Project Raising Exposure Awareness for Caregiver Help-Seeking (Project REACH)

Caregivers are randomized to review the community advisory board-designed dissemination campaign, including flyers, infographics, testimonial videos, and explainer video.

A direct-to-consumer dissemination campaign about exposure therapy for youth anxiety and related disorders, co-designed with a community advisory board of family caregivers and providers and refined through caregiver focus groups. It covers the same core content as standard information about finding mental health care, but uses terminology and explanations developed with the advisory board. It also includes a skills-focused "how-to" guide for finding and accessing an exposure therapist. The campaign targets help-seeking mechanisms from the Theory of Planned Behavior: knowledge, attitudes, perceived norms, and self-efficacy. Participants review the materials online for at least 10 minutes.

Caregivers are randomized to review standard information about finding mental health services for their child (e.g., information found via google and foundation websites)

Standard information about seeking mental health care for a child: links to professional organization websites and summary of information generated from Google searches. Participants review the materials online for at least 10 minutes.

Self-efficacy for finding an exposure therapist for one's child, measured with two caregiver-report items rated on a 7-point agreement scale (e.g., "If I really wanted to, I could find an exposure specialist for my child"). The items are averaged into a score from 1 to 7, and higher scores indicate greater self-efficacy. Groups will be compared on the post-review score, controlling for baseline.

Attitudes toward exposure therapy, measured with four standard semantic differential scales. The total score is the average of z-standardized items, and higher scores indicate more favorable attitudes. Groups will be compared on the post-review score, controlling for baseline.

Perceived norms about seeking exposure therapy, measured with two items rated on a 7-point agreement scale. One asks whether "other caregivers like me" would seek exposure therapy, and the other asks whether people important to the caregiver would approve. The items are averaged into a score from 1 to 7, and higher scores indicate more favorable perceived norms. Groups will be compared on the post-review score, controlling for baseline.

Strength of caregivers' intentions to seek exposure therapy for their child, measured with two items rated on a 7-point scale: how willing and how likely the caregiver is to seek exposure therapy. The items are averaged into a score from 1 to 7, and higher scores indicate stronger intentions. Groups will be compared on the post-review score, controlling for baseline.

Caregiver awareness of and prior experience with exposure therapy, measured with a previously developed two-item measure. Groups will be compared on the post-review score, controlling for baseline.

Caregiver ratings of the acceptability of each dissemination strategy developed with the community advisory board.

Number of caregivers in a purposive subsample (n=32; 16 per arm, selected for high or low baseline intentions) who report successfully connecting their child with mental health services, and the type of treatment sought (including exposure therapy). This is assessed in a 15-minute structured phone interview. Reported barriers to accessing care and the influence of study materials on help-seeking will be analyzed qualitatively with rapid qualitative analysis, using codes from the Theory of Planned Behavior.