Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 27, 2018
Open Peer Review Period: Oct 1, 2018 - Nov 26, 2018
Date Accepted: May 17, 2019
(closed for review but you can still tweet)
A Mobile Phone-Based Intervention to Improve Mental Health Among Homeless Young Adults: A Field Trial
ABSTRACT
Background:
Youth homelessness is a substantial issue and many youth experiencing homelessness have mental health issues as both a cause and consequence of homelessness. These youth face many barriers in seeking out traditional mental health services and as a result, few youth experiencing homelessness receive any form of mental health care.
Objective:
This project aimed to develop and evaluate a technology-based intervention intended to engage young adults experiencing homelessness in a remotely-delivered mental health service and address mental health needs including depression and trauma. We aimed to determine feasibility and acceptability of this intervention by piloting it within a homeless shelter network.
Methods:
A total of 35 young adults (ages 18-23) experiencing homelessness participated in a single-arm field trial of the intervention. Participants received a mobile phone, a service and data plan, and 1 month of support from a therapist consisting of up to 3 brief phone sessions, text messaging, and mobile mental health applications. We evaluated clinical outcomes at baseline as well as clinical outcomes and satisfaction at the end of the 1-month support period. We used validity items to identify participants who might be responding inappropriately and thus only report clinical outcomes and satisfaction ratings from valid responses.
Results:
A majority of participants (57%, 20/35) completed all 3 of their phone sessions, with an average of 2.09 sessions (SD = 1.22) completed by each participant. Participants sent an average of 15.06 text messages (SD = 12.62) and received an average of 19.34 (SD = 12.70). We found higher rates of satisfaction among those participants with valid responses including 100% (23/23) of such participants indicating that they would recommend participation to someone else and 52% (12/23) reporting that they were “very” or “extremely” satisfied with their participation. Overall, we found no significant change in clinical outcomes of depression, posttraumatic stress disorder (PTSD), or emotion regulation during the intervention period (P’s > .59). The experience of traumatic events during the period appeared to impact symptoms, such that those who did not experience traumatic events had larger decreases in PTSD symptoms, but stable depressive symptoms and slight decreases in emotion regulation. The opposite pattern emerged for those who experienced traumatic events.
Conclusions:
This study demonstrated that it was feasible to engage homeless young adults in mental health services in this technology-based intervention with high rates of satisfaction, but we did not find changes in clinical outcomes with a very brief intervention. Technology might be an important avenue to reach young adults experiencing homelessness but additional work could explore the proper interventions to deliver with such a platform. Clinical Trial: NCT03620682
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.