale STANDARD_DEVIATION 3.3 |
| Mental health self-efficacy | 40.3 score on a scale STANDARD_DEVIATION 10.7 | 39.3 score on a scale STANDARD_DEVIATION 11.1 | 37.4 score on a scale STANDARD_DEVIATION 12 |
| Mental health service follow-through Any mental health | 19 Participants | 31 Participants | 12 Participants |
| Mental health service follow-through Inpatient | 2 Participants | 4 Participants | 2 Participants |
| Mental health service follow-through Outpatient | 13 Participants | 22 Participants | 9 Participants |
| Mental health service follow-through Primary Care | 9 Participants | 13 Participants | 4 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 33 Participants | 48 Participants | 15 Participants |
| Sex: Female, Male Female | 27 Participants | 45 Participants | 18 Participants |
| Sex: Female, Male Male | 7 Participants | 7 Participants | 0 Participants |
| Symptom Severity Academic Distress | 1.42 score on a scale STANDARD_DEVIATION 1.02 | 1.58 score on a scale STANDARD_DEVIATION 1 | 1.90 score on a scale STANDARD_DEVIATION 0.88 |
| Symptom Severity Depression | 1.43 score on a scale STANDARD_DEVIATION 0.95 | 1.56 score on a scale STANDARD_DEVIATION 0.97 | 1.81 score on a scale STANDARD_DEVIATION 0.99 |
| Symptom Severity Eating Concerns | 1.37 score on a scale STANDARD_DEVIATION 0.89 | 1.42 score on a scale STANDARD_DEVIATION 0.94 | 1.51 score on a scale STANDARD_DEVIATION 1.06 |
| Symptom Severity Family Distress | 1.28 score on a scale STANDARD_DEVIATION 0.85 | 1.39 score on a scale STANDARD_DEVIATION 0.84 | 1.58 score on a scale STANDARD_DEVIATION 0.81 |
| Symptom Severity General Anxiety | 1.80 score on a scale STANDARD_DEVIATION 0.98 | 1.94 score on a scale STANDARD_DEVIATION 0.98 | 2.22 score on a scale STANDARD_DEVIATION 0.95 |
| Symptom Severity Hostility | 1.00 score on a scale STANDARD_DEVIATION 0.83 | 1.13 score on a scale STANDARD_DEVIATION 0.78 | 1.38 score on a scale STANDARD_DEVIATION 0.61 |
| Symptom Severity Social Anxiety | 2.11 score on a scale STANDARD_DEVIATION 0.93 | 2.20 score on a scale STANDARD_DEVIATION 0.93 | 2.37 score on a scale STANDARD_DEVIATION 0.93 |
| Symptom Severity Substance Abuse | 0.33 score on a scale STANDARD_DEVIATION 0.6 | 0.33 score on a scale STANDARD_DEVIATION 0.64 | 0.33 score on a scale STANDARD_DEVIATION 0.72 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 34 | 0 / 18 |
| other Total, other adverse events | 0 / 34 | 0 / 18 |
| serious Total, serious adverse events | 0 / 34 | 0 / 18 |
Outcome results
Primary
Engagement With Intervention: Drop Out Rate
Participant's engagement with the T2C intervention will be assessed via their response rate to prompts, as the primary outcome of Text2Connect Phase 2. High engagement with T2C will be rated as \>70% response rate. Participants are considered dropped out if they requested to be removed from the T2C intervention and all texts to be stopped.
Time frame: Over 3 months after baseline
Population: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~21/34 participants in this arm reported poor mental health on text-messages and therefore were provided with these web-based check ins.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Text2Connect Intervention | Engagement With Intervention: Drop Out Rate | 0 Participants |
Primary
Engagement With Intervention: Text Message Check-ins
Participant's engagement with the T2C intervention will be assessed via their response rate to SMS prompts, as the primary outcome of Text2Connect Phase 2. High engagement with T2C will be rated as \>70% response rate. All Intervention participants (n=34) received text-message check-ins with question: How would you rate your emotional health this past week? on a likert scale of: 1=excellent; 2=very good; 3=good;4=fair; 5=poor. Participants who did not respond to this message initially were sent a reminder with the same content each week of the intervention.
