Addiction, Depression/Anxiety, Self-harm, Trauma, Psychological
Conditions
Keywords
mental health, prevention, addiction, substance use disorders
Brief summary
The purpose of this study is to evaluate a culturally grounded training program, xaʔtus (meaning First Face) for Mental Health. This program will train community members in how to recognize and respond to youth and adults experiencing mental health crises and ways to serve as a bridge between these individuals and the help they need. All Healing Lodge staff are being asked to complete First Face training. To evaluate First Face, the investigators will ask all trainees to complete surveys before and after training, and again 3 months later. These surveys will measure knowledge about mental health and addiction, as well as the ability and confidence to respond appropriately to mental health crises. The study will help the investigators understand whether the First Face training program influences mental health and attitudes, as well as responses to mental health crisis situations.
Detailed description
With funding from the National Institutes for Health, the investigators created First Face for Mental Health. First Face is a culturally-appropriate community-based mental health training that prepares trainees to provide assistance to someone having a mental health crisis. The more community members within Tribal nations who are trained in a culturally sensitive program to provide support to youth in recovery and members struggling with mental health problems or crises, the better positioned that community is to create a supportive recovery environment for its youth. The investigators are in the process of launching First Face trainings and evaluations among several Tribal communities. Additionally, they will be training staff from the Healing Lodge of the Seven Nations (HL) in the First Face program. This particular application concerns the evaluation of First Face training among HL staff. The investigators will measure primary and secondary outcomes at pre-training, post-training, and 3-month follow-up.
Interventions
BEHAVIORALFirst Face for Mental Heatlh
First Face for Mental Health is a culturally-appropriate community-based mental health training for lay persons and others that prepares learners to provide assistance to someone having a mental health crisis. The course takes approximately 8 hours to complete.
Sponsors
National Institute of General Medical Sciences (NIGMS)
Cambridge Health Alliance
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Pre/post/3-month follow-up model
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Employment at the Healing Lodge of the Seven Nations * Selection to participate in First Face for Mental Health training
Exclusion criteria
° Previous completion of First Face for Mental Health training
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Attitudes Towards Serious Mental Illness - Adolescent Version | Included at pre-training, post-training (i.e. immediately after training), and 3-months post-training | The Attitudes Towards Serious Mental Illness - Adolescent Version (ATSMI-AV) is a validated 21-item self-report scale designed to measure attitudes towards mental illness. Participants respond on a 5-point Likert scale. The scale measures five aspects of mental health attitudes: threat, social construction/concern, wishful thinking, categorical thinking and out of control. The investigators will calculate an overall score as well as factor-specific scores, if they observe adequate internal reliability. Each item has response categories ranging from Completely disagree (coded as 1) to Completely agree (coded as 5), and a mean of all 21 items is calculated to create the scale. The scale has a possible range of 1 to 5 Higher scores indicate higher levels of stigma towards mental illness. |
| First Face Knowledge Assessment | Included at pre-training, post-training (i.e. immediately after training), and 3-months post-training | This is a 12-question quiz testing participants' knowledge of concepts taught in the First Face training. Some questions offer the opportunity to earn more than one point. The investigators will score each response as correct or incorrect and sum scores (possible range = 0-17) on each occasion. Higher scores indicate better knowledge of First Face concepts. |
| Perceived Competence to Respond | Included at pre-training, post-training (i.e. immediately after training), and 3-months post-training | A 10-item measure that taps respondents' confidence in their competence to respond to and help people experiencing mental health problems (i.e., Confidence in Recognizing, Intervening and Connecting Individual(s) with Resources Scale). Each response option has a possible range of 1 (Not at all confident) to 5 (Very confident), and a mean score will be calculated from all 10 items to yield a scale with a possible range of 1 to 5. Higher values indicate greater perceived competence respond to and help people experiencing mental health problems. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction With Training | Post-training (i.e. immediately after training) | One item administered immediately post-training asking about satisfaction with training (from 1 (very dissatisfied) to 7 (very satisfied)), with higher scores indicating greater satisfaction. |
| Intended Use of First Face Learnings in Professional Life | Post-training (i.e. immediately after training) | Participants will report how likely they are to use the First Face training in the professional life on a 4-point scale from Not at all to To a great extent. |
| Use of First Face Learnings | 3-months post-training | Yes/no measure assessing whether participants used their training at all (in either personal or professional life) in the 3 months following training. |
| Intended Use of First Face Learnings in Personal Life | Post-training (i.e. immediately after training) | Participants will report how likely they are to use the First Face training in the personal life on a 4-point scale from Not at all to To a great extent. |
Countries
United States
Participant flow
Recruitment details
Pre- and post-training data were collected in April and December, 2024. During 2024, the Healing Lodge employed 107 unique staff members. All were instructed that they were required to complete a First Face training. In total, 102 employees (95.3% of the year-round total) completed the First Face training. Not all trainees enrolled in the study. A total of 92 trainees in the study. Follow-up data were collected until April, 2025.
