Adolescent dropout from brief digital mental health interventions within and beyond randomized trials

Cohen, Katherine; Schleider, Jessica L.

doi:10.1016/j.invent.2022.100496

Cited by 27 publications

(23 citation statements)

References 35 publications

(50 reference statements)

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“…This relatively high completion rate provides further evidence of youth acceptability for online SSIs, as prior studies of self-guided digital mental health programs have shown substantially lower completion rates (0-28%, on average)- [7]. Furthermore, pre-SSI youth dropout (i.e., dropout occurring during the pre-SSI questionnaires) was only 14.4% in this project-substantially lower than the pre-SSI dropout rate observed in a previous program evaluation of Project YES (37.2%) [53].…”

Section: Discussioncontrasting

confidence: 54%

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

Shroff¹,

Roulston²,

Fassler³

et al. 2022

Preprint

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BACKGROUND. Despite the proliferation of evidence-based digital mental health programs for young people, low uptake and inconsistent implementation precludes them from benefiting youth at scale. Identifying effective implementation strategies for evidence-based supports is especially critical in regions where treatment access is lowest due 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 YES (www.schleiderlab.org/yes)—among English- and Spanish-speaking youth living in south Texas. METHODS. Project YES is an open-access, anonymous platform containing three evidence-based, self-guided interventions for youth mental health. Project YES was culturally adapted via focus groups and co-design sessions with San Antonio youth 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–December 2021), 1,801 San Antonio youth began and 894 completed a 30-minute, single-session intervention within Project YES (ages 11-17; 39.9% male, 53.4% female, 0.2% intersex; 82.0% Hispanic, 4.3% non-Hispanic white, 6.3% Black, 1.6% Asian, 5.2% other). This completion rate (49.6%) surpassed those previously observed for Project YES (e.g., 34% when disseminated via social media). San Antonio youth rated Project YES as highly acceptable across all metrics, both in English and Spanish. Additionally, youth who completed Project YES - ENGLISH reported significant improvements in hopelessness (d = 0.33), self-hate (d = 0.27), and perceived agency (d = 0.25), from pre- to post-intervention, and teens who completed Project YES - SPANISH reported improvements in self-hate (d = 0.37) from pre- to post-intervention. CONCLUSIONS. Results indicate that Project YES—an open-access, free, anonymous online single-session intervention (SSI) platform—is an acceptable, accessible, and applicable mental health support for English- and Spanish-speaking San Antonio youth.

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Section: Discussioncontrasting

confidence: 54%

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

Shroff¹,

Roulston²,

Fassler³

et al. 2022

Preprint

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“…This pilot has limitations. As observed in other SSI evaluations (Cohen & Schleider, 2022), about one-third of eligible respondents who accessed Project Body Neutrality completed the SSI and all preand post-SSI questionnaires. The non-completers' data was not analyzed, so we did not examine their feedback.…”

Section: Strengths and Limitationsmentioning

confidence: 76%

Project Body Neutrality: Piloting a digital single-session intervention for adolescent body image and depression

Smith¹,

Ahuvia²,

Ito³

et al. 2023

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Objective: Eating disorders (EDs) and depression are impacting youth at alarming rates, yet most adolescents do not access treatment. Single-session interventions (SSIs) can reach youth in need. This pilot examines the acceptability and short-term utility of an SSI designed to help adolescents adopt a body neutrality mindset. Method: Pre- to post-intervention data was collected, and within-group effect sizes and 95% confidence intervals were computed, to evaluate the immediate effects of the SSI on hopelessness, functionality appreciation, and body dissatisfaction. Patterns of use, demographics, program feedback, and responses from within the SSI were also collected. Results: The SSI and all questionnaires were completed by 75 adolescents (ages 13-17, 74.70% White/Caucasian, 48.00% woman/girl) who reported elevated body image and mood problems. Analyses detected significant pre-post improvements in hopelessness (dav = 0.60, 95% CI 0.35, 0.84; dz = 0.77, 95% CI 0.51, 1.02), functionality appreciation (dav = 0.72, 95% CI 0.46, 0.97; dz = 0.94, 95% CI 0.67, 1.21), and body dissatisfaction (dav = 0.61, 95% CI 0.36, 0.86; dz = 0.76, 95% CI 0.50, 1.02). The SSI was rated as highly acceptable, with a mean overall score of 4.34/5 (SD = 0.54). Qualitative feedback suggested adolescents' endorsement of body neutrality as a personally-relevant, helpful target for intervention. Discussion: This evaluation supports the acceptability and preliminary effectiveness of a body neutrality-focused SSI for adolescents with body image and mood concerns.

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“…First, demographic data were obtained only from participants who completed the follow-up, preventing tests of whether users with particular identities were differentially likely to complete the follow-up assessment. A previous study found that in the context of brief, online interventions, dropout does not significantly differ between participants by identity (Cohen & Schleider, 2022). Nonetheless, examining differential dropout rates between demographic groups in the specific context of crisis-response interventions may be useful.…”

Section: Discussionmentioning

confidence: 95%

Improving uptake of mental health crisis resources: Randomized test of a single-session intervention embedded in social media

Cohen¹,

Dobias²,

Morris³

et al. 2022

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Young people often experience difficulties accessing mental health support. In moments of crisis, many young people search for mental health-related information or support on social media platforms. When users search or post crisis-related content (e.g., “suicide”) on these platforms, many are programmed to automatically provide the user with crisis hotlines. Little research has examined whether young people use crisis hotlines when they are automatically shared, or whether other resource-provision strategies may better support hope and help-seeking. Methods: Users flagged as being potentially in-crisis by social media platforms were referred to Koko—a nonprofit that partners with online platforms to provide crisis support. Users were randomized to receive either a typical crisis response (988 crisis hotline provision) or a one-minute, enhanced crisis response Single-Session Intervention (SSI). Results: Users who received the enhanced crisis response SSI reported greater decreases in hopelessness ten minutes later, compared to users who received the typical crisis response (t(153) = -2.16, p = 0.03, d = -0.35; 95% CI, -0.67, -0.03). Users who received the SSI were more than twice as likely to report using the resources provided to them, compared to users who received the typical crisis response (78.02% vs. 38.64%; χ2(1) = 27.02, p < 0.001, V = 0.28). Conclusion: An enhanced crisis response SSI embedded within social media platforms can reduce users’ hopelessness and dramatically increase young people’s odds of accessing mental health resources in moments of crisis.

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Adolescent dropout from brief digital mental health interventions within and beyond randomized trials

Cited by 27 publications

References 35 publications

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

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

Project Body Neutrality: Piloting a digital single-session intervention for adolescent body image and depression

Improving uptake of mental health crisis resources: Randomized test of a single-session intervention embedded in social media

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