Digital Mental Health Screening, Feedback, and Referral System for Teens with Socially Complex Needs: Protocol for a Randomized Controlled Trial Integrating the TeACH System into Pediatric Primary Care (Preprint)

Abstract

Teens with socially complex needs–those who face multiple and potentially overlapping adversities–are disproportionately affected by several barriers to mental health screening and treatment. Pediatric Primary Care (PPC) is a typically low-stigmatized setting for teens that is visited at least annually. As such, implementing digital mental health tools (DMH) as low-intensity treatments (LITs) in PPCs may increase the reach of such tools for teens with socially complex needs.

This study evaluates the Teen Assess, Check, and Heal (TeACH) System compared to a control condition while integrated into PPCs at two Medical Centers serving teen patients in Chicago, IL. Through collaboration with key players throughout the design and implementation planning phases, the TeACH System is hypothesized to increase teen patient self-reported engagement with DMH and address specific individual-level barriers to mental healthcare, compared to a digital psychoeducation control condition.

Eligible participants will be recruited through PPC clinics housed within the University of Illinois Chicago (UIC) and Rush University Medical Center (RUSH). Recruitment involves invitations from research staff and primary care clinicians/staff, as well as posting flyers with QR codes at the specified clinics. All participants complete a brief demographic survey, baseline survey, and Kiddie-Computerized Adaptive Tests (K-CAT) Anxiety Module. Participants are randomized to receive either the control condition (digital evidence-based workbook) or the intervention (TeACH System Feedback and Resources). All randomized participants will then be invited to complete an immediate and one-week follow-up survey. The primary outcomes assess changes in engagement with DMH (i.e., likelihood to use DMH for anxiety, actual DMH use) and individual-level barriers to mental healthcare (i.e., symptom understanding, confidence to act). Descriptive analyses will be conducted to characterize the sample and usability ratings of the TeACH System. Linear or generalized linear mixed effects regression models will examine differences in primary outcomes over time.

Recruitment began in July 2024 and data collection is expected to be completed by August 2025.

The current study will provide preliminary feasibility data that may inform how the TeACH System and other DMH LITs might better engage and support teens with socially complex needs.

ClinicalTrials.gov ID NCT05466929