bullying prevention intervention for adolescent primary care patients

Conditions: Cyberbullying

Summary: the purpose of this randomized controlled study is to evaluate acceptability and feasibility, and to gather preliminary data about efficacy, of "ipact" (intervention to prevent adolescent cyber-victimization with text messages), a brief in-clinic introductory session + longitudinal automated text-message-based secondary prevention program for adolescents with a history of past-year cyber-victimization presenting to a pediatric clinic for well-child visits.

cyber-victimization predicts depressive symptoms and suicidality; it correlates with ptsd symptoms, alcohol and other drug use, physical peer violence, and dating violence. almost 80% of adolescents have a well-child visit with their pediatrician each year. pediatricians recognize this visit as an important opportunity for behavioral screening, interventions, and referrals, but they currently lack cyber-victimization interventions that are feasible and effective in the clinical setting. personalized text-message interventions are accessible, feasible, and may be effective with these adolescents. the purpose of this study is to test the feasibility and acceptability of a novel text-message-augmented secondary prevention intervention, "ipact." drawing on effective cognitive behavioral therapy (cbt) and motivational interviewing (mi) depression and violence prevention interventions, a brief in-clinic session will introduce basic cognitive and behavioral strategies. following their clinic visit, eight weeks of tailored cbt-informed daily text messages will be sent, to enhance skills and remind participants of self-determined goals. participants will be identified in the course of usual clinical care. if eligible, parents will be consented and participants assented. participants will complete a baseline assessment and will be randomized to experimental (ipact, n=25) or enhanced usual care (euc, n=25) care, using stratified block randomization. ipact group participants will participate in a brief, structured in-clinic introduction on cbt and the ipact program, followed by 8 weeks of tailored, two-way, cbt-and mi-informed automated text messages (short message service, sms). euc group participants will receive standardized information on cyberbullying. the current standard of care for these patients is no care: no cyber-victimization screening assessment protocols are currently used in our clinic. both ipact and euc conditions therefore exceed current levels of care. at baseline, 8 week follow-up, and 16 week follow-up, participants will complete assessments on cyberbullying, peer violence, and cognitive/behavioral skill-sets. at the 8-week follow-up, standardized qualitative and quantitative process measures will be administered to assess efficacy, acceptability, usability, and feasibility.

Eligibility criteria:
inclusion criteria: * presenting to hasbro children's pediatric clinic * being mentally and physically able to assent * being english-speaking * having a consentable parent present * self-reporting cyber-victimization (defined as endorsing \>1 past-year episode of technology-mediated victimization) exclusion criteria: * being cognitively or emotionally unable to take part in the intervention as determined by the pediatric attending clinician * suspected by clinical staff of being a victim of child abuse * currently incarcerated or under police custody

Keywords: cyber-victimization text message mhealth