Long Covid includes symptoms of fatigue, sleep changes, anxiety and depression lasting at least three months following infection with COVID-19 and occurs in 10-20% of individuals following infection. Approximately 16% of children experience persistent mood symptoms as part of their Long Covid symptoms. This amounts to over two million children with new symptoms of anxiety and depression after COVID-19 in the US since the onset of the pandemic. Studies show that gradual increases in exercise targets or “pacing” improves symptoms in adults with Long Covid, but this treatment remains to be evaluated in children. Most pacing programs require weekly in-person physical therapy visits and therefore, are difficult to access. Our group has demonstrated improvement in mental health outcomes for adolescents following concussion using a virtual paced exercise program, Mobile Subthreshold Exercise Program (MSTEP). This project aims to evaluate MSTEP as an intervention to improve function and improve mental health symptoms in adolescents and young adults with Long Covid.
Funding Type: Philanthropy
Optimizing mental health first-aid programming for sport coaches
Many sport organizations are increasingly vocal about the importance of athlete mental health. Helping organizations move beyond rhetoric to improved athlete wellbeing and safety requires evidence-based resources that are setting-appropriate and feasibly implemented.
This project will develop and obtain feasibility and acceptability data on “Time Out for Mental Health”—a mental health first aid training for sport coaches. This will be accomplished by adapting an existing evidence-based mental health first aid resource to the coach role and sport setting, working closely with a small group of coach partners. The team will focus on ensuring the training is considered useful and feasible by coaches who work in resource deprived school and community-settings given the heightened needs and challenges of youth in such settings, and will train coaches to deliver “Time Out for Mental Health”—to build organizational capacity. “Time Out for Mental Health”—has the potential to strengthen connections between sports organizations and school- and community-based mental health services for millions of adolescents as more than half of high school students play at least one organized school or community sport.
Decreasing engagement and transmission of suicide-related content on TikTok
In the US, approximately one in five adolescent and young adults have seriously thought about suicide and one in 11 have made a suicide attempt. Unfortunately, a third to half of adolescent and young adults who are experiencing suicidal and self-injurious thoughts do not seek professional help and when they do, there is a nationwide shortage of mental health professionals available to support them. When adolescent and young adults are in distress, many seek out support and validation through social media. Some content can be helpful and allow them to find a community where they feel connected, receive the support they need, or share effective coping strategies. Other content can be harmful by encouraging them to commiserate and share or promote harmful coping strategies.
TikTok is the most popular digital platform currently used by over 63% of US adolescent and young adults. Its content recommendation algorithms select and display highly personalized content to each individual user such that the more a user engages with a specific type of content, the more this content will be displayed to them. Many other social media platforms are developing similar content recommendation algorithms to increase user engagement. For adolescent and young adults who are experiencing suicidal thoughts and urges, these content recommendation algorithms can amplify their exposure to suicide-related content and increase suicide risk. The purpose of our project is to identify TikTok content and usage behaviors that increase suicide risk. These findings can inform the development of social media interventions for adolescent and young adults who are experiencing suicidal thoughts and urges.
Adapting a resilience intervention for youth athletes
Youth mental health is in crisis and we do not have adequate providers to treat the current burden of illness. We must identify innovative approaches to support youth mental health that utilize the existing infrastructure and can be administered by non-clinicians. While sports are predominantly a positive outlet for youth, they also bring stressors due to experiences with failure, injury and challenging time commitments, and thus provide an ideal laboratory to develop coping skills for managing stress.
This project aims to build psychological resilience in high school athletes by adapting an intervention developed for youth with chronic illness (PRISM). The intervention will be delivered through the coach via an educational platform with five modules: 1) background/ psychoeducation; 2) creating a supportive team culture; 3) stress management (breathing exercises, visualization and mindfulness); 4) mindset (goal setting, cognitive reframing and meaning making); and 5) fueling the machine (sleep and nutrition). The team will utilize a community-engaged research process to adapt the PRISM approach to an athletic space, using the term “Mentally Strong” to center it in the sport context, and will partner with youth athletes and coaches to ensure the tools we develop support their needs. The Mentally Strong approach has the potential to increase the emotional literacy of a broad swath of high school youth beyond the athletic environment, enhancing their ability to negotiate the acute and chronic stressors they encounter in daily life. The ultimate goal of the project is to prevent the outcomes which occur with negative emotional coping—including depression, anxiety, substance use, burnout, violence, withdrawal from school and even suicide.
Using teen Mental Health First Aid to address mental health inequity among school youth
Over 2.5 million US adolescents struggle with mental health challenges, and multiracial adolescents are at greatest risk due to limited access to mental health programs. As roughly half of lifetime mental disorders have their first onset by mid-adolescence, it is vital to promote help-seeking for prevention and early intervention during this important developmental stage.
