Document text
Principal Investigator: Margaret Weiss
Organization: CAMBRIDGE HEALTH ALLIANCE
Fiscal Year: 2024
Award: $144,662
Funding agency: National Institute of Mental Health
PROJECT SUMMARY AND ABSTRACT – Cambridge Health Alliance
ALACRITY for Early Screening and Treatment of High Risk Youth (eSToRY)
R34 Prevention and Early Identification for High Risk Youth in School-based Clinics
The proposed project aims to implement and test tools necessary to prevent transitions to mental illness
among at-risk youth, and particularly at-risk racial/ethnic and language (REL)-minority youth. Risk factors for
REL-minority youth can be heightened due to their greater likelihood of experiencing discrimination and
socioeconomic barriers and their subsequent impacts on access and engagement in treatment and overall
wellness. The overall aim of this project is to prevent and remediate a surge in youth mental illness and to
reduce persistent treatment disparities. First, we propose to use a remote adaptive testing technology, “K-
CAT+”, to provide rapid community-based screening. Second, we will evaluate the effectiveness of a targeted,
online health promotion intervention, COPE2THRIVE (C2T), to build resilience in a REL-diverse sample of
school-aged youth. Third, we will assess whether this approach mitigates increased risk faced by racial/ethnic
and language (REL)-minority youth.
In Aim 1, we test the feasibility and acceptability of a parent- and youth-reported electronic mental health
screener, K-CAT, among 12-17 year old youth in a school-based setting. The adaptive screening platform, K-
CAT, reduces the time and total number of measures that are required. We supplement K-CAT (to make “K-
CAT+”) with measures of functional status, complex trauma, and individual- and neighborhood-level social
determinants of health (SDOH). In Aim 2, we test the feasibility, acceptability, and preliminary effectiveness of
the COPE2THRIVE (C2T) intervention, a resilience intervention targeting the mechanism of coping self-
efficacy to reduce symptoms and improve function. We select youth determined by the K-CAT+ to be at
moderate risk for mental illness. In Aim 3, we assess whether the combination of early school-based screening
and the preventive C2T intervention reduces disparities in engagement in treatment, and reduces symptoms
and improves function for REL-minorities.
The screening and preventive interventions tested in this project have the potential to reduce persistent REL
disparities in access and engagement in treatment and mental health outcomes, by enhancing the availability
and ease of screening, overcoming known biases in recognition and referral, and by intervening earlier than
usual among at-risk REL-minority youth.
Terms: <17 year old><17 years of age><Abuse Reporting><Access to Care><Accounting><Active Follow-up><COVID-19><CV-19><Clinic><Cognitive><Communities><Complex><Computers><Coronavirus Infectious Disease 2019><Counseling><Data><Data Bases><Databases><Decrease disparity><Diagnosis><Disadvantaged><Disparities><Disparity><Distress><E-learning><Early Intervention><Early identification><Early treatment><Education><Educational aspects><Effectiveness><Effectiveness of Interventions><Electronic Health Record><Electronics><Espanol><Ethnic Origin><Ethnicity><Explosion><Face><Family><Food><Future><Haitian><Health Alliance><Health Promotion><Health Services><Health Services Accessibility><Health system><Individual><Institute of Medicine><Institute of Medicine (U.S.)><Insurance><Intervention><Intervention Strategies><Language><Lower disparity><Measurement><Measures><Mental Health><Mental Hygiene><Mental disorders><Mental health disorders><Methods><Minority><NAS/IOM><Neighborhoods><Outcome><Paper><Parents><Physical distancing><Population><Portuguese><Preventative intervention><Prevention><Preventive><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Race><Races><Reporting><Risk><Risk Factors><Salutogenesis><Sampling><School-Age Population><Schools><Self Efficacy><Single major depression><Single major depressive episode><Social Distance><Spanish><Structure><Students><Substance abuse problem><Symptoms><Technology><Teen><Teenagers><Testing><Therapeutic Intervention><Time><Trauma><Unemployment><Work><Youth><Youth 10-21><abuse of substances><acceptability and feasibility><access disparities><access to health services><access to services><access to treatment><accessibility disparities><accessibility to health services><active followup><adolescent minority><age 17 years><age group><aged><alleviate symptom><ameliorating symptom><assess effectiveness><availability of services><behavioral health><build resilience><build resiliency><care access><college><collegiate><compare effectiveness><computer-assisted instruction><computer-based education><computer-based instruction><computer-based learning><computer-based training><coping><coping mechanism><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><data base><decrease symptom><determine effectiveness><develop resilience><develop resiliency><digital education><digital learning><disparities in access><disparities in treatment><disparity reduction><eLearning><early screening><early therapy><effective intervention><effectiveness assessment><effectiveness evaluation><effectiveness testing><electronic><electronic device><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic learning><electronic medical health record><enhance resilience><enhance resiliency><evaluate effectiveness><examine effectiveness><experienced discrimination><faces><facial><feasibility testing><fewer symptoms><follow up><follow-up><followed up><followup><functional improvement><functional status><health service access><health services availability><help seeking><help-seeking behavior><high risk><improve function><improve resilience><improve resiliency><improved functional outcomes><increase resilience><increase resiliency><inequality in access><inequality in treatment><inequity in access><inequity in accessibility><internet-assisted education><internet-based training><intervention for prevention><intervention therapy><interventional strategy><jobless><joblessness><major depressive episode><mental health personnel><mental illness><minority children><minority communities><minority youth><mitigate disparity><multimedia learning><novel><on-line education><on-line learning><online education><online learning><out of work><outreach><parent><pediatric minority><peer support><perceived discrimination><perception of discrimination><prevent><preventing><prevention intervention><preventional intervention strategy><preventive intervention><promote resilience><promote resiliency><promoting health><psychiatric illness><psychological disorder><racial><racial background><racial origin><reduce disparity><reduce symptoms><reduction in disparity><relieves symptoms><remediation><resilience><resilience development><resilient><school age><school closing><school closure><screening><screenings><self-reported discrimination><service availability><seventeen year old><seventeen years of age><single episode Major Depression><single episode major depressive disorder><social health determinants><social stigma><socio-economic><socio-economically><socioeconomically><socioeconomics><stigma><stressor><substance abuse><substance use><substance using><symptom alleviation><symptom reduction><symptom relief><technology-enhanced learning><teen years><teenage><tool><treatment access><treatment disparity><treatment inequality><treatment inequity><unemployed><virtual learning><web-based instruction><web-based training><young minority>