Designing and testing a brief single-session intervention for adolescents with depression

About This Grant

PROJECT SUMMARY/ABSTRACT Rates of adolescent depression are increasing, and 20% of adolescents in the United States now experience a depressive episode each year. Effective treatments exist, but most adolescents with depression do not receive them because they prefer to self-manage their symptoms, cannot access treatment, or perceive treatment to be too time-consuming or inconvenient. Delivering interventions digitally (i.e., through the internet or a smartphone application) is scalable, accessible, efficacious, and appealing to adolescents. However, digital interventions have low real-world uptake and engagement, and many users drop out in the first few minutes. Single-session interventions (SSIs) address these critical limitations by delivering an entire intervention in a single encounter and have shown promise for engaging mechanisms of action and ameliorating adolescent depression. Therefore, this project will adapt a gold standard treatment for adolescent depression – interpersonal psychotherapy for adolescents (IPT-A) – into a brief, web-based SSI. To reach adolescents with depression, this study includes a partnership with Mental Health America (MHA), a nonprofit advocacy organization that hosts a widely used online depression screen on their website. A deployment-focused approach will be utilized, with a focus on implementation on MHA’s screening website. Aim 1 will design the SSI based on pilot data and in consultation with experts in SSI design and IPT-A, an advisory board of adolescents and providers, and MHA staff. Aim 2 will refine the SSI by iteratively soliciting and incorporating feedback from three cohorts of five adolescents with depression (total n=15) recruited after screening positive for depression on MHA’s website. Among adolescents (n=200) screening positive for depression on MHA’s website, Aim 3 will evaluate the SSI’s acceptability, feasibility, immediate effects on the mechanism of action (interpersonal skill knowledge), and effects on depressive symptoms in a randomized controlled trial with follow-up assessments at 1 week, 1 month, and 3 months. In addition to directly addressing an important public health problem, this project includes training and research activities that will enable Dr. Funkhouser to gain expertise in: (1) digital mental health intervention design methods, (2) implementation science principles and methodologies, (3) clinical trials evaluating digital mental health interventions, and (4) grant writing and networking. The research aims and training goals will be accomplished with mentorship from leading experts in SSIs, implementation science, biostatistics, and IPT-A. This training and mentorship will also prepare Dr. Funkhouser to submit a R01 application and achieve his long- term career goal of becoming an independent investigator focused on designing, evaluating, and disseminating digital depression interventions that increase young people’s access to and utilization of effective support.