The Effectiveness of the Mobile-based Youth COMPASS Program to Promote Adolescent Well-being and Life-control

Study Overview
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Brief Summary
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The aim of this randomized control trial is to examine effectiveness of individually tailored web- and mobile-based Acceptance- and Commitment Therapy interventions to promote adolescents' well-being and life-control and subsequently support their successful transition from basic education to upper secondary education. Our additional aim is to examine to what extent the effectiveness of the intervention varies according to intervention intensity and according to risk for school failure. The five-week structured intervention is delivered using the novel web-and mobile-based program Youth COMPASS following the principles of the Acceptance and Commitment Therapy (ACT). The Internet context is assumed to be particularly motivating for youth who enjoy spending time online using different social media. Internet-based interventions have several advantages; they can include more information and treatment components than traditionally delivered treatments and that intervention programs are accessible at any time and at any place. Another unique aspect of the Youth COMPASS is the fact that it is individually-tailored. Each participant have an individually assigned online coach who provides support and encouragement, reminds about Youth COMPASS, sends individualized feedback, and recommends different exercises. The study hypothetizes that the Youth COMPASS is more effective than school counseling as usual. More specifically, the Youth COMPASS is expected to be more effective when it is combined with face-to-face support than when support and feedback are provided only via the Internet. Also, the Youth COMPASS with no face-to-face support (online only) is expected to be more effective than receiving only regular school counseling. Finally, the Youth COMPASS is expected to be more effective for students at risk for school failure than for students without risk for school failure, especially when at risk-adolescents receive more intensive support (i.e., both online and face-to-face support).

Detailed Description
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The aim of this randomized control trial is to examine effectiveness of individually tailored web- and mobile-based Acceptance- and Commitment Therapy interventions to promote adolescents' well-being and life-control and subsequently support their successful transition from basic education to upper secondary education. Our additional aim is to examine to what extent the effectiveness of the intervention varies according to intervention intensity and according to risk for school failure. The five-week structured intervention is delivered using the novel web-and mobile-based program Youth COMPASS following the principles of the Acceptance and Commitment Therapy (ACT). The Internet context is assumed to be particularly motivating for youth who enjoy spending time online using different social media. Internet-based interventions have several advantages; they can include more information and treatment components than traditionally delivered treatments and that intervention programs are accessible at any time and at any place. Another unique aspect of the Youth COMPASS is the fact that it is individually-tailored. Each participant have an individually assigned online coach who provides support and encouragement, reminds about Youth COMPASS, sends individualized feedback, and recommends different exercises. The study hypothetizes that the Youth COMPASS is more effective than school counseling as usual. More specifically, the Youth COMPASS is expected to be more effective when it is combined with face-to-face support than when support and feedback are provided only via the Internet. Also, the Youth COMPASS with no face-to-face support (online only) is expected to be more effective than receiving only regular school counseling. Finally, the Youth COMPASS is expected to be more effective for students at risk for school failure than for students without risk for school failure, especially when at risk-adolescents receive more intensive support (i.e., both online and face-to-face support). The participants of the effectiveness study of the Youth COMPASS are selected from the participants of the broader longitudinal STAIRWAY (TIKAPUU in Finnish) - From Primary School to Secondary School study, which follows a community sample of Finnish adolescents (n 850) across critical educational transitions. The overall aim of the STAIRWAY project is to broaden our understanding of the individual- and environment-related factors that promote learning, well-being and successful educational transitions.

Official Title
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The Effectiveness of the Novel Web- and Mobile-based Acceptance- and Commitment Therapy Program Youth COMPASS to Promote Adolescent Well-being and Life-control

Conditions
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Well-being

Intervention / Treatment
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* Behavioral: Experimental: face-to-face and online support group:
* Behavioral: Experimental: only online support group:
* Behavioral: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adolescents (n = 120) who have risk for school failure (learning difficulties or low grade point average without learning difficulties) Randomly chosen adolescents (n=120) from the same classrooms who have no risk for school failure