Time frame: Over 3 months after baseline
Population: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Text2Connect Intervention | Engagement With Intervention: Text Message Check-ins | 5 # of text messages sent to participants |
Primary
Engagement With Intervention: Web-based Check Ins
Participant's engagement with the T2C intervention will be assessed via their response rate to prompts, as the primary outcome of Text2Connect Phase 2. High engagement with T2C will be rated as \>70% response rate. Participants received 1 text How would you rate our emotional health this last week on a likert scale of: 1 (excellent), 2 Very good, 3 good 4 fair 5 poor. If respondents answered fair or Poor they were routed to a website with psychoeducational videos and additional questions called a web-based check in. The questions inquired what type of stressors the participant experienced contributing to the Fair or Poor ratings, what types of symptoms the participants noticed as a result of the indicated stressor and if participants felt they could manage their stress.
Time frame: Over 3 months after baseline
Population: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~21/34 participants in this arm reported poor mental health on text-messages and therefore were provided with these web-based check ins.
| Arm | Measure | Value (COUNT_OF_UNITS) |
|---|---|---|
| Text2Connect Intervention | Engagement With Intervention: Web-based Check Ins | 43 total number of web-based check-ins |
Primary
General Self-Efficacy
Mental health self-efficacy will be assessed via the General Self-Efficacy Scale (GSE), as the primary outcome of Text2Connect Phase 2. The GSE contains 10 items scored on a 4-point Likert Scale, with scores ranging from 10-40. Higher scores indicate greater self-efficacy.
Time frame: 2 month Timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | General Self-Efficacy | 30.0 score on a scale | Standard Deviation 4.2 |
| Usual Care-Psychoeducational Videos (PE) Only | General Self-Efficacy | 27.6 score on a scale | Standard Deviation 4.7 |
Primary
General Self-Efficacy
Mental health self-efficacy will be assessed via the General Self-Efficacy Scale (GSE), as the primary outcome of Text2Connect Phase 2. The GSE contains 10 items scored on a 4-point Likert Scale, with scores ranging from 10-40. Higher scores indicate greater self-efficacy.
Time frame: 1 month Timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | General Self-Efficacy | 29.7 score on a scale | Standard Deviation 4.4 |
| Usual Care-Psychoeducational Videos (PE) Only | General Self-Efficacy | 28.3 score on a scale | Standard Deviation 3.8 |
Primary
General Self-Efficacy
Mental health self-efficacy will be assessed via the General Self-Efficacy Scale (GSE), as the primary outcome of Text2Connect Phase 2. The GSE contains 10 items scored on a 4-point Likert Scale, with scores ranging from 10-40. Higher scores indicate greater self-efficacy.
Time frame: 3 month Timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | General Self-Efficacy | 31.3 score on a scale | Standard Deviation 5.2 |
| Usual Care-Psychoeducational Videos (PE) Only | General Self-Efficacy | 27.2 score on a scale | Standard Deviation 4.1 |
Primary
Mental Health Self-Efficacy
Mental health self-efficacy will be assessed via the Mental Health Self-Efficacy Scale (MHSES), as the primary outcome of Text2Connect Phase 2. The MHSES contains 6 items that are scored on a 10-point Likert Scale. Scores range from 6-60 with higher scores indicating greater confidence in participant's mental health self-efficacy.
Time frame: 1 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | Mental Health Self-Efficacy | 42.6 score on a scale | Standard Deviation 11.2 |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Self-Efficacy | 37.9 score on a scale | Standard Deviation 11 |
Primary
Mental Health Self-Efficacy
Mental health self-efficacy will be assessed via the Mental Health Self-Efficacy Scale (MHSES), as the primary outcome of Text2Connect Phase 2. The MHSES contains 6 items that are scored on a 10-point Likert Scale. Scores range from 6-60 with higher scores indicating greater confidence in participant's mental health self-efficacy.
Time frame: 3 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | Mental Health Self-Efficacy | 44.0 score on a scale | Standard Deviation 11 |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Self-Efficacy | 39.5 score on a scale | Standard Deviation 12.4 |
Primary
Mental Health Self-Efficacy
Mental health self-efficacy will be assessed via the Mental Health Self-Efficacy Scale (MHSES), as the primary outcome of Text2Connect Phase 2. The MHSES contains 6 items that are scored on a 10-point Likert Scale. Scores range from 6-60 with higher scores indicating greater confidence in participant's mental health self-efficacy.
