A Digital Health Technology to Prevent Family Violence and Improve Child Mental Health

Project Summary/Abstract Youth with mental health and behavior disorders have been underserved for decades, and many children receive no services at all. Since the COVID-19 pandemic, the need for effective mental health treatments for children and families has increased substantially, with research suggesting that 25% of children and adolescents now report levels of depression in the clinical range (Raccine et al., 2021). For most children, schools are the primary delivery source for mental health and behavioral treatments, yet schools have been adversely impacted by a lack of providers and limited funding to support vulnerable students. Efficacious treatments for mental health problems in children typically involve support for families to improve student behavior at home, yet schools lack the tools to deliver this support. To meet this need, we developed the Family Check-Up Online, a digital health intervention designed to improve child mental health through family- centered intervention. The Family Check-Up is grounded in over 25 years of evidence-based research and has been shown to improve child mental health and behavior including depression and conduct problems. We were supported by an SBIR Phase I award (R43MH132191) to evaluate the feasibility and acceptability of the digital health product in schools and adapt the product based on our findings. Our findings suggested the model is a good fit for schools, with school providers stating a need for family-centered interventions that target child behavior and mental health, but with few resources or evidence-based programs available. We received feedback that suggests the model should be evaluated as both an uncoached version and coached version, delivered with provider support. In our proposed SBIR Phase II, we plan to continue our work in schools to develop the model for commercialization, including understanding the process for embedding the FCU Online into current student support systems and implementation factors that lead to maintenance of the model in schools. We plan to conduct a hybrid type 2 effectiveness-implementation trial to evaluate the effectiveness of the FCU Online when delivered by real world providers. We will randomly assign 30 providers (N=600 students/families) to receive training in the FCU Online coached vs. uncoached models. We will then evaluate outcomes including family relationships, parenting skills, and child mental health and behavior. We predict that the FCU Online will improve child mental health and behavior, and we will test for moderators such as provider training and child baseline risk. Findings will have implications for commercialization of the product in schools and implementation of the model in a range of different school settings.