Text2Connect, Component 2 of iCHART (Integrated Care to Help At-Risk Teens)
Condition: Depression; Suicidal Ideation
MeSH terms: Suicidal Ideation
Study type: Interventional

Summary: 
      This study proposes to develop and examine a personalized, text-based intervention designed
      to improve engagement with mental health (MH) treatment.
    

Detailed description: 
      Text2Connect (T2C) aims to increase perceived susceptibility/severity of
      depression/suicidality and decrease stigma in at-risk adolescents and their parents. The
      investigators hypothesize that modification of patient beliefs leads to change talk, thereby
      increasing the experience of discrepancy which affects motivation for change. These
      experiences in turn influence decisional balance away from ambivalence toward readiness for
      change.

      Assignment of Interventions:

      This study utilized an open trial design. A stepped wedge design was originally proposed and
      efforts were made to adhere to this study design, however after a year of low recruitment and
      resultant recruitment sites pulling out the of the study, the overall study design was
      changed to an open trial. Additional recruitment sites were onboarded to the study and
      provided with the intervention arm in order to obtain feasibility data on the intervention
      components of the study. As a result of the change, there are some TAU participants included
      in this study.

      For reference a stepped wedge design involves the sequential random rollout of an
      intervention over two time periods. Following a baseline period in which no clusters
      (=practices) are exposed to the intervention, the crossover is typically in one direction,
      from control to intervention and continues until both of the clusters have crossed-over to
      receive the intervention, with observations taken from each cluster and at each time period.

      This study will pilot Text2Connect in community pediatric and mental health practices using a
      stepped wedge design (n = 50 adolescents).

      Hypothesis: Readiness for mental health care will be greater among adolescents in T2C vs
      adolescents referred during TAU.
    

Intervention name(s): Text2Connect
Intervention type(s): Behavioral
Intervention description(s): Text2Connect is a personalized text messaging intervention for patients and parents that targets self-identified barriers to engaging in treatment to increase the likelihood that a depressed or suicidal patient will initiate recommended services.
Intervention model: Single Group Assignment
Intervention model description: Ultimately, this study design was an open trial after unsuccessful attempts to maintain initial recruitment sites in the study.
This study initially attempted to use a stepped wedge design, which involves the sequential random rollout of an intervention over 2 time periods. Following a baseline period in which no clusters (= practices) are exposed to the intervention, the crossover is typically in one direction, from control to intervention and continues until both of the clusters have crossed-over to receive the intervention, with observations taken from each cluster and at each time period.
Masking: None (Open Label)
Primary purpose: Health Services Research