Using Performance Feedback and Facilitation to Integrate Motivational Interviewing in Teen Helpline Services - PROJECT SUMMARY/ ABSTRACT The resubmitted proposed K23 Mentored Patient-Oriented Research Career Development Award will provide the applicant with advanced training and skills to launch an independent research program to improve service disparities among youth from underserved backgrounds, by developing and evaluating hybrid effectiveness- implementation trials within helpline settings. The proposed K23 project begins to establish a foundation for research within helplines, which comprise a high-reach and greatly understudied service sector. The proposed project relies on the assistance of scalable digital mental health tools to support the implementation of Motivational Interviewing (MI) to support help-seeking in real life (IRL; e.g., from trusted adults, mental health service linkage) among youth helpline users. The community-partnered study will develop and pilot an implementation strategy using human-centered design to preliminarily test its impact on a provider- level mechanism (self-efficacy) and outcome (MI adherence), and patient-level outcome (help-seeking IRL). The study will partner with Teen Talk App, a large helpline application that provides teen-to-teen emotional support under the supervision of mental health staff. Aim 1 of the study will adapt MI to fit the service context. Adaptations will tailor the innovation for delivery by teen peer helpers through brief text exchanges that promote help-seeking IRL. Aim 2 will develop a multifaceted provider-level implementation strategy (performance feedback and facilitated practice; PF-FP), which will be assisted by Artificial Intelligence (AI) tools to support MI training. This will culminate in Aim 3, a pilot feasibility and acceptability trial, in which teen peer helpers will receive MI training and then be randomized to receive PF-FP, or training as usual. The trial will generate preliminary data on feasibility (using mixed methods data) and impacts of the implementation strategy on the proposed mechanism and outcomes. The applicant is well suited to do this research given her expertise in depression and suicide disparities, including developing cultural adaptations for minoritized youth, but she requires the following additional training: 1) expertise in leading mixed-methods community-partnered effectiveness-implementation hybrid trials; 2) expertise in training non-specialists in Motivational Interviewing strategies; and 3) application of digital mental health tools, such as AI, to support scalable training of peer helpers in MI. Mentorship and consultation from co-sponsors Drs. Anna Lau and Miguel Villodas (hybrid trials, community-partnered human centered design, multilevel statistics), Dr. Lawrence Palinkas (mixed-methods in implementation science) Dr. Elizabeth D’Amico (MI training and adaptation for non-specialist settings), and Dr. Stephen Schueller (digital mental health) will facilitate this training.
