Project 1

项目1

Project 1 Abstract Community college (CC) students experience more prevalent and severe mental health problems compared to their four-year university counterparts1,2 yet are much less likely to receive mental health services. These disparities are amplified among racial and ethnic minority students, who experience multiple attitudinal and logistic barriers to mental health service as well as social and economic stressors4,7,23,25,34. Consistent with the ALACRITY Center Aim 2 to optimize the implementation of STAND, this R34 will focus on culturally responsive and community informed interventions to improve rates of screening and initial uptake of STAND in a CC where students are primarily low-income, and Latinx. With a user-centered-design, we aim to use student input iteratively across four years to develop and test engagement interventions that maximize recruitment and initial uptake of STAND at East Los Angeles College. Initially, 12 focus groups will be conducted with 60-72 ELAC students who have completed 1) screening only, 2) screening and consent/baseline assessment, 3) screening, consent/baseline and attendance at an orientation visit, and 4) those who have not yet signed up for screening, in order to explore facilitators and inhibitors of these phases of engagement. Qualitative findings, preliminary studies, and extant literature will inform the content of the engagement interventions that address barriers commonly known to affect initial service utilization in Latinx students, including mental health stigma, mental health knowledge, and perceived need18,19,21,27. We also have selected interventions that are feasible and have a structure that can be transported to various community college contexts to support spread in the future. During Year 2, we will examine the effectiveness of video testimonials (a low intensity informational intervention) which feature Latinx CC students with lived experiences of anxiety and depression, by comparing rates of those who complete STAND screening during Year 1 (standard recruitment) to Year 2 (standard recruitment with video testimonials). During Year 3, we will examine a culturally embedded digital fotonovela with aspects of motivational enhancement therapy (an intervention that aims to inform and activate). 270 ELAC students will be randomized to the fotonovela condition or to an active control group (e.g., standard educational materials). During year 4, we will examine a peer-led telephone engagement intervention which aims to inform and activate through collaboration with a peer coach; 308 students will be randomized to the peer-led engagement condition or to recruitment as usual. The primary outcome for both RCTs will be initial uptake in STAND as defined by completion of an orientation visit. We will also examine whether each of the engagement interventions leads to changes in mental health knowledge, stigma, self-efficacy, and perceived need that account for higher rates of service uptake. Efforts to improve screening and uptake for mental health programs like STAND are critical to the successful implementation of mental health programs on CC campuses and the reduction of ongoing mental health disparities.