Implementation of mental illness anti-stigma research evidence in the school system to promote help-seeking using a pilot hybrid type III trial with adaptive randomization and digital dissemination

Columbia University Health Sciences, New York NY

Investigators

Abstract

In the United States (U.S.), less than 50% of adolescents with a mental illness receive care, resulting in enduring negative effects on health and well-being. Moreover, mental health burden is growing among adolescents in the U.S. Unmet mental health treatment need persists after accounting for symptom severity and insurance and economic factors, suggesting other obstacles to receiving care. Mental health stigma, while preventable, has a moderate negative effect on help-seeking attitudes and behaviors that influence participation in mental health services. As effective treatments are available, addressing mental health stigma early and head-on is a public health priority to narrow treatment gaps. For youth, education-based mental health anti-stigma interventions have been shown to reduce mental health stigma and promote help-seeking. Yet these proven interventions are rarely integrated in typical school health education. Given this, this project’s central goal is to generate new knowledge regarding the implementation of proven mental health related anti-stigma interventions in natural school settings by targeting principals and health educators and using digital technology to foster research translation to schools. This K01 Mentored Research Scientist Development Award will provide critical knowledge and resources to help Dr. DuPont become an independent, interdisciplinary investigator conducting theory-driven implementation science that links the state-of-the-art in mental health related anti-stigma research with mental health education. The project includes a rigorous evaluation of existing school mental health curricula using archival datasets and literature, an analysis of integrated qualitative–quantitative data from principals and health educators, and a pilot type III hybrid implementation trial using adaptive randomization, digital dissemination, and school leadership support strategies. These studies will identify viable strategies for supporting principals and educators in the real-world to adopt proven mental health related anti-stigma curricula. Currently few scientists exist who can inform strategic decision-making and resource allocation regarding the provision of proven mental health related anti-stigma education. Upon completion of the proposed activities, Dr. DuPont will have a unique combination of knowledge and skills in 1) implementation science focused on schools; 2) qualitative and mixed-methods research; 3) use of digital technology to advance health education; 4) creating sustainable academic–community partnerships; and 5) grant writing, data collection, and dissemination of results. The proposed research uniquely integrates methods across disciplines, using experimental design, adaptive randomization in natural school settings, and digital technology to yield generalizable information concerning real-world implementation of proven mental health related anti-stigma curricula. The research plan also elicits voices from schools to promote school empowerment and engagement, focus on high priorities of schools, and foster a promising collaboration for a higher likelihood of successful future school-based interventions in a future R01 grant.