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Principal Investigator: Mark J Van Ryzin
Organization: UNIVERSITY OF OREGON
Fiscal Year: 2024
Award: $707,157
Funding agency: National Institute of Mental Health
Abstract
Internalizing symptoms (i.e., anxiety, depressive symptoms, suicidality) are alarmingly common among
adolescents. In 2019, nearly 37% of high school students reported feeling anxious, sad, or hopeless,
representing an increase from 2017 (i.e., 31%), and nearly 19% seriously considered suicide1, an increase
from 2017 (17%). The coronavirus pandemic has exacerbated this problem, with research finding that social
isolation resulting from the pandemic was linked to higher levels of stress, fear, loneliness, anxiety, depression,
and suicide ideation among adolescents2-3. Importantly, ethnic/racial disparities have been documented in
internalizing symptoms, with more negative outcomes for Latinas and Black males39-45. Current universal
school-based approaches to prevention have reported uneven or limited effects, or no effects at all6-12.
Questions have also been raised regarding cost and accessibility49-59. Despite the uneven track record of
universal school-based (Tier 1) approaches, which has led some to recommend an emphasis on targeted (Tier
2) approaches48, they possess several advantages. First, given the demographic heterogeneity in risk factors,
as well as disparate access to high-quality, culturally-sensitive health care23, schools remain attractive as they
can ensure equitable access to primary prevention services. Second, universal programs avoid the difficulty of
identifying adolescents at risk12, and third, they minimize the risk of stigmatizing adolescents who seek out or
are referred to services20-22. In this project, submitted to the Transformative Research Award initiative (RFA-
RM-21-017), we will use cooperative learning (CL) as a universal (Tier 1) school-based prevention program to
target malleable peer-based risk factors and subsequently evaluate how change in these mechanisms can
reduce adolescent internalizing symptoms. CL targets various forms of maladaptive peer relations that create
stress and comprise a significant risk factor for internalizing symptoms in adolescence; CL also promotes peer
protective factors that can reduce the likelihood of internalizing symptoms (e.g., peer acceptance)27-34. CL has
also been found to promote more cross-race interaction and interracial attraction, greater cross-ethnic
academic support, and more frequent cross-ethnic friendships95-97. To support teachers in implementing CL,
we will use a Web-based software platform that provides an accessible, high-fidelity mechanism to deliver CL
lessons. We will not only test for intervention effects, but will also evaluate the relative strength of specific,
theoretically-derived change mechanisms, and uncover key issues/barriers related to implementation that will
allow us to dynamically adjust our implementation approach to achieve maximum impact during subsequent
scale-up. Our project is designed to establish feasibility with teachers and schools and counter potential threats
to implementation fidelity while also creating a roadmap to enhanced scalability and sustained implementation.
Significant results from this project could inspire broad uptake of our approach in educational contexts,
potentially addressing a significant public health need during a time of crisis due to the COVID-19 pandemic.
Terms: <12-20 years old><Academic support><Achievement><Achievement Attainment><Active Learning><Address><Adolescence><Adolescent><Adolescent Youth><Anxiety><Approaches to prevention><Award><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Cannot see a future><CoV pandemic><Cognition Therapy><Cognitive Discrimination><Cognitive Psychotherapy><Cognitive Therapy><Cognitive treatment><Computer software><Cooperative Learning><Data><Depressed mood><Development><Disadvantaged><Discrimination><Disparities><Disparity><Education><Educational aspects><Emotional><Emotional Depression><Ensure><Equity><Ethnic Origin><Ethnicity><Experiential Learning><Fear><Feeling><Feeling hopeless><Feeling suicidal><Feels there is no future><Female><Friendships><Fright><Geography><Healthcare><Heterogeneity><High School Student><Hispanic><Individuals from minority><Individuals of minority><Instruction><Latina Population><Latinas><Link><Loneliness><Loss of hope for the future><Mental Depression><Meta-Analysis><Minority Groups><Minority Male><Minority Men><Minority People><Minority Population><Minority individual><Monitor><Negative about the future><No hope for the future><Outcome><Performance><Population><Preventative strategy><Prevention approach><Prevention program><Prevention strategy><Preventive strategy><Primary Prevention><Problem behavior><Public Health><Race><Races><Racial Equity><Randomization trial><Recommendation><Reporting><Research><Risk><Risk Factors><Rural><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Schools><Secondary School Student><Secondary Student><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Social isolation><Software><Stigmatization><Stress><Students><Suicidal thoughts><Suicide><Suicide attempt><Suicide precaution><Suicide prevention><Survey Instrument><Surveys><Symptoms><Teaching Method><Technology><Testing><Time><Training><Victimization><Youth><Youth 10-21><access disparities><accessibility disparities><adolescence (12-20)><adolescent mental health><anxious><behavioral problem><black male><black men><bully><bullying><cognitive behavior intervention><cognitive behavior modification><cognitive behavior therapy><cognitive behavioral intervention><cognitive behavioral modification><cognitive behavioral therapy><cognitive behavioral treatment><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus pandemic><cost><cost effectiveness><depressed><depression><depression symptom><depressive><depressive symptoms><design><designing><developmental><disparities in access><disparities in race><disparity due to race><disparity in ethnic><dosage><ethnic based disparity><ethnic disadvantage><ethnic disparity><ethnic inequality><ethnic inequity><ethnicity disparity><experience><fatal attempt><fatal suicide><feelings><health care><help seeking><help-seeking behavior><high school><high schoolers><hopelessness><implementation fidelity><inequality due to race><inequality in access><inequity due to race><inequity in access><inequity in accessibility><innovate><innovation><innovative><insight><instructional practice><instructional strategy><intent to die><interest><intervention effect><juvenile><juvenile human><lonely><non fatal attempt><nonfatal attempt><online software><pandemic><pandemic disease><peer><prevent><prevent suicidality><prevent suicide><preventing><prevention service><programs><protective factors><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial><racial background><racial disparity><racial inequality><racial inequity><racial origin><racially unequal><randomized trial><risk minimization><sadness><scale up><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><substance use><substance using><suicidal><suicidal attempt><suicidal ideation><suicidal thinking><suicidality><suicidality prevention><suicide ideation><suicide intervention><suicides><teacher><teaching methodology><thoughts about suicide><trend><universal interventions><universal prevention><universal preventive interventions><universal preventive measure><uptake><validation studies><web based software><web software><willingness>