Accepted for/Published in: JMIR Formative Research
Date Submitted: May 20, 2021
Open Peer Review Period: May 20, 2021 - Jul 15, 2021
Date Accepted: Aug 12, 2021
(closed for review but you can still tweet)
A text-message intervention for adolescents with depression and their parent/caregiver to overcome cognitive barriers to mental health treatment initiation: Focus groups and a pilot trial
ABSTRACT
Background:
Many adolescents with depression do not pursue mental health (MH) treatment following referral by a heathcare provider. We developed a theory-based automated text message intervention (Text to Connect, T2C) that attempts to reduce cognitive barriers to initiation of MH care.
Objective:
In this 2-phase study, we sought to first understand potential for T2C and then test engagement, usability, and potential efficacy of T2C among adolescents with depression and their parent/caregiver.
Methods:
In phase 1, we conducted focus groups with adolescents with depression (n=9) and their parent/caregiver (n=9) separately and transcripts were examined for themes. In phase 2, we conducted an open trial of T2C with adolescents with depression referred to MH care (n=43) and their parent/caregiver (n=28). We assessed usability by examining program engagement, usability ratings and qualitative feedback at 4-weeks follow-up. We assessed potential effectiveness by examining change in perceived barriers to treatment and MH care initiation from baseline to 4-weeks.
Results:
In phase 1, we found that themes supported the T2C approach. In phase 2, we found high engagement with daily negative affect check-ins, high usability ratings, and self-reported decreases in barriers to MH treatment over time among adolescents. At 4-weeks follow-up, most adolescents reported either having initiated MH care (52%) or pending scheduling (15%), leaving only 15% of adolescents still not interested in MH care.
Conclusions:
Findings from this study suggest that T2C is acceptable to adolescents with depression and most parent/caregivers, is used at high rates, and may be helpful to reduce cognitive barriers to MH care initiation. Clinical Trial: NCT04560075
Citation
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