Time frame: 2 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~Usual Care: 2 additional participants lost to follow up at 2 month time point
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | Mental Health Self-Efficacy | 42.9 score on a scale | Standard Deviation 11.3 |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Self-Efficacy | 39.9 score on a scale | Standard Deviation 10.7 |
Primary
Usability & Satisfaction-CSQ
Satisfaction with the technical components of interventions will be assessed through the certain questions from the Client Satisfaction Questionnaire (CSQ8). 8 items are scored on a likert scale of 1 to 4. Item 1 (reverse scored): scale 1(excellent)-4 (poor); Item 2: 1(definitely not)-4(definitely); item 3(reverse scored): 1(none of needs met)-4(all needs met); item 4: 1(definitely not)-4(definitely); item 5: 1(quite dissatisfied)-4(very satisfied); item 6(reverse scored): 1(made things worse)-4(helped a great deal); item 7 (reverse scored): 1(quite dissatisfied)-4(very satisfied); item 8: 1(definitely not)-4(definitely). Higher scores=higher satisfaction (score sum range is 8-32).
Time frame: 3 month follow up timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Text2Connect Intervention | Usability & Satisfaction-CSQ | 27.4 score on a scale | Standard Deviation 4.1 |
| Usual Care-Psychoeducational Videos (PE) Only | Usability & Satisfaction-CSQ | 25.4 score on a scale | Standard Deviation 5.8 |
Primary
Usability & Satisfaction-PSSUQ
Satisfaction with the technical components of interventions will be assessed through the certain questions from the Post System Satisfaction and Usability Questionnaire (PSSUQ), as the primary outcome of Text2Connect Phase 2. The PSSUQ utilize 16 items w/ response options ranging from 1-7 where 1=strongly disagree and 7=strongly agree. The PSSUQ has sub-scores derived from subsets of the questions which reflect system usefulness, information quality, and interface quality. Scores are added and range from 16-112, with higher score indicating less satisfaction. Questions 1 to 16 result in the Overall score; Questions 1 to 6 result in System Usefulness score; Questions 7 to 12 result in Information Quality score; Questions 13 to 16 result in Interface Quality.
Time frame: 3 month follow up timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Usability & Satisfaction-PSSUQ | Overall Score | 32.3 score on a scale | Standard Deviation 25.3 |
| Text2Connect Intervention | Usability & Satisfaction-PSSUQ | System usefulness | 11.4 score on a scale | Standard Deviation 9.9 |
| Text2Connect Intervention | Usability & Satisfaction-PSSUQ | Quality of information | 13.1 score on a scale | Standard Deviation 9 |
| Text2Connect Intervention | Usability & Satisfaction-PSSUQ | Quality of interface | 7.7 score on a scale | Standard Deviation 6.7 |
| Usual Care-Psychoeducational Videos (PE) Only | Usability & Satisfaction-PSSUQ | Quality of interface | 9.0 score on a scale | Standard Deviation 7.3 |
| Usual Care-Psychoeducational Videos (PE) Only | Usability & Satisfaction-PSSUQ | Overall Score | 35.4 score on a scale | Standard Deviation 25.2 |
| Usual Care-Psychoeducational Videos (PE) Only | Usability & Satisfaction-PSSUQ | Quality of information | 14.4 score on a scale | Standard Deviation 10.3 |
| Usual Care-Psychoeducational Videos (PE) Only | Usability & Satisfaction-PSSUQ | System usefulness | 12.0 score on a scale | Standard Deviation 8.4 |
Secondary
Mental Health Service Follow-through
Mental health service follow-through will be assessed via the Client Service Receipt Inventory (CSRI). Ratings of 4 questions are Yes or No indicating if participants received the type of service. Scores described below are count of participants indicating Yes on the scale.
Time frame: 3 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Text2Connect Intervention | Mental Health Service Follow-through | Any mental health care | 15 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Inpatient | 0 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Outpatient | 12 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Primary care | 5 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Primary care | 1 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Any mental health care | 7 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Outpatient | 7 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Inpatient | 0 Participants |
Secondary
Mental Health Service Follow-through
Mental health service follow-through will be assessed via the Client Service Receipt Inventory (CSRI). Ratings of 4 questions are Yes or No indicating if participants received the type of service. Scores described below are count of participants indicating Yes on the scale.
