Homeless Youth Study - Stepping Stone 2.0

Study Overview
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Brief Summary
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Housing instability is both a cause and consequence of mental health problems. As such youth experiencing housing instability (e.g., homeless or marginally housed) have higher rates of mental health problems.Because of their circumstances, these youth also face significant barriers to mental health care and are therefore less likely to receive the treatment that they need. Mobile technology may offer a novel platform for increasing access to mental health care in this population. The primary goals of this pilot study are to (1) establish the feasibility and acceptability of delivering automated mental health interventions via smartphone technology, (2) examine the extent to which automated mental health interventions delivered via mobile technology improve mental health in homeless, marginally-housed, and exiting foster youth.

Official Title
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Homeless Youth Study - Stepping Stone 2.0

Conditions
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Mental Health Issue (E.G., Depression, Psychosis, Personality Disorder, Substance Abuse)

Intervention / Treatment
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* Behavioral: Mobile self-help intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 16-25 years English-speaking Youth must meet one of the following risk criteria Experiencing housing instability as defined by: lacking a fixed, regular, and adequate nighttime residence OR whose primary nighttime residence is a shelter, institution, or a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings sharing the housing of other persons due to loss of housing [or] economic hardship. frequent moves, poor housing quality (e.g., living in severely overcrowded housing). Imminently leaving the foster care system Willingness and ability to comply with requirements of the study protocol Exclusion Criteria: * Inability to understand study procedures and participate in the informed consent process.

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mobile self-help intervention<br>This study uses automated self-help interventions designed as a kit of smartphone tools. | Behavioral: Mobile self-help intervention<br>* Participants receive several apps on their phone including IntelliCare apps, which are based on principles of cognitive-behavioral therapy. Participants also receive the Pocket Helper app, which has been designed for this study. The tools within the Pocket Helper app include a crisis text line that is available 24/7, the Illinois Warm Line which is available Monday through Friday from 8am to 5pm, directions to call 911 in the case of an emergency, the Koko web app that provides crowdsourced emotional support, brief cognitive-behavioral interventions, daily tips, and daily surveys. Phones will also include the StreetLight Chicago app, which provides homeless individuals with up-to-date information on shelters, health clinics, emergency contacts, mental health services, and more.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Program adherence | Program adherence will be assessed based on usage data determining how often participants utilized the study applications, and how often they completed daily surveys and rated daily tips. | Baseline to Endpoint (6 months) | 
| Program satisfaction | Program satisfaction will be assessed using a self-report questionnaire that participants will be asked to complete at the midpoint and endpoint of the study. Participants will be asked to report the extent to which they benefited from the study, how helpful the mobile applications were, and if they would recommend the study to others. These responses are recorded on 5-point likert type scales with higher ratings indicating higher satisfaction. | Midpoint (3 months) and Endpoint (6 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anxiety symptoms | Anxiety symptoms will be assessed using the adaptive PROMIS Bank v1.0 for anxiety. | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| Depression symptoms | Depression symptoms will be assessed using the adaptive PROMIS Bank v1.0 for depression. | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| Alcohol use | Alcohol use will be assessed using the Alcohol Use Disorders Identification Test (AUDIT-C). | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| Cannabis use | Cannabis use will be assessed using the Cannabis Use Disorder Identification Test - Revised (CUDIT-R). | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| Risky sexual behavior | Risky sexual behaviors will be assessed using the sexual behavior items from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey (2011). | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| PTSD symptoms | PTSD symptoms will be assessed using the The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| Satisfaction with life: Satisfaction with Life Scale (SWLS) | General satisfaction with life will be assessed using the Satisfaction with Life Scale (SWLS). This measure is 5 items, with each item rated on a scale from 1-7. All 5 items are summed to achieve a total score of 5-35. Higher scores indicate higher satisfaction with one's life circumstances. | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) | 
| Psychosocial flourishing | Psychological resources and strengths will be assessed using the Flourishing Scale (FS). This measure is 8 items, with each item rated on a scale from 1-7. All 8 items are summed to achieve a total score of 8-56. Higher scores indicate that an individual has more psychological resources and strengths. | Baseline (0 months), Midpoint (3 months), Endpoint (6 months) |