A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination

Abstract

Background Despite the proliferation of evidence-based digital mental health programs for young people, their low uptake and inconsistent implementation preclude them from benefiting youths at scale. Identifying effective implementation strategies for evidence-based supports is especially critical in regions where treatment access is lowest owing to mental health provider shortages. Objective The goal of this academic-community partnership, funded by the City of San Antonio Metropolitan Health District, was to culturally adapt, disseminate, and gauge the acceptability and utility of an evidence-based digital mental health platform—Project Youth Empowerment and Support (YES)—among English- and Spanish-speaking youths living in south Texas. Methods Project YES is an open-access, anonymous platform containing 3 evidence-based, self-guided interventions for youth mental health. Project YES was culturally adapted via focus groups and co-design sessions with San Antonio youths with lived experience of depression and anxiety; translated into Spanish; and disseminated throughout San Antonio, Texas, via community and school partnerships. Results During the project period (April 2021 to December 2021), 1801 San Antonio youths began and 894 (49.64%) of them completed a 30-minute, single-session intervention within Project YES (aged 11-17 years; n=718, 39.87% male; n=961, 53.36% female; and n=3, 0.17% intersex; n=1477, 82.01% Hispanic; n=77, 4.28% non-Hispanic White; n=113, 6.27% Black; n=28, 1.55% Asian; and n=93, 5.16% other). This completion rate (49.64%) surpassed those previously observed for Project YES (eg, 34% when disseminated via social media). San Antonio youths rated Project YES as highly acceptable across all metrics, both in English and Spanish. In addition, the youths who completed Project YES—ENGLISH reported significant improvements in hopelessness (Cohen d=0.33; P<001), self-hate (Cohen d=0.27; P<001), and perceived agency (Cohen d=0.25; P<001) from before to after the intervention, and the youths who completed Project YES—SPANISH reported significant improvements in self-hate (Cohen d=0.37; P=.049) from before to after the intervention. Conclusions The results indicate that Project YES—an open-access, free, and anonymous web-based single-session intervention platform—is an acceptable, accessible, and applicable mental health support for English- and Spanish-speaking San Antonio youths.

Understanding University Students' Perspectives towards Digital Tools for Mental Health Support: A Cross-country Study

“…Second, only students from the UK recognised psychotherapy or psychological support in general as useful content of digital tools, alongside the lack of personalisation as a relevant disadvantage. These findings could outline a greater awareness in UoS students about the use of digital technologies for mental health support, potentially related to specific sociodemographic characteristics and cultural factors [ 39 - 41 ]. In the UK, living on campuses or in shared residences is the most popular choice of accommodation for university applicants [ 80 ].…”

“…Although students' perspectives on the topic have been previously investigated in some specific National contexts [ 32 , 38 ], the actual use of digital tools for mental health support, along with their relevance in students' lives, may be influenced by cultural specificities, as well as lifestyle habits [ 39 - 41 ]. Diverse strategies for promoting engagement and individual differences could influence the awareness and exploitation of these digital tools [ 42 , 43 ].…”

A WHO digital intervention to address depression among young Chinese adults: a type 1 effectiveness-implementation randomized controlled trial

“…Also, one-fourth of those who dropped out from the intervention reported that the program contained too much content, which indicates that effort is needed to make the SbS intervention briefer while keeping its core treatment elements to improve the acceptance of the intervention among young population. Recent trial evidence demonstrated that single-session digital interventions showed good acceptance among young people [ 62 ]. In addition, our study also identified a dropout pattern that could be specific to digital interventions: most of the people who dropped out did so before the first intervention session.…”

Technology Matters: Online, self‐help single session interventions could expand current provision, improving early access to help for young people with depression symptoms, including minority groups

“…Specifically, their evaluation supported the acceptability and utility of the SSIs for young people experiencing psychological distress outside of a trial and importantly, those accessing this platform were diverse on several dimensions including >50% non‐White and >40% sexual minorities (Schleider, Dobias, Sung, Mumper, & Mullarkey, 2020). Through an academic‐community partnership in San Antonio, Texas, they have also shown that it is possible to translate, culturally adapt and disseminate these resources specifically for low‐resourced and minoritized communities with evidence of good uptake, acceptability and utility (Shroff et al., 2023).…”