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 16 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: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Treatment, Parallel assessment, Randomized, Efficacy study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Face-to-face and online support group<br>Behavioral: Structured web- and mobile-based intervention with Youth COMPASS program to support adolescents' well-being, career preparation and life-control and subsequently support successful transition to upper secondary education. The Youth COMPASS is the five-week online program according to principles of Acceptance and Commitment Therapy aiming to enhance adolescents' psychological flexibility by guiding adolescents in exploring their values and setting goals and changing behaviors according to their goals (week 1), and learning acceptance defusion and mindfulness skills (weeks 2-3) and integrating these skills into their personal life (weeks 4-5). The participants in this condition receive weekly online support and feedback from their individually assigned coach. In addition, they meet their coach twice in the face-to-face meetings. The aim of the meetings is to increase adolescents' internal motivation and thereby participation in the program. | Behavioral: Experimental: face-to-face and online support group:<br>* 5-week intervention according to Acceptance and Commitment Therapy principles with the web-and mobile-based Youth COMPASS program, face-to-face support (2 meetings) and weekly online mobile support and feedback from the individually assigned coach (one third of the participants is randomly assigned to this group)<br>|
| Experimental: Only online support group<br>Behavioral: web- and mobile-based intervention with Youth COMPASS program to support adolescents' well-being, career preparation and life-control and subsequently support successful transition to upper secondary education. The Youth COMPASS is a five-week online program according to principles of Acceptance and Commitment Therapy aiming to enhance adolescents' psychological flexibility by guiding adolescents in exploring their values and setting goals and changing behaviors according to their goals (week 1), and learning acceptance defusion and mindfulness skills (weeks 2-3) and integrating these skills into their personal life (weeks 4-5). The participants in this condition receive weekly online support and feedback from their individually assigned coach. | Behavioral: Experimental: only online support group:<br>* 5-week intervention according to ACT principles with the web-and mobile-based Youth COMPASS program, no face-to-face support, weekly mobile online support and feedback from the individually assigned coach (one third of the participants is randomly assigned to this group)<br>|
| Experimental: Control group<br>Behavioral: No intervention, school counseling as usual | Behavioral: Control<br>* Control group, no intervention, school counseling as usual. (one third of the participants is randomly assigned to this group)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Life satisfaction (Diener et al., 1985) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Self-esteem (Rosenberg, 1965), | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Depressive symptoms (Salokangas et al., 1995) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Stress (Elo et al., 2003) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Difficulties and Strenghts questionnaire (SDQ, Goodman et al. 1997) measuring emotional symptoms, hyperactivity, conduct problems and prosociality | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Well-being in school (World Health Organization) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Career choice preparedness (Koivisto et al., 2011) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Educational expectations | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychological flexibility (Greco et al., 2008) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Mindfulness skills (Ciarrochi et al., 2011) | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| Identity formation (DIDS; Luyckx et al., 2008; see also Marttinen et al., 2016) | In addition to self-reports, also school register information is collected regarding academic performance, school absences and progress in studies. | Change from baseline at 2, 6, 12 and 18 months after the intervention | 
| Truancy | Study has five timepoints when same questionnaires are administered to assess possible changes in the outcome measures. | Change from baseline at 2, 6, 12 and 18 months after the intervention. | 
| School grades | In addition to self-reports, also school register information is collected. | Four years from the baseline. | 
| Initiation of upper secondary education | In addition to self-reports, also school register information is collected. | Four years from the baseline. | 
| Progress in upper secondary studies | In addition to self-reports, also school register information is collected. | Four years from the baseline. | 
| Changes in study field in upper secondary education | In addition to self-reports, also school register information is collected. | Four years from the baseline. | 
| Staying in vs. dropping out of education | In addition to self-reports, also school register information is collected. | Four years from the baseline. | 
| Graduation time | In addition to self-reports, also school register information is collected. | Four years from the baseline. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Career preparation, Lifecontrol, Adolescents, Web- and mobile-based intervention, Acceptance and Commitment therapy, Psychological well-being, Successful educational transitions, Learning difficulties, Psychological flexibility and mindfulness skills