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

A.摘要 在美国，青少年抑郁和焦虑是治疗不足的公共卫生问题， 社会后果。资源匮乏环境中的青少年，包括许多代表实里少数民族的青少年， 联系，遭受不平等的精神疾病负担，但得到的治疗较少，更难接触。这些社会-- 经济上处于不利地位的青年需要获得参与干预措施，改变发展的轨迹， 压力和焦虑症状。将这些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（支持我们有价值的青少年）同伴大使亲， gram吸引有抑郁或焦虑症状的年轻人，并愿意定期捐款。 （每月）博客文章和评论（每周）对他人的帖子分享他们的经验与心理健康。 SOVA是一个由我们的研究团队为青少年和年轻人开发的网站，旨在 (1)提高心理健康素养;（2）解决对抑郁、焦虑诊断的负面健康信念 和治疗;（3）发展一个匿名的在线支持社区，其总体目标是增加治疗， 订婚。大使计划基于弹性组合模型，该框架描述了 基于力量的弹性资产：自我和人际调节，并从困难的经验中获得意义 riences。这些因素的变化可能会改善应对和积极的功能，并导致减少 抑郁或焦虑的症状。一项单组初步研究招募了3个月后发现的临床样本， SOVA大使的自尊、能力和信心都有所提高。了解 至于资源较少的青少年，特别是少数族裔青少年，是否也能获得类似的好处，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青年传播该计划： 一个社区机构虽然该机构和青年表现出兴趣，但该方案没有得到充分实施。 需要进一步开展工作，与社区合作伙伴一起制定一项了解社区情况的执行战略。在 这个R21，我们建议应用实施映射技术和青年创业者驱动的AP- 设法继续调整SOVA，使其在文化上对种族/民族少数群体敏感和平易近人， 低收入青年，并制定实施战略（目标1），纳入SOVA同行大使 在社区工作准备方案设置方案。我们将进行一项随机对照试验 (RCT)SOVA同伴大使计划与在线新闻写作（注意力控制）的对比，以了解 干预的可行性和可接受性，并评估目标1（目标2）中制定的实施战略。 这些结果将为设计一个有足够动力的1型混合实施有效性试验提供信息， 测试SOVA干预和伴随的SOVA同伴大使计划是否可以增加治疗 吸收少数，低资源青年与抑郁或焦虑在社区环境中，以及聚集在- 利用一个充分知情的执行战略，就其交付和执行潜力进行培训。

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.