Time frame: 1 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Text2Connect Intervention | Mental Health Service Follow-through | Any mental health care | 17 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Inpatient | 0 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Outpatient | 15 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Primary care | 4 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Primary care | 1 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Any mental health care | 11 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Outpatient | 11 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Inpatient | 0 Participants |
Secondary
Mental Health Service Follow-through
Mental health service follow-through will be assessed via the Client Service Receipt Inventory (CSRI). Ratings of 4 questions are Yes or No indicating if participants received the type of service. Scores described below are count of participants indicating Yes on the scale.
Time frame: 2 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Text2Connect Intervention | Mental Health Service Follow-through | Any mental health care | 16 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Inpatient | 0 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Outpatient | 12 Participants |
| Text2Connect Intervention | Mental Health Service Follow-through | Primary care | 6 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Primary care | 3 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Any mental health care | 11 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Outpatient | 10 Participants |
| Usual Care-Psychoeducational Videos (PE) Only | Mental Health Service Follow-through | Inpatient | 1 Participants |
Secondary
Psychosocial Functioning
Psychosocial functioning will be assessed via the College Adjustment Questionnaire (CAQ) The CAQ contains 14 questions & 3 subscales (Educational, Relational, & Psychological functioning) embedded within. Each subscale is scored on 1(very inaccurate)-5 (very accurate) likert scale. Educational Functioning items include: 1, 5, 7, 12, 13; Relational Functioning items include: 2, 4, 9, 10, 14; Psychological Functioning items include: 3, 6, 8, 11. Items 2 & 9 from Relational subscale, 13 from Educational subscale, & 8 & 11 from Psychological subscale are reversed scored on 5 (very inaccurate)-1(very accurate) likert scale. The Educational functioning subscale score can be summed range from 5-25; the Relational functioning subscale score can be summed range from 5-25; the Psychological subscale can be summed range from 4-20. Total scores across all 3 subscales can be summed & range from 14-70. Higher scores indicate better functioning on each scale and across the total measure.
Time frame: 1 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Psychosocial Functioning | Educational Functioning | 21.0 score on a scale | Standard Deviation 4.8 |
| Text2Connect Intervention | Psychosocial Functioning | Psychological Functioning | 14.3 score on a scale | Standard Deviation 4.1 |
| Text2Connect Intervention | Psychosocial Functioning | Relational Functioning | 17.7 score on a scale | Standard Deviation 5.3 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Educational Functioning | 19.4 score on a scale | Standard Deviation 4 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Psychological Functioning | 12.1 score on a scale | Standard Deviation 4 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Relational Functioning | 14.5 score on a scale | Standard Deviation 6.2 |
Secondary
Psychosocial Functioning
Psychosocial functioning will be assessed via the College Adjustment Questionnaire (CAQ) The CAQ contains 14 questions & 3 subscales (Educational, Relational, & Psychological functioning) embedded within. Each subscale is scored on 1(very inaccurate)-5 (very accurate) likert scale. Educational Functioning items include: 1, 5, 7, 12, 13; Relational Functioning items include: 2, 4, 9, 10, 14; Psychological Functioning items include: 3, 6, 8, 11. Items 2 & 9 from Relational subscale, 13 from Educational subscale, & 8 & 11 from Psychological subscale are reversed scored on 5 (very inaccurate)-1(very accurate) likert scale. The Educational functioning subscale score can be summed range from 5-25; the Relational functioning subscale score can be summed range from 5-25; the Psychological subscale can be summed range from 4-20. Total scores across all 3 subscales can be summed & range from 14-70. Higher scores indicate better functioning on each scale and across the total measure.
Time frame: 2 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Psychosocial Functioning | Educational Functioning | 20.2 score on a scale | Standard Deviation 4.6 |
| Text2Connect Intervention | Psychosocial Functioning | Psychological Functioning | 14.3 score on a scale | Standard Deviation 4.3 |
| Text2Connect Intervention | Psychosocial Functioning | Relational Functioning | 17.3 score on a scale | Standard Deviation 5.2 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Educational Functioning | 17.7 score on a scale | Standard Deviation 5.6 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Psychological Functioning | 10.8 score on a scale | Standard Deviation 3.9 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Relational Functioning | 13.7 score on a scale | Standard Deviation 5.6 |
Secondary
Psychosocial Functioning
Psychosocial functioning will be assessed via the College Adjustment Questionnaire (CAQ) The CAQ contains 14 questions & 3 subscales (Educational, Relational, & Psychological functioning) embedded within. Each subscale is scored on 1(very inaccurate)-5 (very accurate) likert scale. Educational Functioning items include: 1, 5, 7, 12, 13; Relational Functioning items include: 2, 4, 9, 10, 14; Psychological Functioning items include: 3, 6, 8, 11. Items 2 & 9 from Relational subscale, 13 from Educational subscale, & 8 & 11 from Psychological subscale are reversed scored on 5 (very inaccurate)-1(very accurate) likert scale. The Educational functioning subscale score can be summed range from 5-25; the Relational functioning subscale score can be summed range from 5-25; the Psychological subscale can be summed range from 4-20. Total scores across all 3 subscales can be summed & range from 14-70. Higher scores indicate better functioning on each scale and across the total measure.
