Clinical trial NCT04979481: BRAVE Study: Designing and Evaluating Technologies to Promote Adolescent Mental Health
Official title: We R Native: Designing and Evaluating Technologies to Promote Adolescent Mental Health
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mental Health Wellness 1
Keywords: adolescent
Lead sponsor: Northwest Portland Area Indian Health Board
Sponsor class: OTHER
Collaborators: name: mHealth Impact Lab
First posted: 2021-07-28
Enrollment: 1030
Sex: ALL
Minimum age (years): 15
Maximum age (years): 24
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: Teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages or 8 weeks of STEM text messages; and then crossed over to the other arm and received the next set of messages.
Primary purpose: PREVENTION

Brief summary: The BRAVE study is a randomized controlled trial carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,330 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,030 to participate in the 9-month study. Teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and promote cultural pride and resilience; or 8 weeks of Science Technology Engineering and Math (STEM) text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine; and then received the other set of messages. Retention in the study was high, with 87% of participants completing both BRAVE and STEM intervention arms.

Detailed description: There are approximately 2.1 million self-identified American Indian and Alaska Native (AI/AN or Native) youth under the age of 24 living in the United States. Like many teens, AI/AN youth report frequent technology use and poor mental health outcomes, including trauma, stress, anxiety, depression, and suicidality.

To support Native youth, the Northwest Portland Area Indian Health Board (NPAIHB) launched We R Native in 2012, a holistic health resource for Native youth, by Native youth (www.weRnative.org).

While this broad reach and utilization is promising, more focused research is needed to better understand the acceptability and usability of the mental health messages delivered by We R Native, and systematic research is needed to determine whether We R Native's messages actually improve mental health and resilience, teach mental health skills (like coping skills, mindfulness, help-seeking, and use of suicide prevention chat-lines, etc.), and promote healthy social norms - all protective factors against suicide and substance abuse.

Housed at the Colorado School of Public Health, the mission of the mHealth Impact Lab is to facilitate the rapid and rigorous development, implementation, and evaluation of mobile and digital technology for health promotion and disease prevention that address inequalities in health outcomes.

The research teams tested whether We R Native's BRAVE messages improved self-efficacy and behaviors related to mental health, resilience, and cultural pride; as well as the relative impact of user engagement.

The BRAVE study will improve the relevance, efficacy, and utilization of mental health resources delivered through We R Native' messaging channels - reaching a high-risk, underserved population - and will create new mechanisms to monitor and evaluate the impact of mHealth interventions. Both teams are committed to sharing resultant data collection tools and processes with those working in the field.

Eligibility criteria: Inclusion Criteria:

* The study included self-identified American Indian and Alaska Native youth
* Age 15-24 years old

Exclusion Criteria:

-Participants were required to have a cell phone with text message capabilities

Primary outcomes:
measure: Health
timeFrame: Up to 8 months
measure: Resilience
timeFrame: Up to 8 months
measure: Positive Coping
timeFrame: Up to 8 months
measure: Self-esteem
timeFrame: Up to 8 months
Secondary outcomes:
Other outcomes:
Locations:
city: Portland
country: United States
facility: NPAIHB
state: Oregon
Study officials:
affiliation: Principal Investigator
name: Stephanie Craig Rushing, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Craig Rushing S, Kelley A, Hafner S, Stephens D, Singer M, Bingham D, Caughlan C, Fatupaito B, Gaston A, Ghost Dog T, Smith P, Love Brown D, McCray C. The BRAVE Study: Formative Research to Design a Multimedia Intervention for American Indian and Alaska Native Young Adults. Am Indian Alsk Native Ment Health Res. 2021;28(1):71-102. doi: 10.5820/aian.2801.2021.71.
citation: Stephens D, Peterson R, Singer M, Johnson J, Rushing SC, Kelley A. Recruiting and Engaging American Indian and Alaska Native Teens and Young Adults in a SMS Help-Seeking Intervention: Lessons Learned from the BRAVE Study. Int J Environ Res Public Health. 2020 Dec 16;17(24):9437. doi: 10.3390/ijerph17249437.
citation: Wrobel J, Silvasstar J, Peterson R, Sumbundu K, Kelley A, Stephens D, Craig Rushing S, Bull S. Text Messaging Intervention for Mental Wellness in American Indian and Alaska Native Teens and Young Adults (BRAVE Study): Analysis of User Engagement Patterns. JMIR Form Res. 2022 Feb 25;6(2):e32138. doi: 10.2196/32138.
citation: Craig Rushing S, Kelley A, Bull S, Stephens D, Wrobel J, Silvasstar J, Peterson R, Begay C, Ghost Dog T, McCray C, Love Brown D, Thomas M, Caughlan C, Singer M, Smith P, Sumbundu K. Efficacy of an mHealth Intervention (BRAVE) to Promote Mental Wellness for American Indian and Alaska Native Teenagers and Young Adults: Randomized Controlled Trial. JMIR Ment Health. 2021 Sep 15;8(9):e26158. doi: 10.2196/26158.