Moore Kiara L, Rodwin Aaron H, Gwadz Marya, Chang Doris F, Collins Linda M, Munson Michelle R
Silver School of Social Work, New York University, New York, NY, United States.
School of Global Public Health, New York University, New York, NY, United States.
JMIR Res Protoc. 2025 Jun 17;14:e68885. doi: 10.2196/68885.
BACKGROUND: Young adults from racial and ethnic minority (REM) groups are at greater risk of disengaging from vital mental health services than their majority group peers. Emerging research suggests developmentally tailored interventions that enable personalized exploration of cultural and structural contexts; encourage trust in relationships with service providers; enhance hope for recovery; and increase self-efficacy to adhere to treatment can improve engagement among underserved REM young adults with mental health disorders. OBJECTIVE: Just Do You is a brief young adult treatment engagement intervention. Although Just Do You showed evidence of efficacy with medium effect sizes in a previous clinical trial, not all participants benefited, and some of the proposed mediators were not changed. Grounded in the multiphase optimization strategy (MOST), we propose to improve the provision and effects of Just Do You by testing a set of new candidate intervention components that complement the original Just Do You program. This can potentially enhance its effects on engagement and mental health service use for REM young adults. METHODS: A total of 3 new candidate behavioral intervention components and their putative mediators were designed in collaboration with REM young adults and other key informants. The new candidate components and their mechanisms of action are (1) cultural identity (perceived cultural competency), (2) future self (hope), and (3) understanding environments (self-efficacy). A pilot optimization randomized controlled trial will be conducted in an outpatient mental health setting with REM participants aged 18-34 years (N=80). The candidate components will be tested in a 2-factorial design where all participants will receive Just Do You and be randomly assigned to one of 8 experimental conditions, each composed of a unique combination of candidate components. We will assess the new components' acceptability and feasibility, and explore preliminary evidence of their effects on the primary outcome (engagement in mental health care) and mediators at a 3-month follow-up assessment. RESULTS: The study began recruitment in December 2024 and is planned to continue through December 2026. Final study completion is planned for March 2027. The results will be disseminated via professional and scientific publications, presentations, and social media, as well as to members of the participant community. CONCLUSIONS: Findings from this study will supply critical deployment-focused evidence to inform a future randomized controlled trial as the next step in this program of research. We ultimately aim to create an effective, efficient, and scalable intervention to improve engagement and mental health outcomes among REM young adults. TRIAL REGISTRATION: ClinicalTrials.gov NCT06508450; https://clinicaltrials.gov/study/NCT06508450. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/68885.
背景:与多数群体的同龄人相比,来自种族和族裔少数群体(REM)的年轻人更有可能脱离重要的心理健康服务。新出现的研究表明,针对不同发育阶段量身定制的干预措施能够促进对文化和结构背景的个性化探索;鼓励对与服务提供者关系的信任;增强康复的希望;并提高坚持治疗的自我效能感,从而改善心理健康障碍的REM年轻成年人的参与度。 目的:“做你自己”是一种简短的针对年轻成年人的治疗参与干预措施。尽管“做你自己”在之前的一项临床试验中显示出中等效应大小的疗效证据,但并非所有参与者都从中受益,并且一些提出的中介因素并未改变。基于多阶段优化策略(MOST),我们建议通过测试一组补充原始“做你自己”计划的新候选干预组件,来改进“做你自己”的提供方式和效果。这有可能增强其对REM年轻成年人参与度和心理健康服务使用的影响。 方法:与REM年轻成年人和其他关键信息提供者合作,共设计了3个新的候选行为干预组件及其假定的中介因素。新的候选组件及其作用机制分别为:(1)文化认同(感知到的文化能力),(2)未来自我(希望),以及(3)理解环境(自我效能感)。将在门诊心理健康环境中对18 - 34岁的REM参与者(N = 80)进行一项试点优化随机对照试验。候选组件将采用二因素设计进行测试,所有参与者都将接受“做你自己”干预,并被随机分配到8种实验条件之一,每种条件由候选组件的独特组合构成。我们将评估新组件的可接受性和可行性,并在3个月的随访评估中探索其对主要结局(参与心理保健)和中介因素影响的初步证据。 结果:该研究于2024年12月开始招募,计划持续到2026年12月。计划于2027年3月完成最终研究。研究结果将通过专业和科学出版物、报告以及社交媒体,以及向参与社区的成员进行传播。 结论:本研究的结果将提供关键的以实施为重点的证据,为未来的随机对照试验提供参考,作为该研究计划的下一步。我们最终旨在创建一种有效、高效且可扩展的干预措施,以改善REM年轻成年人的参与度和心理健康结局。 试验注册:ClinicalTrials.gov NCT06508450;https://clinicaltrials.gov/study/NCT06508450。 国际注册报告识别码(IRRID):DERR1-10.2196/68885。
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