Using Digital Media Advertising to Reduce the Duration of Untreated Psychosis

There is compelling evidence that longer duration of untreated psychosis independently predicts negative outcomes. The proposal aims to explore whether targeted and proactive online outreach through search engine advertisements, coupled with engaging, informative, and interactive online resources, can effectively reduce the duration of untreated psychosis and facilitate earlier treatment initiation in New York State. Results from this initiative will be critical to informing the subsequent design and conduct of larger, focused, and proactive digital media campaigns targeting patient with First Episode Psychosis and their caregivers online, intended to accelerate linkage to care and reduce the duration of untreated psychosis throughout the U.S.

Study Overview

• Status: Completed
• Conditions: Schizophrenia; First Episode Psychosis
• Intervention / Treatment: Behavioral: search engine advertisement campaign

Detailed Description

Approximately 100,000 individuals in the Unites States experience a first episode of psychosis (FEP) each year. Psychotic symptoms typically emerge during formative years of adolescence and young adult development and interfere with the establishment of healthy educational, vocational, and social foundations. Despite the severity of symptoms and significant decline in functioning, the time between symptom onset and receiving appropriate care in the U.S. is alarmingly lengthy. Longer Duration of Untreated Psychosis (DUP) has been shown to independently predict negative outcomes, including poorer response to treatment, worse global, vocational, social, and cognitive functioning, greater risk of relapse, higher symptom severity, and poorer quality of life. Prior successful DUP reduction initiatives have utilized various marketing strategies to educate the community about early intervention services, however these strategies are expensive, inefficient, and outdated. Targeted online outreach, supported by technological innovation, offers the prospect of proactively reaching individuals earlier in the course of illness development, as well as individuals who might not otherwise come into contact with traditional referral sources. In response to this challenge, Northwell Health's early psychosis research team is collaborating with Strong365, a nonprofit initiative dedicated to raising early psychosis intervention awareness, to develop and test a proactive and targeted comprehensive digital media marketing campaign designed to facilitate help-seeking and encourage treatment initiation in prospective patients with FEP and their caregivers. Investigators will take advantage of search engine advertisements, which allow advertisers (researchers) to select keywords/phrases and create linked ads appearing as a strategically placed search result. Dedicated ads will appear in response to online search queries conducted by prospective patients and their caregivers throughout New York State (NYS) that align with the campaign's pre-selected keywords/phrases. Individuals who click on the ads will be immediately directed to a landing page/website, and offered a variety of innovative and interactive online engagement tools intended to instantly connect users with specialty care staff and to facilitate earlier treatment initiation. Campaign referrals will be centralized and individuals with FEP will be enrolled into OnTrackNY (OTNY), a network of 21 dedicated early psychosis intervention programs throughout NYS. The campaign will target individuals as well as their caregivers, searching for psychosis-related terms or information online. Investigators will measure the DUP of individuals enrolled into OTNY before and after campaign activation and track the impact of the campaign on the number of FEP referrals and number of patients admitted to OTNY in NYS. Furthermore, investigators aim to identify the campaign target audience most effective at promoting treatment initiation as well as the online tools and resources most effective at encouraging treatment initiation for individuals with FEP. Investigators will additionally explore the online trajectories to care of individuals with FEP engaging with the campaign.

• Study Type: Interventional
• Enrollment (Actual): 698
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Glen Oaks, New York, United States, 11004
      • Northwell
    • Queens, New York, United States, 11004
      • Northwell

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria: All individuals searching online for information related to mental health

Exclusion Criteria: none

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Pre-Campaign; Investigators will measure the duration of untreated psychosis and rates of referrals to OnTrackNY programs throughout New York States prior to campaign initiation.
Active Comparator: Active Campaign; Investigators will measure the duration of untreated psychosis and rates of referrals to OnTrackNY programs throughout New York States during the active campaign initiation.	Behavioral: search engine advertisement campaign; This proposal aims to explore whether targeted and proactive online outreach through search engine advertisements, coupled with engaging, informative, and interactive online resources, can effectively reduce the duration of untreated psychosis and facilitate earlier treatment initiation in New York State.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reducing the Duration of Untreated Psychosis	Evaluate the effectiveness of a search engine ad campaign on reducing the duration of untreated psychosis (DUP) by directly comparing DUP pre-campaign to DUP during the campaign.	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rates of Referrals	Evaluate the effectiveness of a search engine ad campaign on rates of referrals by directly comparing referrals pre-campaign to referrals during the campaign.	2 years

Collaborators and Investigators

• Sponsor: Northwell Health
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Michael L Birnbaum, MD, Northwell Health

Study record dates

Study Major Dates

• Study Start (Actual): April 22, 2020
• Primary Completion (Actual): May 31, 2022
• Study Completion (Actual): May 31, 2023

Study Registration Dates

• First Submitted: May 30, 2019
• First Submitted That Met QC Criteria: June 3, 2019
• First Posted (Actual): June 5, 2019

Study Record Updates

• Last Update Posted (Estimated): November 3, 2023
• Last Update Submitted That Met QC Criteria: October 12, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Schizophrenia Spectrum and Other Psychotic Disorders; Schizophrenia; Psychotic Disorders; Mental Disorders
• Other Study ID Numbers: 19-0266; 5R34MH120790-03 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No