Using a Mentoring Afterschool Program to Improve Adolescent Mental Health and Physical Activity: A Pilot Study

Coming out of the COVID-19 pandemic many youth are experiencing declines in physical activity and worsening mental health (e.g., depression symptoms). These declines are exacerbated among underserved youth who experience greater barriers to health services and exposure to life stressors that put them at increased risk for impaired mental, emotional, and behavioral health. School-based afterschool programming is an important strategy to reach this population of youth and provides intervention at a time when youth are likely to otherwise be in environments not supportive of health. Further participation in extracurricular activities has been shown to be a protective factor for youth mental health. However, consistent with the Behavioral Theory of Depression, youth who are currently inactive and who have depression symptoms are unlikely to participate in afterschool programming on their own and likely require heightened positive reinforcement when they do attend to encourage retention. Given the high prevalence of youth who experience symptoms of depression and resource and staffing challenges faced by many schools, the level of support needed to engage students to consistently participate and benefit from afterschool programming is often beyond the capacity of school-based afterschool programs. In partnership with a local afterschool program for middle school students in a low resource community, the investigators developed an augmented version of the current afterschool program in which college students are trained to mentor and assist in the afterschool program, expanding the capacity of the afterschool program to engage students.

The mentoring intervention uses behavioral activation principles to help youth connect their behaviors with their mood and support youth to engage in behaviors that improve their mood, including physical activity. The main purpose of this study is to pilot the feasibility of the newly developed intervention.

Study Overview

• Status: Completed
• Conditions: Depression
• Intervention / Treatment: Behavioral: After School Plus

Detailed Description

The proposed study builds from formative work in which the investigators developed an augmented version of an existing afterschool program in which college students are trained to mentor and assist in the afterschool program. Specifically, the mentoring intervention uses behavioral activation principles to help youth connect their behaviors with their mood and support youth to engage in behaviors that improve their mood, including physical activity. The main purpose of this study is to pilot the feasibility of the newly developed intervention. The study will use a modified, quasi-experimental crossover pilot trial design (n= 1 schools; 1 Afterschool program as usual and 1 After School Plus) conducted in partnership with St. Paul Public School District's school-based afterschool programming, "Flipside". School A will receive After School Plus in semester 1 and After School as Usual in semester 2. School B will receive After School as Usual in semester 1 and After School Plus in Semester 2. After School as Usual. The afterschool program as usual runs M-H and consists of a variety of clubs from which middle school students chose to enroll for a semester (~4 months). Clubs are offered on either a M/W or T/H schedule. Students receive a snack in the cafeteria each day before attending their class. During the After School as Usual condition, participants will not receive any extra intervention, but will participate in data collection using the same procedures and methodologies as the intervention schools.

After School Plus. After School Plus is the same as Afterschool as Usual with the addition of young adult mentors. Following snack, mentors will lead students in a short emotion regulation exercise including physical activity and breathing exercises. Mentors will prompt students to identify how they are feeling and make connections between the activities they are doing and their mood and then do activities with students in each class. On T/H, ~4 mentors will lead a new DiscoverU club which is based on behavioral activation principles and spends more time helping students identify and do more activities that improve their mood. The class promotes physical activity as an important strategy for mental health. Recruitment. Adolescents will be invited to participate in the study when they enroll in the afterschool program. The investigators will work closely with the site lead and teacher at each school assigned to help us with recruitment and retention. Adolescents can participate in the afterschool program without participating in the study (i.e., data collection).

Parents will need to provide written parental consent and students provide written assent before a student can enroll in the study. Because students can enroll in afterschool program at any time over the year, we will allow study enrollment on an ongoing basis through February 2025. Mentors will be recruited by emailing a description of the mentor opportunity to various student organizations and professors to share with their classes. This study targets courses with large class sizes. The study will also post flyers describing the opportunity across campus.

