RCT of a Brief Video Intervention Targeting Peer Inclusion to Reduce Depression-related Stigma in Adolescents

RCT of a Brief Video Intervention Targeting Peer Social Inclusion to Reduce Depression-related Stigma and Increase Help-seeking Among Adolescents

The goal of this study is to test the efficacy of a brief video intervention emphasizing peer inclusion on depression-related stigma and stigma outcomes (e.g., help seeking attitudes, secrecy) among adolescents 14-18.

Timely identification and treatment of depression in adolescents is a public health priority. However, most youth with depression do not seek treatment, and stigma has been identified as the primary barrier to help-seeking. Experiments have found brief video-based interventions (BVIs), 1-2 minute videos similar to those viewed by youth on social media platforms, based on the principle of "social contact" with individuals affected by a stigmatized condition, effective in reducing depression-related stigma and increasing help-seeking among adolescents. However, given the extreme time constraints of these videos, optimizing the messaging is paramount. Prior research has indicated that concerns about peer social inclusion are fundamental in shaping stigma among adolescents.

In this 3-arm RCT, we will recruit adolescents aged 14-18 using an online crowdsourcing platform, to test the efficacy of a) standard BVI that addresses mental health treatment but does not address concerns about peer inclusion/exclusion, b) novel BVI focused on mental health treatment and peer inclusion, and c) control condition that provides information without social contact.

Study Overview

• Status: Not yet recruiting
• Conditions: Depression; Stigma, Social; Adolescent - Emotional Problem; Help-Seeking Behavior
• Intervention / Treatment: Other: brief video

Detailed Description

Brief video-based interventions (BVIs) have been studied as a means of reducing stigma toward mental health problems and increasing help-seeking among youth. "Contact-based interventions," in which a representative of a stigmatized group shares their personal stories, have been found one of the most effective anti-stigma intervention. Effective contact-based interventions target to a specific population, account for the specific interests of that population, and credibly provide stories that highlight recovery in a plausible manner to moderately disconfirm stereotypes. BVIs package contact-based stigma interventions into a format desirable to youth-- short (1-2 minute) messages in the style of social media content. Prior RCTs have tested BVIs targeting depression-related stigma in adolescents, featuring a young person describing experiences with depressive symptoms, that improved as they sought support from parents and professionals, compared to a control video of a young person discussing family and activities with no mention of mental health. Prior BVIs have not emphasized adolescent concerns about peer rejection and identity. Since existing research emphasizes the central nature of these concerns in shaping mental health-related stigma among adolescents [4, 5], BVIs that address peer social concerns may be most effective. Thus, we hypothesize that a BVI focused on peer inclusion will have greater impact on reducing stigma and increasing help-seeking than a BVI with more general content.

We will measure three distinct domains of stigma:

1. personally held attitudes,
2. perceptions of how peers may devalue and discriminate against teens with depression, and
3. secrecy (i.e., to avoid potential negative repercussions of stigma).

• Study Type: Interventional
• Enrollment (Estimated): 650
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Timothy Becker, MD; Phone Number: 929-746-0260; Email: timothy.becker@nyspi.columbia.edu
• Study Contact Backup: Name: Doron Amsalem, MD; Phone Number: 929-404-8802; Email: doron.amsalem@nyspi.columbia.edu

Study Locations

• United States
  • New York
    • New York, New York, United States, 10032
      • New York State Psychiatric Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Self-identify as English-speaking
• US residents
• 14-18 years old

Exclusion Criteria:

• Non English speakers
• Do not reside in the US
• <14 or greater than or equal to 19 years old

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Peer social-inclusion enhanced social contact brief video; Novel brief video (1-2 mins) in which an adolescent talks about feeling depressed, and the impact this has on peer relationships, getting treatment, selectively disclosing mood problems with some friends, and experiencing support from both peers and family which helped facilitate recovery from depression.	Other: brief video; brief video about depression
Active Comparator: Generic social contact brief video; Similar to existing brief videos (1-2 mins), an adolescent talks about feeling depressed, and then asking parents for help, and receiving professional treatment. This video does not make any references to peers or social support.	Other: brief video; brief video about depression
Other: Control; Brief video (1-2 mins) provides information about symptoms of depression and how to seek help with computer-generated voice, to isolate mechanisms of information from identification and emotional engagement.	Other: brief video; brief video about depression

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depression Stigma Scale (modified)	measures personally held attitudes toward depression; modified to remove element irrelevant to teens	immediately after viewing video
Ultra-brief Self-stigma of Help-Seeking	attitudes toward seeking professional help for mental health problem	immediately after viewing video

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adolescent Stigma Scale (modified)	subscales measuring perceived societal devaluation and secrecy coping	immediately after viewing video

Collaborators and Investigators

• Sponsor: New York State Psychiatric Institute
• Collaborators: Columbia University
• Investigators: Principal Investigator: Doron Amsalem, MD, Columbia University

Publications and helpful links

General Publications

• Amsalem D, Martin A. Reducing depression-related stigma and increasing treatment seeking among adolescents: randomized controlled trial of a brief video intervention. J Child Psychol Psychiatry. 2022 Feb;63(2):210-217. doi: 10.1111/jcpp.13427. Epub 2021 Apr 6.

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2024
• Primary Completion (Estimated): July 1, 2024
• Study Completion (Estimated): July 1, 2024

Study Registration Dates

• First Submitted: April 8, 2024
• First Submitted That Met QC Criteria: April 8, 2024
• First Posted (Actual): April 11, 2024

Study Record Updates

• Last Update Posted (Actual): April 11, 2024
• Last Update Submitted That Met QC Criteria: April 8, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Depression; Depressive Disorder
• Other Study ID Numbers: 76729

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