This project will test the implementation of an evidence-based mental illness prevention program — teen Mental Health First Aid (tMHFA) — in a diverse and underserved school district to facilitate help seeking among teens aged 16-18. While tMHFA has a proven track record of effectively enhancing knowledge of mental health problems, reducing stigma and promoting help-seeking behaviors, its efficacy across dimensions of race and ethnicity is underexamined in the US.
Academic (UW & SMART Center), education (Tacoma Public Schools) and behavioral health organization (MultiCare) stakeholders will address this gap by conducting a mixed-methods study with 1) focus groups to obtain diverse teens aged 15-18 opinions about facilitators and barriers in help-seeking; and 2) longitudinal data collection to examine the impact of the innovative tMHFA’s potential to address help-seeking barriers across dimensions of race and ethnicity. The findings of this project will guide both the revisions to the program to improve its efficacy and the scaling of this program to support government legislation to expand service delivery to other schools and to rural areas across the state.
Addressing suicide risk in primary care to reduce youth suicide
Suicide is a leading cause of death among 10- to 24-year-olds in the US, and half of youth who die by suicide contact a primary care provider within one month prior to suicide. Suicide risk screening and access to brief and effective suicide prevention interventions remain an important step in reducing suicide, yet comprehensive suicide prevention pathways focused on youth have not been widely implemented or evaluated in primary care settings, in part due to lack of trained clinicians and time to provide services.
This project aims to address these challenges by developing clinician training and adapting and optimizing a brief, evidence-based suicide intervention, SAFETY- Acute(A), for use in primary care to support the development of an effective and sustainable primary care-based suicide prevention pathway for youth with low to moderate suicide risk.
Monitoring mood symptoms in young adults at-risk for bipolar disorder
The ages of 18-25 years are ‘peak onset’ times of major depression and bipolar disorder. These disorders have different courses and treatments, but diagnosing bipolar disorder is difficult because manic symptoms occur less often than depressive symptoms and many individuals do not recall manic symptoms. A ‘misdiagnosis lag’ of 8-10 years can contribute to prolonged periods of potentially ineffective treatments and suboptimal outcomes such as high symptom burden, relationship problems, educational attainment and occupational functioning.
This project will use remote prospective assessment and monitoring of depressive and manic symptoms in at-risk patients in-between patient visits to increase the ‘data points’ clinicians have when assessing a bipolar disorder diagnosis. This is especially important for people at risk for bipolar disorder (for example those with a family history of bipolar disorder) because manic symptoms can be provoked by first-line medication treatments for major depression. The project will use a new manic symptom measure (the Patient Mania Questionnaire-9) and a commonly used depressive symptom measure (the Patient Health Questionnaire-9) to monitor symptoms, and learn how clinicians and patients use this information clinically.
Reducing barriers to accessing mental health care using a web-based program for young adults
Most young adults with mental health (e.g., depression, anxiety) or substance use disorders do not receive treatment. Untreated mental health and substance use can be associated with impairments in social relationships, overall functioning and suicide. National data indicate that almost half of young adults with symptoms of a mental health disorder reported they needed mental health care in the past year but did not access those services. Barriers to accessing mental health care include stigma, not knowing where to go, lack of transportation and cost.
This project aims to develop a personalized web-based program for young adults to reduce self-reported barriers and increase motivation to access mental health and substance use services. Investigators will work with clinicians and young adults to develop strategies and solutions to address the identified barriers. The team will work with a community advisory board to develop program content that will be further refined through focus groups and individual interviews with young adults and clinicians. From this, the team will develop the web-based program which will serve as the first step needed to establish a larger program of research focused on reducing barriers and increasing access to mental health care to improve young adult well-being.
Parent Educator Action Response (PEAR)
Through a community-partnered approach we will develop and deliver a parent-teacher relationship intervention at local preschools that serve under-represented minority families.
Using neurocomputational modeling to track memory decline
The most salient and debilitating aspect of dementia is memory loss. Unfortunately, memory loss is also the most difficult to quantify because it relies on doctor-administered tests that cannot be repeated very often. Without frequent and accurate measurements, it is difficult for clinicians to make reliable diagnoses, for patients and their caretakers to prepare in advance and for researchers to better understand the relationship between brain changes and cognitive decline.
This project will recruit 100 patients who are just beginning to experience memory loss as well as 100 healthy controls. Their memory function will be measured weekly through a brief, online test that can be accessed through any device and performed in less than 10 minutes. Data from the test will be fed to a computer model that simulates how fast memories fade in each patient’s brain, and the parameter that represents each patient’s speed of forgetting will be tracked over time. While the model simulates the patient, it also adapts the difficulty of the weekly task, ensuring it remains engaging but doable as memory declines.
The weekly estimates will provide the first, detailed trajectories of how fast memory declines over time in healthy aging and in different forms of dementia. The trajectory of the rate of forgetting will be used to analyze MRI data, producing precise associations between different types of memory loss and different types of brain damage.
