Brief Precision Behavioral Health Screening and Early Intervention for Rural Youth

Project Summary/Abstract: Behavioral health help-seeking among adolescents has risen sharply in recent years, resulting in a crisis with respect to unmet behavioral health, particularly in rural regions. This crisis has been exacerbated by resource strains experienced by service providers. Sadly, youth and families served by community youth service providers (YSPs), including departments for children, youth, and family services, health services, child welfare, juvenile justice services, school health clinics, foster care, and managed care organizations contracting behavioral services with states, are among those least likely to receive services, especially those of quality. In rural communities, the situation is worse; youth-serving treatment programs are in short supply, few trained staff are available and treatment, reserved for the most severe problem youth, is outsourced and expensive. Services are notably less accessible for racial/ethnic minority youth. This reality is compounded by the frequent co-occurrence of problem behaviors (CPs) such as substance abuse, depression, trauma-related problems, and disruptive behavior and underscores the urgent need for services that are coordinated, engaging and adaptive. Communities desperately need more innovative, evidence-based, fully integrated delivery models that can access the large number of youth with CPs who are not receiving needed services. Early interventions for youth beginning to experience CPs that are delivered before adolescents develop a more chronic mental health disorder offer the best opportunity to reduce the economic and health costs associated with these disorders. The goal of the proposed SBIR Phase I research is to develop and pilot test a prototype for “e-Health Early Treatment Resource for Youth” (eTRY), a web-based intervention to allow for broad-scale delivery at low-cost to expand YSPs’ early intervention services for adolescents whose access is limited due to barriers such as distance from providers, lack of trained clinicians, and agencies with long waiting lists. eTRY will involve a multi-screener and a set of brief behavior change counseling modules to guide the youth and staff to address drug use and other problem behaviors informed by the screening process. The specific aims of the proposed study are: (1) Conduct focus groups with 10 YSP staff to inform eTRY implementation within state and community programs as well as with 20 YSP-involved adolescents and 10 parents to guide the development of eTRY content, structure and delivery methods for its four current modules. Feedback will be integrated iteratively in eTRY development. (2) Create and evaluate the software for a prototype and materials for one of the four eTRY modules, including the online framework that contains the basic essential elements of text, graphics, and interactive features. (3) Conduct a usability test of the single module with an independent sample of YSP-involved youth (n=20) to examine functionality (e.g., technical errors), feasibility (e.g., percent completions), usability (e.g., acceptability, appeal), and potential impact of the eTRY prototype. We will also engage stakeholders at the national, state, and community levels to inform implementation and engage in commercialization planning.