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Principal Investigator: Jessica Lynne Jenness
Organization: UNIVERSITY OF WASHINGTON
Fiscal Year: 2024
Award: $237,496
Funding agency: National Institute of Mental Health
PROJECT SUMMARY
Approximately 3.1 million adolescents are diagnosed with depression each year with over 60% not receiving or
engaging in mental health care. In an effort to address the significant challenges in access to and engagement
with evidence-based psychosocial interventions (EBPIs) for adolescent depression, investigators in the
University of Washington’s Departments of Psychiatry and Behavioral Sciences (MPI Jenness) and Human
Centered Design and Engineering (MPI Kientz) partnered to conduct pilot work addressing these challenges
through the use of Asynchronous Remote Communities (ARC) supported behavioral activation (BA+ARC). ARCs
are technology-mediated groups that use private online platforms (e.g., Slack, Microsoft Teams) to deliver weekly
tasks to participants and includes features such as asynchronous therapist and chatbot coaching, ecological
momentary assessment (EMA) of mood, activity, and skill-use tracking, and peer communities that aim to
improve support and motivation to engage in therapy and behavior change. Pilot work included successful design
and development of a preliminary BA+ARC prototype (ActivaTeen) that was found to be acceptable, usable, and
engaging to clinician and patient target users. The present proposal responds to PAR-21-131 “Pilot
Effectiveness Trials for Treatment, Preventive and Services Interventions” and aims to advance this pilot
work by conducting a mixed-methods study that 1) builds and conducts usability testing on a functional, usable,
and robust BA+ARC platform that will satisfy the needs of mental health clinicians and adolescent patients
identified through our pilot study (e.g., data security, HIPAA compliance, clinician workflow integration), and 2)
tests the feasibility, usability, and change in proposed target mechanisms and outcomes of BA+ARC compared
to BA treatment only (BA-Only) within a moderately-sized randomized control trial conducted within our partner
site’s outpatient psychiatry clinic. We hypothesize 1) BA+ARC target users will report increased acceptability,
feasibility, usability, and less burden than users of BA-Only; 2) BA+ARC adolescents will demonstrate
improvements on hypothesized treatment mechanisms including therapist alliance, timeliness of intervention,
social belongingness, and greater engagement in care compared to BA-Only adolescents; 3) Adolescents
treated by BA+ARC versus BA+Only will have improved outcomes in depression symptoms and diagnoses and
functional impairments. This research addresses the broader NIMH Strategic Plan Goal 4.3: Develop
innovative service delivery models to dramatically improve the outcomes of mental health services
received in diverse communities and populations by investigating a novel, technology-mediated service
model that has the potential to improve access to and effectiveness of EBPIs for adolescent depression.
Terms: <Access to Care><Address><Adolescent><Adolescent Youth><Behavior><Behavioral><Behavioral Sciences><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><Caring><Chronic><Clinic><Clinical Treatment><Clinical Trials><Communities><Data><Data Collection><Data Security><Data awareness><Development><Diagnosis><Ecological momentary assessment><Effectiveness><Elements><Emotional Depression><Engineering><Ethnic Origin><Ethnicity><Evaluation><Feedback><Functional impairment><Funding><Future><Goals><HIPAA><Health Insurance Portability and Accountability Act><Health Services Accessibility><Improve Access><Intervention><Intervention Strategies><Investigators><Kennedy Kassebaum Act><Low-resource area><Low-resource community><Low-resource environment><Low-resource region><Low-resource setting><Mediating><Mental Depression><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Methods><Modeling><Monitor><Moods><Motivation><NIMH><National Institute of Mental Health><Out-patients><Outcome><Outpatients><PL 104-191><PL104-191><Participant><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Pilot Projects><Population><Preventative intervention><Privatization><Psyche structure><Psychiatry><Psychological Health><Public Law 104-191><Race><Races><Randomized, Controlled Trials><Reporting><Research><Research Personnel><Researchers><Resource-constrained area><Resource-constrained community><Resource-constrained environment><Resource-constrained region><Resource-constrained setting><Resource-limited area><Resource-limited community><Resource-limited environment><Resource-limited region><Resource-limited setting><Resource-poor area><Resource-poor community><Resource-poor environment><Resource-poor region><Resource-poor setting><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><Service delivery model><Service model><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><Site><Social Interaction><Socio-economic status><Socioeconomic Status><Strategic Planning><Symptoms><Technology><Teen><Teenagers><Testing><Time><United States Health Insurance Portability and Accountability Act><Universities><Washington><Work><access to health services><access to services><access to treatment><accessibility to health services><adolescent depression><adolescent health><adolescent mental health><adolescent patient><adolescents with depression><arm><availability of services><behavior change><behavior outcome><behavioral outcome><care access><care delivery model><chat bot><chatbot><child depression><childhood depression><childhood onset depression><conversational agent><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><data visualization><depressed adolescents><depression><depression in adolescence><depression symptom><depressive><depressive symptoms><design><designing><developmental><digital><digital delivery><digital tool><digitally deliver><disability><effectiveness trial><evidence base><feasibility testing><health care delivery model><health service access><health services availability><healthcare delivery model><human centered design><improved><improved outcome><information gathering><information security><innovate><innovation><innovative><intervention for prevention><interventional strategy><juvenile><juvenile human><light weight><lightweight><mental><mental health care><mental healthcare><mobile computing><mobile platform><mobile technology><novel><patient oriented outcomes><pediatric depression><peer><pilot study><pilot test><prevention intervention><preventional intervention strategy><preventive intervention><prototype><psychosocial><racial><racial background><racial origin><randomized control trial><remote communities><service availability><service intervention><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><social><social media><socio-economic position><socioeconomic position><synchronous ehealth therapy><synchronous therapy><synchronous treatment><technology platform><technology system><teen years><teenage><tool><treatment access><trial regimen><trial treatment><usability><youth depression>