Project Relate: Romantic Relationship Competence SSI

Study Overview
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Brief Summary
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The COVID-19 pandemic has increased social isolation and depressive symptoms in youth, adding strain to an already overwhelmed mental healthcare system. Online single-session interventions are digital programs that can help expand access to care and teach evidence-based skills. To help youth build healthy relationships, we developed 3 online single-session interventions (SSI) to teach romantic competence skills to adolescents and emerging adults. Youth, ages 16-20, will be recruited to social media and randomly assigned to one of two conditions: the intervention condition, offering them three SSIs to select from, or an information-only control group. Within the intervention condition, youth will complete one of three romantic competence SSIs: (1) Insight, targeting awareness of one's needs in relationships, (2) Communication, teaching listening and communication skills, and (3) Stay vs. Go, helping youth make difficult decisions. Investigators will assess each SSI's relative benefits on relationship knowledge and depressive symptoms up to three months later compared to the information-only control group. Results will reveal if online SSIs can teach romantic competence skills and if engaging in these interventions has psychosocial benefits for youth with elevated depressive symptoms.

Official Title
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Project Relate: Romantic Relationship Competence Single-Session Intervention Trial

Conditions
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Relational Problems, Depression

Intervention / Treatment
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* Behavioral: Romantic Competence Intervention
* Behavioral: Information Only Control Condition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: are fluent in English have consistent internet and computer/laptop/smartphone access report elevated depressive symptoms (a score of >2 on the Patient Health Questionnaire-2 item version [PHQ-2]) Exclusion Criteria: fail to meet the above-listed inclusion criteria exit the study prior to condition randomization respond with either copy/pasted responses from text earlier in the intervention to any of free response questions obvious lack of English fluency in open response questions responding with random text in open response questions duplicate responses from the same individual in baseline or follow-up surveys

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants will be randomized to either the intervention condition or the information-only control group.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Information Only Control Condition<br>The information only control condition is designed to mimic relationship education that could be easily found online by adolescents. This condition does not teach romantic competence skills such as insight, communication/mutuality, or emotion regulation skills; rather, it focuses on educating subjects about the healthy and unhealthy signs of a romantic relationship. In addition, this condition is designed to control for nonspecific aspects of the intervention, such as engaging in an online program and taking time to reflect on one's relationships. | Behavioral: Information Only Control Condition<br>* Online, 30-minute self-administered relationship education activity for youth ages 16-20<br>|
| Experimental: Romantic Competence Intervention<br>The Romantic Competence Single-Session Intervention provides adolescents with the opportunity to learn one of three relational skills online: (1) Insight, the ability to understand what one needs in relationships and act in alignment with one's needs, (2) Communication, the capacity to listen to others and express one's needs effectively, and (3) Stay vs. Go, the ability to reflect and make difficult decisions in relationships. Adolescents are presented with the opportunity to choose which module they would like to complete. Each module has the following components: psychoeducation, a personalized action plan, and practice overcoming barriers. | Behavioral: Romantic Competence Intervention<br>* Online, 30-minute self-administered relationship competence program for youth ages 16-20<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Health Questionnaire (PHQ-9; Kroenke et al., 2001) | The PHQ-9 is a reliable, valid measure of depression symptom severity. Higher scores indicate more severe symptoms of depression. | Pre-SSI to 3-month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Beck Hopelessness Scale - 4 Item Version (Steed, 2001) | This scale asks participants 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). Average scores across all items range from 0 to 3, with a higher score indicating greater levels of hopelessness. | Pre-Intervention to Immediately Post-Intervention; Pre-Intervention to 3-month follow-up | 
| Relationship Learning Inventory (Davila et al., 2000) | This measure uses 3 questions post-intervention to assess the extent to which participants gained learned something important after the activity, thought about relationships differently, or felt validated in the way that they have been thinking/acting in their relationships. | Pre-Intervention to Immediately Post-Intervention | 
| Generalized Anxiety Disorder (GAD-7; Steed, 2001) | The GAD-7 measures the severity of clinical anxiety symptoms, based on diagnostic criteria for generalized anxiety disorder. The GAD-7 includes 7 items asking respondents how often, during the last 2 weeks, they were bothered by each of 7 anxiety symptoms. Higher scores reflect higher generalized anxiety symptoms. | Pre-SSI to 3-month follow-up | 
| Relationship Decision Making Scale (Vennum & Fincham, 2011) | The Relationship Deciding Scale measures effective decision-making during interpersonal situations. It has three subscales with items rated on a 5- point scale (1 = strongly disagree, 5 = strongly agree), relationship confidence, assessing confidence in maintaining a relationship; warning signs, assessing awareness of and ability to deal with warning signs in relationships; and deciding, assessing thoughtfulness regarding decisions. Higher scores suggest more effective decision-making. | Pre-SSI to 3-month follow-up | 
| Relationship Knowledge and Efficacy Scale (Davila et al., 2020) | This measure consists of 21 items, rated 1-7 (1 = strongly disagree, 7 = strongly agree), and measures six domains: (1) confidence in one's knowledge about what a healthy relationship is and ability to manage relationships; (2) confidence in one's knowledge about and ability to cope with relationship problems; (3) willingness to compromise oneself; (4) beliefs that any relationship can work if you work hard enough; and (5) overreliance on emotions for relationship decisions. Higher scores reflect better relationship knowledge and efficacy. | Pre-SSI to 3-month follow-up | 
| Qualitative Changes in the Relationship Learning Inventory | Immediately after the activity, participants will be asked, In your opinion, what was the most important thing you learned from this activity? Based on what you learned, will you do anything differently in your relationships? If yes, please elaborate on what you will do differently. At the 3-month follow-up, we also ask two additional questions, From what you remember, what was the most important thing you learned in our relationship education activity? and Since completing this activity, have you noticed any changes in how you navigate your relationships? If yes, please tell us what you have noticed. Participants are provided with space to answer these questions via text entry. | Immediately Post-Intervention |