SOVA (Supporting Our Valued Adolescents) Peer Ambassador Program Pilot Study, Enhancing Resiliency in Low-Resource Youth

A.摘要 青少年抑郁症和焦虑症在美国是未得到充分治疗的公共卫生问题，具有严重的临床和 社会后果。低资源环境中的青少年，包括许多代表种族/民族少数民族的青少年-- 这种联系，遭受着不平等的精神疾病负担，但接受的治疗较少，而且更难达到。这些社会- 经济上处于不利地位的青年需要获得参与性干预措施，从而改变消除贫困的轨迹 抑郁和焦虑症状。将这种干预措施纳入现有的社区环境 可以增强可扩展性和覆盖范围。SOVA(支持我们宝贵的青少年)同行大使亲- 格拉姆吸引有抑郁或焦虑症状的年轻人，并愿意定期做出贡献 (每月)博客帖子和对他人帖子的评论(每周)，以分享他们在心理健康方面的经验。 Sova是一个由我们的研究团队为青少年和年轻人开发的主持网站，旨在 (1)提高心理健康素养；(2)消除对抑郁、焦虑诊断的负面健康信念 和治疗；以及(3)发展一个匿名在线支持社区，总体目标是增加治疗- 门票订婚。大使计划基于恢复力投资组合模型，该模型是一个描述 基于强项的韧性资产：自我和人际调节，以及从困难中获得意义-- 里奥斯。这些因素的变化可能会改善应对和积极功能，并导致 抑郁或焦虑的症状。一项单臂试点研究招募了3个月后发现的临床样本， SOVA大使的自尊心、能力和自信都有所提高。要理解 资源较少的青少年，特别是少数族裔青少年，会否享有类似的好处，我们在- 试图通过与以下机构合作，向参与暑期工作准备计划的年轻人传播该计划 一家社区机构。尽管该机构和年轻人表现出了兴趣，但该计划并未完全实施。 需要进一步开展工作，与社区伙伴一起制定一项了解社区情况的执行战略。在……里面 在R21中，我们建议应用实施映射技术和青年利益相关者驱动的AP- 继续量身定做SOVA，使其在文化上顺应和接近种族/少数民族，并 为低收入青年制定一项执行战略(目标1)，将SOVA同行大使纳入其中 社区工作准备计划设置中的计划。我们将进行一项试点随机对照试验 SOVA对等大使计划(RCT)与在线新闻写作(注意力控制)之间的对比 干预措施的可行性和可接受性，并评估目标1(目标2)中制定的执行战略。 这些结果将为设计提供充足动力的第一类混合动力实施-有效性试验提供参考 检验SOVA干预和伴随SOVA同行大使计划是否能增加治疗 在社区环境中对患有抑郁症或焦虑症的少数族裔、低资源青年以及聚集在- 利用知情的执行战略，形成对其交付和执行潜力的认识。

A. Abstract Adolescent depression and anxiety are under-treated public health problems in the US with serious clinical and societal consequences. Adolescents in low resource settings, including many representing racial/ethnic minori- ties, suffer an unequal burden of mental illness yet receive less treatment, and are harder to reach. These soci- oeconomically disadvantaged youth need access to engaging interventions which change the trajectory of de- pression and anxiety symptoms. Incorporation of such interventions into existing community-based settings may enhance scalability and reach. The SOVA (Supporting Our Valued Adolescents) Peer Ambassador pro- gram engages youth experiencing symptoms of depression or anxiety and willing to regularly contribute (monthly) blog posts and comment (weekly) on others’ posts to share their experiences with mental health. SOVA is a moderated website developed by our research team for adolescents and young adults designed to (1) increase mental health literacy; (2) address negative health beliefs toward depression, anxiety diagnosis and treatment; and (3) grow an anonymous online support community with the overall goal of increasing treat- ment engagement. The Ambassador program is based on Resilience Portfolio Model, a framework describing strengths-based assets of resilience: self and interpersonal regulation, and making meaning from difficult expe- riences. Changes in these factors may improve coping and positive functioning and lead to a decrease in symptoms of depression or anxiety. A one-arm pilot study recruiting a clinical sample found after 3 months, SOVA Ambassadors experienced an increase in self-esteem, competence, and confidence. To understand whether youth with less resources, especially racial minority youth, may experience similar benefits, we at- tempted to disseminate the program to youth involved in a summer work readiness program by partnering with a community agency. Although the agency and youth showed interest, the program was not fully implemented. Further work is needed to develop a community-informed implementation strategy with community partners. In this R21, we propose to apply the technique of Implementation Mapping and a youth stakeholder–driven ap- proach to continue to tailor SOVA so it is culturally responsive and approachable to racial/ethnic minority and low-income youth and develop an implementation strategy (Aim 1) to incorporate the SOVA Peer Ambassador Program in community work readiness program settings. We will conduct a pilot randomized controlled trial (RCT) of the SOVA Peer Ambassador Program vs. online journalistic writing (attention control) to understand intervention feasibility and acceptability and evaluate the implementation strategy developed in Aim 1 (Aim 2). These results will inform design of an adequately powered Type 1 hybrid implementation-effectiveness trial to test whether SOVA intervention and accompanying SOVA Peer Ambassador Program can increase treatment uptake in minority, low-resource youth with depression or anxiety in community settings, as well as gather in- formation on its delivery and potential for implementation using a well-informed implementation strategy.