Promising candidates based on their application will be invited to group information sessions at which the research team observes their interactions in a group setting and provides information about the role. Interested candidates are asked to schedule a one- on-one interview. Mentors can receive class credit for mentoring. We previously used these strategies in the proof-of-concept study to recruit a diverse group of mentors, reflective of many majors and colleges. Data Collection. Primary data collection will include process data (e.g., attendance) and pre, midpoint, and post surveys (October, December, and April) among adolescents and mentors. Surveys will assess constructs including depressive symptoms, anxiety symptoms, behavioral activation, and emotion regulation. Additionally, approximately 75-80% of adolescent participants will provide accelerometry data to measure the amount and intensity of physical activity they do during the afterschool program

• Study Type: Interventional
• Enrollment (Actual): 209
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Minnesota
    • Minneapolis, Minnesota, United States, 55455
      • University of Minnesota

Participation Criteria

Eligibility Criteria

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

Description

Student Inclusion Criteria:

• Any 6th , 7th , or 8th grade student who is enrolled in their after school plus program at a participating middle school

Parent/Guardian Inclusion Criteria:

• Any parent of a student who is enrolled in the study is eligible to participate.

Mentor Inclusion Criteria:

• Any mentor in the after school plus program is eligible to participate.

Staff Member Inclusion Criteria:

• Any staff member affiliated with the after school program at a participating middle school

Exclusion Criteria:

• Have a substantial cognitive impairment that would prevent the completion of data collection activities.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: School A; Middle school students at School A who participate in the after school program. They will receive after school as usual in months 1-4, followed by after school plus in months 5-8.	Behavioral: After School Plus; The afterschool program as usual runs M-H and consists of a variety of clubs from which middle school students chose to enroll for a semester (~4 months). Clubs are offered on either a M/W or T/H schedule. Students receive a snack in the cafeteria each day before attending their class. Afterschool plus is the same as "Afterschool as Usual" with the addition of young adult mentors. Following snack, mentors will lead students in a short emotion regulation exercise including physical activity and breathing exercises. Mentors will prompt students to identify how they are feeling and make connections between the activities they are doing and their mood and then do activities with students in each class. On T/H, ~4 mentors will lead a new "DiscoverU " club which is based on behavioral activation principles and spends more time helping students identify and do more activities that improve their mood. The class promotes physical activity as an important strategy for mental health.
Experimental: School B; Middle school students at School B who participate in the after school program. They will receive after school plus in months 1-4, followed by after school as usual in months 5-8.	Behavioral: After School Plus; The afterschool program as usual runs M-H and consists of a variety of clubs from which middle school students chose to enroll for a semester (~4 months). Clubs are offered on either a M/W or T/H schedule. Students receive a snack in the cafeteria each day before attending their class. Afterschool plus is the same as "Afterschool as Usual" with the addition of young adult mentors. Following snack, mentors will lead students in a short emotion regulation exercise including physical activity and breathing exercises. Mentors will prompt students to identify how they are feeling and make connections between the activities they are doing and their mood and then do activities with students in each class. On T/H, ~4 mentors will lead a new "DiscoverU " club which is based on behavioral activation principles and spends more time helping students identify and do more activities that improve their mood. The class promotes physical activity as an important strategy for mental health.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
intervention feasibility	This will be measured by participant semester 1 rate of attendance at the after school program (i.e., the number of days attended divided by the number of days the class(es) the student was signed up for were offered in semester 1)	4 months
intervention feasibility	This will be measured by participant semester 2 rate of attendance at the after school program (i.e., the number of days attended divided by the number of days the class(es) the student was signed up for were offered in semester 2)	8 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depression symptoms	Will be measured using PHQ-8	Baseline
Depression symptoms	Will be measured using PHQ-8	4 months
Depression symptoms	Will be measured using PHQ-8	8 months
Activity level in after school program	Accelerometry measured 2 days per semester at randomly selected intervals per class	4 months
Activity level in after school program	Accelerometry measured 2 days per semester at randomly selected intervals per class	8 months

Collaborators and Investigators

• Sponsor: University of Minnesota
• Investigators: Principal Investigator: Katherine Hendel, University of Minnesota

Study record dates

Study Major Dates

• Study Start (Actual): September 24, 2024
• Primary Completion (Actual): June 17, 2025
• Study Completion (Actual): March 9, 2026

Study Registration Dates

• First Submitted: November 11, 2024
• First Submitted That Met QC Criteria: November 11, 2024
• First Posted (Actual): November 13, 2024

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 17, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Depression
• Other Study ID Numbers: STUDY00020498

Drug and device information, study documents

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