Time frame: 3 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Psychosocial Functioning | Educational Functioning | 21.0 score on a scale | Standard Deviation 4.1 |
| Text2Connect Intervention | Psychosocial Functioning | Psychological Functioning | 14.2 score on a scale | Standard Deviation 3.8 |
| Text2Connect Intervention | Psychosocial Functioning | Relational Functioning | 17.1 score on a scale | Standard Deviation 5.1 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Educational Functioning | 18.0 score on a scale | Standard Deviation 6.5 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Psychological Functioning | 10.1 score on a scale | Standard Deviation 4.1 |
| Usual Care-Psychoeducational Videos (PE) Only | Psychosocial Functioning | Relational Functioning | 13.1 score on a scale | Standard Deviation 6.4 |
Secondary
Symptom Severity
Symptom severity will be assessed via the CCAPS Mental Health Symptoms. The CCAPS is a 62-item instrument with 8 subscales (depression, general anxiety, social anxiety, academic distress, eating concerns, family distress, hostility, substance abuse) related to psychological symptoms & distress in college students. Scores are on a 5 point likert scale for each subscale: 0 (not at all like me), 1,2,3,4 (Extremely like me). Lower scores indicate greater severity of symptoms. Some items are reverse-scored. To score, average the items scores for each subscale to create the subscale raw score.
Time frame: 1 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Symptom Severity | Depression | 1.36 score on a scale | Standard Deviation 0.96 |
| Text2Connect Intervention | Symptom Severity | General Anxiety | 1.82 score on a scale | Standard Deviation 1.05 |
| Text2Connect Intervention | Symptom Severity | Social Anxiety | 2.06 score on a scale | Standard Deviation 1.07 |
| Text2Connect Intervention | Symptom Severity | Academic Distress | 1.45 score on a scale | Standard Deviation 1.06 |
| Text2Connect Intervention | Symptom Severity | Eating Concerns | 1.22 score on a scale | Standard Deviation 1.03 |
| Text2Connect Intervention | Symptom Severity | Family Distress | 1.13 score on a scale | Standard Deviation 0.96 |
| Text2Connect Intervention | Symptom Severity | Hostility | 0.93 score on a scale | Standard Deviation 0.8 |
| Text2Connect Intervention | Symptom Severity | Substance Abuse | 0.43 score on a scale | Standard Deviation 0.72 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Substance Abuse | 0.32 score on a scale | Standard Deviation 0.54 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Depression | 1.57 score on a scale | Standard Deviation 1 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Eating Concerns | 1.61 score on a scale | Standard Deviation 1.11 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | General Anxiety | 2.02 score on a scale | Standard Deviation 1.07 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Hostility | 1.26 score on a scale | Standard Deviation 0.81 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Social Anxiety | 2.15 score on a scale | Standard Deviation 0.95 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Family Distress | 1.41 score on a scale | Standard Deviation 1 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Academic Distress | 1.76 score on a scale | Standard Deviation 0.96 |
Secondary
Symptom Severity
Symptom severity will be assessed via the CCAPS Mental Health Symptoms. The CCAPS is a 62-item instrument with 8 subscales (depression, general anxiety, social anxiety, academic distress, eating concerns, family distress, hostility, substance abuse) related to psychological symptoms & distress in college students. Scores are on a 5 point likert scale for each subscale: 0 (not at all like me), 1,2,3,4 (Extremely like me). Lower scores indicate greater severity of symptoms. Some items are reverse-scored. To score, average the items scores for each subscale to create the subscale raw score.
