Intervention to Prevent Peer Violence & Depressive Symptoms Among At-Risk Adolescents
| Status: | Recruiting |
|---|---|
| Conditions: | Depression, Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 13 - 17 |
| Updated: | 3/31/2019 |
| Start Date: | August 1, 2018 |
| End Date: | February 2023 |
| Contact: | Megan L Ranney, MD MPH |
| Email: | mranney@lifespan.org |
| Phone: | 401-444-2557 |
A Technology-Augmented Intervention to Prevent Peer Violence & Depressive Symptoms Among At-Risk Emergency Department Adolescents
The purpose of this investigation is to test the efficacy of "iDOVE2" (a brief emergency
department introductory session and longitudinal automated text-message depression prevention
program for high-risk teens), and to determine the most potent and parsimonious combination
of intervention components for preventing peer violence and depressive symptoms among at-risk
youth.
department introductory session and longitudinal automated text-message depression prevention
program for high-risk teens), and to determine the most potent and parsimonious combination
of intervention components for preventing peer violence and depressive symptoms among at-risk
youth.
Peer violence and depressive symptoms have mutual, reinforcing negative impacts on teens'
emotional and behavioral regulation strategies.
The emergency department (ED) is the primary source of care for many high-risk teens. It
provides an opportunity to initiate preventive interventions, to complement existing mental
health treatment or to stand alone for those who may lack access to formal care. Personalized
text-message interventions are accessible, feasible, and may be effective with these
adolescents.
The purpose of this study is to expand on the PI's pilot randomized controlled trial (RCT) of
iDOVE (K23 MH095866; PI: Ranney) by testing the efficacy of "iDOVE2" (a brief emergency
department introductory session and longitudinal automated text-message depression prevention
program for high-risk teens). The investigators will use a 2x2 factorial design to determine
the most potent and parsimonious combination of intervention components for preventing peer
violence and depressive symptoms among at-risk youth.
Participants will be identified in the course of usual clinical care in the ED. If eligible,
parents will be consented and participants assented. Participants will complete a baseline
assessment and will be randomized to one of four groups: Brief ED Intervention (BI) + Text;
BI + No Text; No BI + Text; or No BI + No Text. Youth in the Text arm who show no signal of
improvement at 7 days, per daily self-reported mood ratings, will be re-randomized to
additional "LiveText" (once-weekly real-time micro-counseling via text) or to continue with
standard, automated Text intervention curriculum.
At baseline and follow-ups at 2 months, 4 months, and 8 months, participants will complete
assessments on depressive symptoms, violence, cognitive/behavioral skill-sets, and resource
utilization.
emotional and behavioral regulation strategies.
The emergency department (ED) is the primary source of care for many high-risk teens. It
provides an opportunity to initiate preventive interventions, to complement existing mental
health treatment or to stand alone for those who may lack access to formal care. Personalized
text-message interventions are accessible, feasible, and may be effective with these
adolescents.
The purpose of this study is to expand on the PI's pilot randomized controlled trial (RCT) of
iDOVE (K23 MH095866; PI: Ranney) by testing the efficacy of "iDOVE2" (a brief emergency
department introductory session and longitudinal automated text-message depression prevention
program for high-risk teens). The investigators will use a 2x2 factorial design to determine
the most potent and parsimonious combination of intervention components for preventing peer
violence and depressive symptoms among at-risk youth.
Participants will be identified in the course of usual clinical care in the ED. If eligible,
parents will be consented and participants assented. Participants will complete a baseline
assessment and will be randomized to one of four groups: Brief ED Intervention (BI) + Text;
BI + No Text; No BI + Text; or No BI + No Text. Youth in the Text arm who show no signal of
improvement at 7 days, per daily self-reported mood ratings, will be re-randomized to
additional "LiveText" (once-weekly real-time micro-counseling via text) or to continue with
standard, automated Text intervention curriculum.
At baseline and follow-ups at 2 months, 4 months, and 8 months, participants will complete
assessments on depressive symptoms, violence, cognitive/behavioral skill-sets, and resource
utilization.
Inclusion Criteria:
- English-speaking
- presenting to the emergency department for routine care
- reporting past-year physical violence (using a modified version of The Revised
Conflict Tactics Scales (CTS-2) score ≥1), as identified on a brief screen
administered in the ED
- reporting past 2-week mild-to-moderate depressive symptoms (using Patient Health
Questionnaire (PHQ-9) score 5-19), as identified on a brief screen administered in the
ED
- Accompanied by a parent/guardian who is present and able to consent
- Possession of a cell phone with text-messaging capability
Exclusion Criteria:
- Chief complaint of suicidality, psychosis, sexual assault, or child abuse
- In police or child protective services' custody (as per state law)
- Unable to assent
- In need of emergency psychiatric care
We found this trial at
1
site
Providence, Rhode Island 02906
Principal Investigator: Megan L Ranney, MD, MPH
Phone: 401-444-8873
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