Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 19, 2025
Date Accepted: Jul 21, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Study protocol of a randomized trial of U-PEACE: An iteratively adapted transdiagnostic prevention program for diverse high school settings
ABSTRACT
Background:
Despite many adolescents experiencing mental health concerns, a substantial portion lack access to evidence-based treatments (EBTs) for psychopathology; this issue is magnified for adolescents belonging to marginalized communities. One way to ameliorate this is by adapting existent EBTs—typically delivered in research settings —so they are feasible and scalable in locations where adolescents naturally reside, such as high schools. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) may be particularly suited for this purpose due to its transdiagnostic, modular approach and its focus on adolescent clients.
Objective:
The goal of the study described is to iteratively adapt and implement the UP-A in three Title I high schools—with a focus on feasibility and scalability of the intervention in diverse high school settings.
Methods:
For initial adaptation, members of participating high school communities will be presented with original pre-adaptation materials and asked to provide qualitative feedback on how to make the program more appropriate and feasible for their schools (Aim 1). After initial adaptations are implemented, an open-trial pilot case series will assess the appropriateness and feasibility of the resulting program: the Unified Protocol for Emotional and Academic Challenges in Education (U-PEACE; Aim 2). Initial outcome data and qualitative feedback from pilot case series participants will then inform final adaptations for the randomized control trial—in which the adapted program will be compared to high schools’ mental health services as usual (Aim 3). The adapted program's effectiveness will be evaluated by employing a mixed methods approach, and feasibility will be preliminarily assessed through cost-effectiveness analyses (Aim 4).
Results:
Data collection for the study is expected to conclude in May 2025, with primary outcome analyses anticipated to be completed by August 2025.
Conclusions:
This protocol may serve as a promising guide for adapting youth EBTs in more accessible, diverse settings, as well as result in a useful prevention program for youth with emotional concerns. Clinical Trial: Trial Registration: ClinicalTrials.gov NCT06056674; https://clinicaltrials.gov/study/NCT06056674
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