Intervention to Enhance Coping and Help-seeking Among Youth in Foster Care

NCT06019377 | Recruiting

• 2 other identifiers: 4301R34MH127141-01A1
• Study Type: interventional
• Target: 106
• Locations: 1 country
• Sites: 1

Brief Summary

This study will deploy a scalable secondary prevention program that leverages existing foster youth transition services to improve mental health functioning and service use before and after exiting foster care. Our short-term objective is to remotely test a group intervention called Stronger Youth Networks and Coping (SYNC) that targets cognitive schemas influencing stress responses, including mental health help-seeking and service engagement, among foster youth with behavioral health risk. SYNC aims to increase youth capacity to appraise stress and regulate emotional responses, to flexibly select adaptive coping strategies, and to promote informal and formal help-seeking as an effective coping strategy. The proposed aims will establish whether the 10-module program engages the targeted proximal mechanisms with a signal of efficacy on clinically-relevant outcomes, and whether a fully-powered randomized control trial (RCT) of SYNC is feasible in the intended service context. Our first aim is to refine our SYNC curriculum and training materials, prior to testing SYNC in a remote single-arm trial with two cohorts of 8-10 Oregon foster youth aged 16-20 (N=26). Our second aim is to conduct a remote two-arm individually-randomized group treatment trial with Oregon foster youth aged 16-20 with indicated behavioral health risk (N=80) to examine: (a) intervention group change on proximal mechanisms of coping self-efficacy and help-seeking attitudes, compared to services-as-usual at post-intervention and 6-month follow-up: and (b) association between the mechanisms and targeted outcomes, including emotional regulation, coping behaviors, mental health service use, and symptoms of depression, anxiety, and PTSD. Our third aim is to refine and standardize the intervention and research protocol for an effectiveness trial, including confirming transferability with national stakeholders.

Conditions

Adolescent Behavior; Psychosocial Functioning; Coping Behavior; Help-Seeking Behavior; Utilization, Health Care; Depression; Anxiety; Stress Disorders, Post-Traumatic; Emotion Regulation; Child Welfare

Keywords

Mental health; Help-seeking; Coping; Youth; Foster care; Near-peer; Independent living

Outcome Measures

Primary Outcomes (2)

• Cognitive control and coping flexibility

  Cognitive Control and Flexibility Questionnaire (CCFQ; 18 items with 7-pt Likert-type response scale ranging from 1 'strongly disagree' to 7 'strongly agree', youth report) assesses cognitive control over emotion; and appraisal and coping flexibility. Average scores can range from 1 to 7, with higher scores indicating more (better) control and flexibility.

  immediately after program completion, 6 months after program completion

• Help-seeking intentions

  General Help Seeking Questionnaire (22 items with 7-pt response scale ranging from 1 'Extremely unlikely' to 7 'Extremely likely', youth report) assesses intentions to seek help in the event of a personal or emotional problem and if having suicidal thoughts. Average scores can range from 1 to 7, with higher scores indicating more (better) help-seeking intentions.

  immediately after program completion, 6 months after program completion

Secondary Outcomes (3)

• Barriers to seeking help

  immediately after program completion, 6 months after program completion

• Self-efficacy and empowerment specific to mental health

  immediately after program completion, 6 months after program completion

• Coping self-efficacy

  immediately after program completion, 6 months after program completion

Other Outcomes (4)

• Domains for psychiatric diagnoses

  immediately after program completion, 6 months after program completion

• Mental health service use

  immediately after program completion, 6 months after program completion

• Depression and anxiety

  immediately after program completion, 6 months after program completion

Study Arms (2)

Intervention

EXPERIMENTAL

The Intervention group receives the SYNC intervention in addition to typical child welfare services (i.e., services as usual). The SYNC intervention includes 8 weekly remote (videoconference) 90-minute sessions delivered by a facilitator and a near-peer young adult aged 20-26, both with lived experience in child welfare.

Behavioral: Stronger Youth Networks and Coping (SYNC)

Services-as-usual

NO INTERVENTION

The Services-as-usual (SAU) group receives typical child welfare services, which include ILP, or federally funded transition planning (e.g., identifying and supporting youth education and employment goals) and life skills (e.g., budgeting, renting an apartment, insurance) services typically delivered through a mix of classes, group activities, and/or individual skill-building with a paraprofessional service provider.

Interventions

Stronger Youth Networks and Coping (SYNC) BEHAVIORAL

SYNC is a 8-module online curriculum adapted from evidence-based cognitive change methods, including Coping Effectiveness Training (CET), co-facilitated by service providers in Independent Living Programs (ILPs; federally-funded transition skill-building services accessed by most foster youth in the US) and near-peers (have lived experience in foster care). SYNC aims to increase youth capacity to appraise stress and regulate emotional responses, to flexibly select adaptive coping strategies, and to specifically promote informal and formal help-seeking as an effective coping strategy.

Intervention

Eligibility Criteria

• Age: 16 Years - 20 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Eligible to receive federally-funded transition-related services in Oregon (ages 16-20 and in foster care at least 90 days after they turned age 14),
• Indicated behavioral health risk. Behavioral health risk is indicated by child welfare administrative indicators of lifetime behavioral health need or service involvement (DSM diagnoses, psychotropic medication, emotional-behavioral disability, congregate care/residential placement)

You may not qualify if:

• Inability to actively participate in the intervention, including you who are: non-English speaking, significantly developmentally disabled, or where participation is otherwise contraindicated (e.g., youth is in crisis, youth is in a placement that will not allow for participation)

Sponsors & Collaborators

• Portland State University: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

Portland State University

Portland, Oregon, 97201, United States

RECRUITING

MeSH Terms

Conditions

Adolescent Behavior; Help-Seeking Behavior; Patient Acceptance of Health Care; Depression; Anxiety Disorders; Stress Disorders, Post-Traumatic; Emotional Regulation; Psychological Well-Being

Interventions

Coping Skills

Condition Hierarchy (Ancestors)

Behavior; Social Behavior; Treatment Adherence and Compliance; Health Behavior; Behavioral Symptoms; Mental Disorders; Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Self-Control; Personal Satisfaction

Intervention Hierarchy (Ancestors)

Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Jennifer Blakeslee, PhD,MSW,BS

  Portland State University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jennifer Blakeslee, PhD,MSW,BS

CONTACT

5037258389; jblakes@pdx.edu

Rebecca A Miller, M.Ed, BA

CONTACT

ramiller@pdx.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Associate Professor

Model Details: 8-module group psychoeducational curriculum model

Study Record Dates

• First Submitted: August 18, 2023
• First Posted: August 31, 2023
• Study Start: April 22, 2024
• Primary Completion: March 31, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: February 28, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)