Behavioral health help-seeking among adolescents has risen sharply in recent years, resulting in a crisis withrespect to unmet behavioral health, particularly in rural regions. This crisis has been exacerbated by resourcestrains experienced by service providers. Sadly, youth and families served by community youth service providers(YSPs), including departments for children, youth, and family services, health services, child welfare, juvenilejustice services, school health clinics, foster care, and managed care organizations contracting behavioralservices with states, are among those least likely to receive services, especially those of quality. In ruralcommunities, the situation is worse; youth-serving treatment programs are in short supply, few trained staff areavailable and treatment, reserved for the most severe problem youth, is outsourced and expensive. Services arenotably less accessible for racial/ethnic minority youth. This reality is compounded by the frequent co-occurrenceof problem behaviors (CPs) such as substance abuse, depression, trauma-related problems, and disruptivebehavior and underscores the urgent need for services that are coordinated, engaging and adaptive.Communities desperately need more innovative, evidence-based, fully integrated delivery models that canaccess the large number of youth with CPs who are not receiving needed services. Early interventions for youthbeginning to experience CPs that are delivered before adolescents develop a more chronic mental healthdisorder offer the best opportunity to reduce the economic and health costs associated with these disorders. Thegoal of the proposed SBIR Phase I research is to develop and pilot test a prototype for "e-Health Early TreatmentResource for Youth" (eTRY), a web-based intervention to allow for broad-scale delivery at low-cost to expandYSPs' early intervention services for adolescents whose access is limited due to barriers such as distance fromproviders, lack of trained clinicians, and agencies with long waiting lists. eTRY will involve a multi-screener anda set of brief behavior change counseling modules to guide the youth and staff to address drug use and otherproblem behaviors informed by the screening process. The specific aims of the proposed study are: (1) Conductfocus groups with 10 YSP staff to inform eTRY implementation within state and community programs as well aswith 20 YSP-involved adolescents and 10 parents to guide the development of eTRY content, structure anddelivery methods for its four current modules. Feedback will be integrated iteratively in eTRY development. (2)Create and evaluate the software for a prototype and materials for one of the four eTRY modules, including theonline framework that contains the basic essential elements of text, graphics, and interactive features. (3)Conduct a usability test of the single module with an independent sample of YSP-involved youth (n=20) toexamine functionality (e.g., technical errors), feasibility (e.g., percent completions), usability (e.g., acceptability,appeal), and potential impact of the eTRY prototype. We will also engage stakeholders at the national, state,and community levels to inform implementation and engage in commercialization planning.
Public Health Relevance Statement: Project Narrative
The unmet behavioral health needs of adolescents have reached a crisis level. State and local youth service
providers are least able to meet youths' needs, especially in sparsely populated rural areas, minority youth and
those with co-occurring substance use and other behavioral health problems. This research aims to develop and
pilot test a web-based personalized and youth-centered intervention that will allow youth service providers to
offer broad-scale service delivery at low cost and expand early treatment for underserved adolescents with co-
occurring problems.
Project Terms: <0-11 years old>
