A. Abstract
Adolescent depression and anxiety are under-treated public health problems in the US with serious clinical and
societal consequences. Adolescents in low resource settings, including many representing racial/ethnic minori-
ties, suffer an unequal burden of mental illness yet receive less treatment, and are harder to reach. These soci-
oeconomically disadvantaged youth need access to engaging interventions which change the trajectory of de-
pression and anxiety symptoms. Incorporation of such interventions into existing community-based settings
may enhance scalability and reach. The SOVA (Supporting Our Valued Adolescents) Peer Ambassador pro-
gram engages youth experiencing symptoms of depression or anxiety and willing to regularly contribute
(monthly) blog posts and comment (weekly) on others’ posts to share their experiences with mental health.
SOVA is a moderated website developed by our research team for adolescents and young adults designed to
(1) increase mental health literacy; (2) address negative health beliefs toward depression, anxiety diagnosis
and treatment; and (3) grow an anonymous online support community with the overall goal of increasing treat-
ment engagement. The Ambassador program is based on Resilience Portfolio Model, a framework describing
strengths-based assets of resilience: self and interpersonal regulation, and making meaning from difficult expe-
riences. Changes in these factors may improve coping and positive functioning and lead to a decrease in
symptoms of depression or anxiety. A one-arm pilot study recruiting a clinical sample found after 3 months,
SOVA Ambassadors experienced an increase in self-esteem, competence, and confidence. To understand
whether youth with less resources, especially racial minority youth, may experience similar benefits, we at-
tempted to disseminate the program to youth involved in a summer work readiness program by partnering with
a community agency. Although the agency and youth showed interest, the program was not fully implemented.
Further work is needed to develop a community-informed implementation strategy with community partners. In
this R21, we propose to apply the technique of Implementation Mapping and a youth stakeholder–driven ap-
proach to continue to tailor SOVA so it is culturally responsive and approachable to racial/ethnic minority and
low-income youth and develop an implementation strategy (Aim 1) to incorporate the SOVA Peer Ambassador
Program in community work readiness program settings. We will conduct a pilot randomized controlled trial
(RCT) of the SOVA Peer Ambassador Program vs. online journalistic writing (attention control) to understand
intervention feasibility and acceptability and evaluate the implementation strategy developed in Aim 1 (Aim 2).
These results will inform design of an adequately powered Type 1 hybrid implementation-effectiveness trial to
test whether SOVA intervention and accompanying SOVA Peer Ambassador Program can increase treatment
uptake in minority, low-resource youth with depression or anxiety in community settings, as well as gather in-
formation on its delivery and potential for implementation using a well-informed implementation strategy.