Pre-assignment details
All participants were assigned to complete the First Face training; there was no comparison group.
Participants by arm
| Arm | Count |
|---|---|
| Healing Lodge First Face Training Evaluation Study All participants in this evaluation will be assigned to the First Face for Mental Health training condition. The investigators will use a pre-post design to measure change in relevant outcomes from pre-training, to post-training, to 3-months post-training. | 92 |
| Total | 92 |
Baseline characteristics
| Characteristic | Healing Lodge First Face Training Evaluation Study |
|---|---|
| Age, Customized Age | 0 Participants |
| Department Administration | 13 Participants |
| Department Behavioral health | 44 Participants |
| Department Maintenance | 6 Participants |
| Department Medical | 5 Participants |
| Department Mental health | 4 Participants |
| Department Missing | 4 Participants |
| Department Programs and support services | 16 Participants |
| Race/Ethnicity, Customized Tribal membership Enrolled in or descended from a federally-recognized Tribe | 32 Participants |
| Race/Ethnicity, Customized Tribal membership Not enrolled in or descended from a federally-recognized Tribe | 60 Participants |
| Reside on a reservation Do not reside on a reservation | 92 Participants |
| Reside on a reservation Reside on a reservation | 0 Participants |
| Sex/Gender, Customized Gender Another description | 4 Participants |
| Sex/Gender, Customized Gender Man | 41 Participants |
| Sex/Gender, Customized Gender Woman | 47 Participants |
| Years working with at-risk youth | 8.23 Years STANDARD_DEVIATION 8.98 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 90 |
| other Total, other adverse events | 0 / 90 |
| serious Total, serious adverse events | 0 / 90 |
Outcome results
Primary
Attitudes Towards Serious Mental Illness - Adolescent Version
The Attitudes Towards Serious Mental Illness - Adolescent Version (ATSMI-AV) is a validated 21-item self-report scale designed to measure attitudes towards mental illness. Participants respond on a 5-point Likert scale. The scale measures five aspects of mental health attitudes: threat, social construction/concern, wishful thinking, categorical thinking and out of control. The investigators will calculate an overall score as well as factor-specific scores, if they observe adequate internal reliability. Each item has response categories ranging from Completely disagree (coded as 1) to Completely agree (coded as 5), and a mean of all 21 items is calculated to create the scale. The scale has a possible range of 1 to 5 Higher scores indicate higher levels of stigma towards mental illness.
