Project SOLVE: Trial of a Brief Digital Problem-solving Intervention

Study Overview
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Brief Summary
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The goal of this trial is to examine the effectiveness of a universal, self-guided, digital single-session intervention focusing on problem-solving skills in improving adolescent mental health and well-being, relative to an active control intervention focusing on study skills, within the context of school settings during the coronavirus disease pandemic.

Detailed Description
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More than 20% of adolescents will experience at least one mental health disorder or problem before adulthood that warrants treatment, yet 80% of these adolescents will never receive care. This need-to-access gap appears to be heightened during the current coronavirus disease pandemic and its resulting disruptions to healthcare and education systems. Both within and beyond the context of the pandemic, preventive mental health interventions are positioned to help adolescents build and strengthen coping strategies that can preclude the emergence of mental health difficulties that require more resource-intensive levels of clinical care. Preventive mental health interventions delivered via digital platforms and within school-based settings might be especially scalable. The current school-based trial is designed to test one such strategy that harnesses technology to boost the scalability of adolescent mental health interventions: a brief (one 30 minute session) digital program designed to empower adolescents (10-14 years old) to solve, rather than be overwhelmed by, everyday problems (Project SOLVE). Single-session interventions designed to help adolescents cultivate adaptive mindsets have reduced anxiety and depression among adolescents with and without elevated symptoms of these disorders. Building on this strong foundation, Project SOLVE targets these mental health challenges with problem solving skills-one of the most versatile, commonly used, and potent therapeutic techniques for adolescents.

Official Title
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Project SOLVE: A School-based Trial of a Universal Single-session Digital Problem-solving Intervention for Adolescent Mental Health

Conditions
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Anxiety, Depression, Stress

Intervention / Treatment
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* Other: Project SOLVE
* Other: Project SUCCESS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adolescent is in grades 6-8 (inclusive) at partnering schools Adolescent is between the ages of 10-14 years (inclusive) at the time of study enrollment Adolescent and at least one guardian consent to adolescent participation in study Adolescent reads English well enough to effectively complete the digital programs Adolescent has access to a digital device Exclusion Criteria: Adolescent is non-English speaking, as the programs are only available in English Adolescent does not have access to a digital device Adolescent has an intellectual disability that precludes comprehension of the program content

