Stiles-Shields Colleen, Bobadilla Gabriella, Reyes Karen, Gustafson Erika L, Lowther Matthew, Smith Dale L, Frisbie Charles, Antognini Camilla, Dyer Grace, MacCarthy Rae, Martinengo Nicolò, Morris Guy, Touranachun Alissa, Wilkens Kimberlee M, Julion Wrenetha A, Karnik Niranjan S
Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago, IL, United States.
AI.Health4All Center, College of Medicine, University of Illinois Chicago, Chicago, IL, United States.
JMIR Res Protoc. 2025 Feb 18;14:e65245. doi: 10.2196/65245.
Teens with socially complex needs-those who face multiple and potentially overlapping adversities-are disproportionately affected by several barriers to mental health screening and treatment. Pediatric primary care (PPC) is a typically low-stigmatized setting for teens that is visited at least annually. As such, implementing digital mental health tools (DMH), as low-intensity treatments in PPCs may increase the reach of such tools for teens with socially complex needs.
This study aimed to evaluate the Teen Assess, Check, and Heal (TeACH) System in comparison to a control condition while integrated into PPCs at 2 Medical Centers serving teen patients in Chicago, Illinois. Through collaboration with key players throughout the design and implementation planning phases, the TeACH System is hypothesized to increase teen patient self-reported engagement with DMH and address specific individual-level barriers to mental health care, compared with a digital psychoeducation control condition.
Eligible participants will be recruited through PPC clinics housed within the University of Illinois Chicago (UIC) and Rush University Medical Center (RUSH). Recruitment involves invitations from research staff members and primary care clinicians and staff members, as well as posting flyers with QR codes at the specified clinics. All participants complete a brief demographic survey, baseline survey, and Kiddie-Computerized Adaptive Tests Anxiety Module. Participants are randomized to receive either the control condition (digital evidence-based workbook) or the intervention (TeACH System Feedback and Resources). All randomized participants will then be invited to complete an immediate and 1-week follow-up survey. The primary outcomes assess changes in engagement with DMH (ie, likelihood to use DMH for anxiety and actual DMH use) and individual-level barriers to mental health care (ie, symptom understanding and confidence to act). Descriptive analyses will be conducted to characterize the sample and usability ratings of the TeACH System. Linear or generalized linear mixed effects regression models will examine differences in primary outcomes over time.
Recruitment began in July 2024 and data collection is expected to be completed by August 2025. To date, 122 teens have assented to complete study activities, 80 have been randomized (an additional 24 teens have had subthreshold anxiety symptoms and were therefore not randomized), and 42 teens have completed the 1-week follow-up assessment.
This study will provide preliminary feasibility data that may inform how the TeACH System and other DMH low-intensity treatments might better engage and support teens with socially complex needs.
ClinicalTrials.gov NCT05466929; https://clinicaltrials.gov/study/NCT05466929.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/65245.
有复杂社交需求的青少年——即面临多种且可能相互重叠的逆境的青少年——在心理健康筛查和治疗的多个障碍方面受到的影响尤为严重。儿科初级保健（PPC）对青少年来说通常是一个耻辱感较低的场所，青少年至少每年会去一次。因此，在PPC中实施数字心理健康工具（DMH）作为低强度治疗方法，可能会扩大此类工具对有复杂社交需求的青少年的覆盖范围。
本研究旨在将青少年评估、检查与治愈（TeACH）系统与对照条件进行比较，该系统已整合到伊利诺伊州芝加哥市为青少年患者服务的2家医疗中心的PPC中。通过在整个设计和实施规划阶段与关键参与者合作，假设TeACH系统与数字心理教育对照条件相比，能够增加青少年患者自我报告的对DMH的参与度，并解决心理健康护理中特定的个体层面障碍。
符合条件的参与者将通过伊利诺伊大学芝加哥分校（UIC）和拉什大学医学中心（RUSH）内的PPC诊所招募。招募方式包括研究人员、初级保健临床医生和工作人员发出邀请，以及在指定诊所张贴带有二维码的传单。所有参与者都要完成一份简短的人口统计学调查问卷、基线调查问卷和儿童计算机自适应测试焦虑模块。参与者被随机分配接受对照条件（基于数字证据的工作手册）或干预（TeACH系统反馈与资源）。然后，所有随机分组的参与者将被邀请完成即时和1周后的随访调查。主要结局评估对DMH的参与度变化（即使用DMH治疗焦虑的可能性和实际使用DMH的情况）以及心理健康护理的个体层面障碍（即症状理解和采取行动的信心）。将进行描述性分析，以描述样本特征和TeACH系统的可用性评级。线性或广义线性混合效应回归模型将检验主要结局随时间的差异。
招募工作于2024年7月开始，预计数据收集将于2025年8月完成。截至目前，已有122名青少年同意完成研究活动，80名青少年已被随机分组（另有24名青少年有亚阈值焦虑症状，因此未被随机分组），42名青少年完成了1周后的随访评估。
本研究将提供初步的可行性数据，可为TeACH系统和其他DMH低强度治疗方法如何更好地吸引和支持有复杂社交需求的青少年提供参考。
ClinicalTrials.gov NCT05466929；https://clinicaltrials.gov/study/NCT05466929。
国际注册报告识别码（IRRID）：DERR1-10.2196/65245。
