Clinical trial NCT04929262: Parent Key Opinion Leaders to Increase Demand of Effective Treatments for Youth Anxiety
Official title: Increasing Parent Demand for Evidence-Based Practices to Treat Youth Anxiety: The Effect of Parent Key Opinion Leaders
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Anxiety Disorders
Keywords: dissemination
key opinion leader
direct-to-consumer marketing
healthcare utilization
evidence-based practice
youth anxiety
Lead sponsor: Temple University
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
name: University of Illinois at Chicago
name: Brown University
name: Drexel University
First posted: 2021-06-18
Enrollment: 301
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Despite research identifying effective treatments for youth anxiety, parents (and other primary caregivers) are unaware that some treatments are more effective than others. This study investigates whether having a local parent key opinion leader co-facilitate an educational outreach presentation on effective treatment for youth anxiety will increase parent demand for evidence-based practices (EBPs). It is hypothesized that participants who receive a presentation co-presented by a key opinion leader will be more likely to have sought cognitive behavioral therapy for their child at the three-month follow up, relative to participants who receive a presentation presented by two researchers.

Detailed description: Anxiety disorders are common among adults and youth and, when left untreated, are associated with several long-term negative sequelae. Although research has identified a number of EBPs for treating youth anxiety (in particular, cognitive behavioral therapy \[CBT\] with exposures) and despite large-scale implementation efforts, few youth receive EBPs. Direct-to-consumer marketing offers a different approach to increase provider uptake of EBPs by increasing parent demand for EBPs. Direct-to-consumer initiatives are especially important given patient-barriers that prevent youth from receiving treatment, including lack of parental knowledge of EBPs and stigma associated with mental health treatment. Although parent preferences for receiving information about EBPs vary based on demographic factors and individual experiences, research has not investigated methods of tailoring direct-to- consumer efforts to local contexts. Involving a local parent key opinion leader (KOL) to tailor direct-to- consumer initiatives to local contexts may be an effective strategy to increase parent demand for EBPs. KOLs are credible and trustworthy members of a local community who can use their social influence to disseminate information and validate messages about EBPs. Research indicates that KOLs improve health promotion campaigns, but KOLs have not been studied in the context of increasing parent demand for EBPs. The project will examine the role of KOL participation in conducting outreach presentations to increase parent desire to seek CBT for their youth's anxiety. Parent attendees (or primary caregivers; N = 180) will be cluster-randomized by school to one of two different approaches for presentations on EBPs for youth anxiety (90 parents per condition). Both approaches will include community outreach presentations providing information about youth anxiety, effective treatments for youth anxiety, and seeking CBT for youths. The researcher-only condition will be co-facilitated by two researchers. In the KOL condition, a parent KOL from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. The parent-teacher association (or a similar group of parents) from each school will nominate a parent who is well-known and well-respected within their community as the KOL. Parent attendees for both conditions will be recruited by contacting school mental health workers/other school administrators, who will advertise the presentations via their school email list and fliers sent home with children. Parent attendees will complete measures assessing their knowledge of, attitudes towards, and intention to seek CBT pre- and post- presentation, and they will indicate whether they sought CBT for their youth at a three-month follow-up. This study will use a mixed methods approach (integrating quantitative and qualitative methods) to test the effect of KOLs on increasing caregiver demand for CBT for youth anxiety. Primary aims test the relative effects of researcher-only and KOL conditions on changing caregivers' intention to seek CBT for their youth, and actual CBT seeking at three-month follow up. Secondary aims examine (1) the relative effects of researcher-only and KOL conditions on changing caregivers' perceived subjective norms about seeking CBT, attitudes about CBT, stigma about mental illness, and knowledge of how to seek EBPs; and (2) how KOLs affect participants' impression of the researcher presenter. This study will provide future direct-to-consumer efforts with evidence about effective strategies to increase parent demand for EBPs, which in turn will enable parents to seek the best care for their child.

Eligibility criteria: Inclusion Criteria:

* Be least 18 years of age
* Be fluent in English
* Be the primary caregiver of a youth aged 5 to 18 years
* Have a child at one of the schools offering a presentation

Exclusion Criteria:

• None

Primary outcomes:
measure: Change From Pre-Presentation to Post-Presentation in Treatment Seeking Evaluation - Intention to Seek Cognitive Behavioral Therapy
timeFrame: pre-presentation; post-presentation (within 1 week after the presentation)
measure: Number of Participants Who Sought Cognitive Behavioral Therapy as Assessed by Treatment Seeking Evaluation - Actual Cognitive Behavioral Therapy Seeking
timeFrame: 3-month follow-up
Secondary outcomes:
measure: Change From Pre-Presentation to Post-Presentation in Parent Engagement in Evidence-Based Services Questionnaire, Knowledge Subscale
timeFrame: pre-presentation; post-presentation (within 1 week after the presentation)
measure: Change From Pre-Presentation to Post-Presentation in Therapy Subjective Norms Questionnaire
timeFrame: pre-presentation; post-presentation (within 1 week after the presentation)
measure: Change From Pre-Presentation to Post-Presentation in Caregiver Attitudes About Cognitive Behavioral Therapy
timeFrame: pre-presentation; post-presentation (within 1 week after the presentation)
measure: Change From Pre-Presentation to Post-Presentation in Parents' Internalized Stigma of Mental Illness Scale
timeFrame: pre-presentation; post-presentation (within 1 week after the presentation)
Other outcomes:
measure: Change From Pre-Presentation to Post-Presentation and to 3-Month Follow-Up in Barriers to Seeking Treatment
timeFrame: pre-presentation; post-presentation (within 1 week after the presentation)
measure: Change From Pre-Presentation to 3-Month Follow-Up in Barriers to Seeking Treatment
timeFrame: pre-presentation; 3-month follow-up
measure: Client Satisfaction Questionnaire
timeFrame: post-presentation (within 1 week after the presentation)
measure: Relatability Evaluation
timeFrame: post-presentation (within 1 week after the presentation)
measure: Brief Revised Child Anxiety and Depression Scale-Parent Version
timeFrame: pre-presentation
measure: Demographics
timeFrame: pre-presentation
measure: Content Checklist
timeFrame: during the 1.5 hour presentation
measure: Qualitative Interview
timeFrame: 3-month follow-up
Locations:
city: Philadelphia
country: United States
facility: Temple University
state: Pennsylvania
Study officials:
affiliation: Temple University
name: Philip C Kendall, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Crane ME, Atkins MS, Becker SJ, Purtle J, Olino TM, Kendall PC. The effect of caregiver key opinion leaders on increasing caregiver demand for evidence-based practices to treat youth anxiety: protocol for a randomized control trial. Implement Sci Commun. 2021 Sep 23;2(1):107. doi: 10.1186/s43058-021-00213-x.