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 14 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants (anticipated N = 1,000), ages 10-14 years old, will be randomized to complete one of two 30-minute, digital programs: (1) Project SOLVE: a program designed to teach adolescents how to solve, rather than be overwhelmed by, everyday problems; or (2) Project SUCCESS: a control program designed to teach adolescents helpful study skills.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Project SOLVE<br>This program is self-guided, digital, and approximately 30 minutes in length. Content is designed to help adolescents solve, rather than be overwhelmed by, everyday problems. The program includes: (1) An introduction to problem solving; (2) Testimonials from valued others (older adolescents; celebrities) describing their use of problem solving skills; (3) Evidence from studies that our brains are capable of problem solving and that problem solving can be helpful; and (4) Activities designed to enable adolescents to practice sequential problem solving using a few steps (SOLVE Steps). | Other: Project SOLVE<br>* This 30-minute, self-guided, digital program is designed to help adolescents solve, rather than be overwhelmed by, everyday problems.<br>|
| Active Comparator: Project SUCCESS<br>This program is self-guided, digital, and approximately 30 minutes in length. Content is designed to help adolescents improve their study skills. This program includes: (1) An introduction to study skills; (2) Testimonials from valued others describing their use of study skills; (3) Description of helpful and commonly used study skills (e.g., note-taking); and (4) Activities designed to encourage adolescents to practice these skills in their daily lives. | Other: Project SUCCESS<br>* This 30-minute, self-guided, digital program is designed to help adolescents develop study skills.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Behavior and Feelings Survey (Internalizing Subscale) From Baseline to 3-month Follow-Up | Trajectories of self-reported symptoms of anxiety and depression from the 6-item (each item rated on a 0-4 scale, with higher ratings indicating more symptoms) Internalizing subscale of the Behavior and Feelings Survey. Total scores range from 0 to 24, with higher scores indicating more symptoms. | Baseline to 3-month follow-up | 
| Change in Behavior and Feelings Survey (Internalizing Subscale) From Baseline to 12-month Follow-Up | Trajectories of self-reported symptoms of anxiety and depression from the 6-item (each item rated on a 0-4 scale, with higher ratings indicating more symptoms) Internalizing subscale of the Behavior and Feelings Survey. Total scores range from 0 to 24, with higher scores indicating more symptoms. | Baseline to 12-month follow-up | 
| Change in State Hope Scale Pathways Subscale From Immediately Pre-Intervention to Immediately Post-Intervention | Change in self-reported hopefulness, as measured via the 3-item pathways (planning of ways to meet goals) subscale of the State Hope Scale. Each item is rated on a 1-8 scale and total scores range from 1 to 24, with higher scores indicating higher levels of hopefulness. | Immediately pre-intervention to immediately post-intervention | 
| Change in Beck Hopelessness Scale From Immediately Pre-Intervention to Immediately Post-Intervention | The Beck Hopelessness Scale (BHS) asks adolescents to rate 4 statements based on their sense of hopelessness. Participants rate the 4 statements on a 4 point scale ranging from 0 (Absolutely Disagree) to 3 (Absolutely Agree). Total score ranges from 0 to 12, with higher scores indicating greater levels of hopelessness. | Immediately pre-intervention to immediately post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived Program Acceptability and Helpfulness | Post-intervention feedback on the program's perceived acceptability and helpfulness as measured via a 7-item scale, with each item rated on a 1-5 scale, with higher scores indicating greater acceptability and helpfulness. | Immediately post-intervention | 
| Change in Behavior and Feelings Survey (Externalizing Subscale) From Baseline to 3-month Follow-Up | Trajectories of self-reported misbehavior from the 6-item (each item rated on a 0-4 scale, with higher ratings indicating more symptoms) Externalizing subscale of the Behavior and Feelings Survey. Total scores range from 0 to 24, with higher scores indicating more symptoms. | Baseline to 3-month follow-up | 
| Change in Behavior and Feelings Survey (Externalizing Subscale) From Baseline to 12-month Follow-Up | Trajectories of self-reported misbehavior from the 6-item (each item rated on a 0-4 scale, with higher ratings indicating more symptoms) Externalizing subscale of the Behavior and Feelings Survey. Total scores range from 0 to 24, with higher scores indicating more symptoms. | Baseline to 12-month follow-up | 
| Change in State Hope Scale From Baseline to 3-Month Follow-Up | Change in self-reported total hopefulness from the 6-item (each item rated on a 1-8 scale, with higher scores indicating greater hopefulness) State Hope Scale, as well as self-reported scores on the 3-item agency (goal-directed determination) and 3-item pathways (planning of ways to meet goals) subscales of this measure. | Baseline to 3-month follow-up | 
| Change in State Hope Scale From Baseline to 12-Month Follow-Up | Change in self-reported total hopefulness from the 6-item (each item rated on a 1-8 scale, with higher scores indicating greater hopefulness) State Hope Scale, as well as self-reported scores on the 3-item agency (goal-directed determination) and 3-item pathways (planning of ways to meet goals) subscales of this measure. | Baseline to 12-month follow-up | 
| Change in Beck Hopelessness Scale From Baseline to 3-Month Follow-Up | The Beck Hopelessness Scale (BHS) asks adolescents to rate 4 statements based on their sense of hopelessness. Participants rate the 4 statements on a 4 point scale ranging from 0 (Absolutely Disagree) to 3 (Absolutely Agree). Total score ranges from 0 to 12, with higher scores indicating greater levels of hopelessness. | Baseline to 3-month follow-up | 
| Change in Beck Hopelessness Scale From Baseline to 12-Month Follow-Up | The Beck Hopelessness Scale (BHS) asks adolescents to rate 4 statements based on their sense of hopelessness. Participants rate the 4 statements on a 4 point scale ranging from 0 (Absolutely Disagree) to 3 (Absolutely Agree). Total score ranges from 0 to 12, with higher scores indicating greater levels of hopelessness. | Baseline to 12-month follow-up |