Depression Anxiety and Co-occurring Rural Youth
Conditions
Brief summary
This research study examines rural youth's experience of an internet based cognitive behavioral therapy intervention, and their experience of symptoms of depression, anxiety and co-occurring disorders.
Detailed description
In the United States, and rural Montana, a substantial health disparity exists for rural youths' mental health and mental health care access. In 2017, nearly a third of all Montana high school students reported being impacted by depression; 21% considered suicide compared to 17% nationally. Over 30% of Montana adolescents indicated drinking alcohol and 20% indicated using marijuana. Rural Montanans face enormous barriers to behavioral health care including low mental health care provider coverage, long distances to adequate care, and stigma. We have developed a culturally and developmentally appropriate Internet-based Cognitive Behavior Therapy (iCBT) program designed to teach skills that address mental and behavioral health challenges common to adolescents. Building on previous development and evaluation of an adult version of iCBT (Thrive), the investigators propose to pilot the newly developed youth version of Thrive (Y-T), a fully automated stand-alone program. Y-T will deliver CBT skills through educational, real life adolescent scenarios, and tailored feedback videos to address symptoms of depression, anxiety and co-occurring (addiction) behaviors. The investigators intend to conduct feasibility analyses of pilot study implementation in school communities. The investigators will document and assess organization-level facilitators and barriers that impact the study processes at each study site. Short-term goal for this research are to understand how to effectively conduct trials within school community settings and to obtain preliminary information on the acceptability and effectiveness of the Y-T program to address depression and anxiety symptoms, and addictive behaviors. The investigators will conduct post-intervention focus groups to assess the program as experienced by participants and insight on the extent of program engagement and learning. The investigators hypothesize that those using Y-T over an 8-week period will report markedly decreased scores on anxiety, depression, and addictive behaviors. The long-term goal is to conduct a larger trial of the program to determine the evidence of impact among youth. Provided that this research demonstrates such programs to be evidence-based, the investigators will work on a broader dissemination plan with the ultimate aim of decreasing mental and behavioral health and respective health care disparities among rural youth.
Interventions
OTHERinternet based iCBT program, Youth Thrive
iCBT program is a skills program which teaches assertive communication, constructive thinking and rewarding activities
Sponsors
Montana State University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
multiple baseline pre-post design
Eligibility
Sex/Gender
ALL
Age
13 Years to 19 Years
Healthy volunteers
Yes
Inclusion criteria
* participants are youth enrolled in participating schools * ages 13 - 18 years old * have access to electronic device to access iCBT intervention
Exclusion criteria
* none.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Beck's Anxiety Inventory, Youth Version | 8 weeks | The inventory measures anxiety symptoms and utilizes T Scores. 52.45 indicates the population mean with a standard deviation of 11.4 55 or less minimal, average symptoms of anxiety 55-59 mild symptoms of anxiety 60-69 moderate symptoms of anxiety 70+ severe symptoms of anxiety |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Youth Thrive iCBT Program Youth Thrive iCBT online program
internet based iCBT program, Youth Thrive: iCBT program is a skills program which teaches assertive communication, constructive thinking and rewarding activities | 67 |
| Total | 67 |
Baseline characteristics
| Characteristic | Youth Thrive iCBT Program | — |
|---|---|---|
| Age, Categorical Anxiety Symptoms <=18 years | 67 Participants | — |
| Age, Categorical Anxiety Symptoms >=65 years | 0 Participants | — |
| Age, Categorical Anxiety Symptoms Between 18 and 65 years | 0 Participants | — |
| Age, Categorical Depressive Symptoms <=18 years | 67 Participants | — |
| Age, Categorical Depressive Symptoms >=65 years | 0 Participants | — |
| Age, Categorical Depressive Symptoms Between 18 and 65 years | 0 Participants | — |
| Age, Categorical Substance Use Attitudes & Behaviors <=18 years | 67 Participants | — |
| Age, Categorical Substance Use Attitudes & Behaviors >=65 years | 0 Participants | — |
| Age, Categorical Substance Use Attitudes & Behaviors Between 18 and 65 years | 0 Participants | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Region of Enrollment United States | 67 participants | — |
| Sex: Female, Male Female | 33 Participants | — |
| Sex: Female, Male Male | 34 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 67 |
| other Total, other adverse events | 0 / 67 |
| serious Total, serious adverse events | 0 / 67 |
Outcome results
Primary
Beck's Anxiety Inventory, Youth Version
The inventory measures anxiety symptoms and utilizes T Scores. 52.45 indicates the population mean with a standard deviation of 11.4 55 or less minimal, average symptoms of anxiety 55-59 mild symptoms of anxiety 60-69 moderate symptoms of anxiety 70+ severe symptoms of anxiety
Time frame: 8 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Youth Thrive iCBT Program | Beck's Anxiety Inventory, Youth Version | 52.45 T Score | Standard Deviation 11.4 |
p-value: 0.0195% CI: [0, 60]t-test, 1 sided