Time frame: Included at pre-training, post-training (i.e. immediately after training), and 3-months post-training
Population: Some missing data, some participants lost to attrition.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | Attitudes Towards Serious Mental Illness - Adolescent Version | Pre-training | 2.05 Score on a scale | Standard Error 0.11 |
| Healing Lodge First Face Training Evaluation Study | Attitudes Towards Serious Mental Illness - Adolescent Version | Post-training | 1.94 Score on a scale | Standard Error 0.1 |
| Healing Lodge First Face Training Evaluation Study | Attitudes Towards Serious Mental Illness - Adolescent Version | 3-month follow-up | 1.96 Score on a scale | Standard Error 0.11 |
Primary
First Face Knowledge Assessment
This is a 12-question quiz testing participants' knowledge of concepts taught in the First Face training. Some questions offer the opportunity to earn more than one point. The investigators will score each response as correct or incorrect and sum scores (possible range = 0-17) on each occasion. Higher scores indicate better knowledge of First Face concepts.
Time frame: Included at pre-training, post-training (i.e. immediately after training), and 3-months post-training
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | First Face Knowledge Assessment | 3-month follow-up | 12.26 Score on a scale | Standard Error 0.58 |
| Healing Lodge First Face Training Evaluation Study | First Face Knowledge Assessment | Pre-training | 9.18 Score on a scale | Standard Error 0.42 |
| Healing Lodge First Face Training Evaluation Study | First Face Knowledge Assessment | Post-training | 13.04 Score on a scale | Standard Error 0.53 |
Primary
Perceived Competence to Respond
A 10-item measure that taps respondents' confidence in their competence to respond to and help people experiencing mental health problems (i.e., Confidence in Recognizing, Intervening and Connecting Individual(s) with Resources Scale). Each response option has a possible range of 1 (Not at all confident) to 5 (Very confident), and a mean score will be calculated from all 10 items to yield a scale with a possible range of 1 to 5. Higher values indicate greater perceived competence respond to and help people experiencing mental health problems.
Time frame: Included at pre-training, post-training (i.e. immediately after training), and 3-months post-training
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | Perceived Competence to Respond | Pre-training | 4.17 Score on a scale | Standard Error 0.14 |
| Healing Lodge First Face Training Evaluation Study | Perceived Competence to Respond | Post-training | 4.44 Score on a scale | Standard Error 0.09 |
| Healing Lodge First Face Training Evaluation Study | Perceived Competence to Respond | 3-month follow-up | 4.28 Score on a scale | Standard Error 0.13 |
Secondary
Intended Use of First Face Learnings in Personal Life
Participants will report how likely they are to use the First Face training in the personal life on a 4-point scale from Not at all to To a great extent.
Time frame: Post-training (i.e. immediately after training)
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Personal Life | Missing | 4 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Personal Life | Somewhat | 28 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Personal Life | To a great extent | 58 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Personal Life | Very little | 0 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Personal Life | Not at all | 0 Participants |
Secondary
Intended Use of First Face Learnings in Professional Life
Participants will report how likely they are to use the First Face training in the professional life on a 4-point scale from Not at all to To a great extent.
Time frame: Post-training (i.e. immediately after training)
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Professional Life | Missing | 5 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Professional Life | Somewhat | 21 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Professional Life | To a great extent | 62 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Professional Life | Very little | 2 Participants |
| Healing Lodge First Face Training Evaluation Study | Intended Use of First Face Learnings in Professional Life | Not at all | 0 Participants |
Secondary
Satisfaction With Training
One item administered immediately post-training asking about satisfaction with training (from 1 (very dissatisfied) to 7 (very satisfied)), with higher scores indicating greater satisfaction.
Time frame: Post-training (i.e. immediately after training)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | Satisfaction With Training | 2.92 Score on a scale | Standard Deviation 1.98 |
Secondary
Use of First Face Learnings
Yes/no measure assessing whether participants used their training at all (in either personal or professional life) in the 3 months following training.
Time frame: 3-months post-training
Population: Some missing data
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Healing Lodge First Face Training Evaluation Study | Use of First Face Learnings | Missing | 1 Participants |
| Healing Lodge First Face Training Evaluation Study | Use of First Face Learnings | Yes-used training | 37 Participants |
| Healing Lodge First Face Training Evaluation Study | Use of First Face Learnings | No - did not use training | 9 Participants |