Time frame: 2 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Symptom Severity | Depression | 1.24 score on a scale | Standard Deviation 0.94 |
| Text2Connect Intervention | Symptom Severity | General Anxiety | 1.70 score on a scale | Standard Deviation 1.15 |
| Text2Connect Intervention | Symptom Severity | Social Anxiety | 1.92 score on a scale | Standard Deviation 1.07 |
| Text2Connect Intervention | Symptom Severity | Academic Distress | 1.39 score on a scale | Standard Deviation 1.06 |
| Text2Connect Intervention | Symptom Severity | Eating Concerns | 1.21 score on a scale | Standard Deviation 0.97 |
| Text2Connect Intervention | Symptom Severity | Family Distress | 1.18 score on a scale | Standard Deviation 0.82 |
| Text2Connect Intervention | Symptom Severity | Hostility | 0.75 score on a scale | Standard Deviation 0.82 |
| Text2Connect Intervention | Symptom Severity | Substance Abuse | 0.38 score on a scale | Standard Deviation 0.6 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Substance Abuse | 0.21 score on a scale | Standard Deviation 0.38 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Depression | 1.85 score on a scale | Standard Deviation 1.02 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Eating Concerns | 1.72 score on a scale | Standard Deviation 1.13 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | General Anxiety | 2.24 score on a scale | Standard Deviation 0.99 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Hostility | 1.39 score on a scale | Standard Deviation 0.86 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Social Anxiety | 2.39 score on a scale | Standard Deviation 1.02 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Family Distress | 1.13 score on a scale | Standard Deviation 0.83 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Academic Distress | 2.13 score on a scale | Standard Deviation 0.9 |
Secondary
Symptom Severity
Symptom severity will be assessed via the CCAPS Mental Health Symptoms. The CCAPS is a 62-item instrument with 8 subscales (depression, general anxiety, social anxiety, academic distress, eating concerns, family distress, hostility, substance abuse) related to psychological symptoms & distress in college students. Scores are on a 5 point likert scale for each subscale: 0 (not at all like me), 1,2,3,4 (Extremely like me). Lower scores indicate greater severity of symptoms. Some items are reverse-scored. To score, average the items scores for each subscale to create the subscale raw score.
Time frame: 3 month timepoint
Population: In Intervention Arm: 2 participants lost to follow up at 1 month timepoint after baseline, 1 additional participant lost to follow up 3 month time point with final 31/34 participants completing research visits.~In Usual Care Arm: 1 participant lost to follow up at 1 month time point, 2 additional participants lost to follow up at 2 month time point and 1 further participant lost at 3 month follow up timepoint. A total of 14/18 completed research visits in usual care arm.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Text2Connect Intervention | Symptom Severity | Depression | 1.12 score on a scale | Standard Deviation 0.94 |
| Text2Connect Intervention | Symptom Severity | General Anxiety | 1.42 score on a scale | Standard Deviation 0.99 |
| Text2Connect Intervention | Symptom Severity | Social Anxiety | 1.81 score on a scale | Standard Deviation 1.03 |
| Text2Connect Intervention | Symptom Severity | Academic Distress | 1.31 score on a scale | Standard Deviation 0.98 |
| Text2Connect Intervention | Symptom Severity | Eating Concerns | 1.01 score on a scale | Standard Deviation 0.86 |
| Text2Connect Intervention | Symptom Severity | Family Distress | 0.93 score on a scale | Standard Deviation 0.63 |
| Text2Connect Intervention | Symptom Severity | Hostility | 0.82 score on a scale | Standard Deviation 0.89 |
| Text2Connect Intervention | Symptom Severity | Substance Abuse | 0.40 score on a scale | Standard Deviation 0.58 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Substance Abuse | 0.39 score on a scale | Standard Deviation 0.76 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Depression | 1.83 score on a scale | Standard Deviation 1.11 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Eating Concerns | 1.55 score on a scale | Standard Deviation 0.97 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | General Anxiety | 1.96 score on a scale | Standard Deviation 0.93 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Hostility | 1.10 score on a scale | Standard Deviation 0.73 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Social Anxiety | 2.39 score on a scale | Standard Deviation 0.9 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Family Distress | 1.10 score on a scale | Standard Deviation 0.71 |
| Usual Care-Psychoeducational Videos (PE) Only | Symptom Severity | Academic Distress | 2.12 score on a scale | Standard Deviation 1.11 |