Bullying Prevention Intervention for Adolescent Primary Care Patients (iPACT)

Lifespan

Status: Completed

Conditions: Cyberbullying

Treatments: Other: Control: Enhanced Usual Care (EUC); Behavioral: iPACT Intervention- app; Behavioral: iPACT Intervention

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03467009

R21HD088739 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this randomized controlled study is to evaluate acceptability and feasibility, and to gather preliminary data about efficacy, of "iPACT" (intervention to Prevent Adolescent Cyber-victimization with Text messages), a brief in-clinic introductory session + longitudinal automated text-message-based secondary prevention program for adolescents with a history of past-year cyber-victimization presenting to a pediatric clinic for well-child visits.

Full description

Cyber-victimization predicts depressive symptoms and suicidality; it correlates with PTSD symptoms, alcohol and other drug use, physical peer violence, and dating violence.

Almost 80% of adolescents have a well-child visit with their pediatrician each year. Pediatricians recognize this visit as an important opportunity for behavioral screening, interventions, and referrals, but they currently lack cyber-victimization interventions that are feasible and effective in the clinical setting. Personalized text-message interventions are accessible, feasible, and may be effective with these adolescents.

The purpose of this study is to test the feasibility and acceptability of a novel text-message-augmented secondary prevention intervention, "iPACT." Drawing on effective cognitive behavioral therapy (CBT) and motivational interviewing (MI) depression and violence prevention interventions, a brief in-clinic session will introduce basic cognitive and behavioral strategies. Following their clinic visit, eight weeks of tailored CBT-informed daily text messages will be sent, to enhance skills and remind participants of self-determined goals.

Participants will be identified in the course of usual clinical care. If eligible, parents will be consented and participants assented. Participants will complete a baseline assessment and will be randomized to experimental (iPACT, n=25) or enhanced usual care (EUC, n=25) care, using stratified block randomization.

iPACT group participants will participate in a brief, structured in-clinic introduction on CBT and the iPACT program, followed by 8 weeks of tailored, two-way, CBT-and MI-informed automated text messages (short message service, SMS). EUC group participants will receive standardized information on cyberbullying. The current standard of care for these patients is no care: no cyber-victimization screening assessment protocols are currently used in our clinic. Both iPACT and EUC conditions therefore exceed current levels of care.

At baseline, 8 week follow-up, and 16 week follow-up, participants will complete assessments on cyberbullying, peer violence, and cognitive/behavioral skill-sets. At the 8-week follow-up, standardized qualitative and quantitative process measures will be administered to assess efficacy, acceptability, usability, and feasibility.

Enrollment: 77 patients

Sex: All

Ages: 13 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• presenting to Hasbro Children's pediatric clinic
• being mentally and physically able to assent
• being English-speaking
• having a consentable parent present
• self-reporting cyber-victimization (defined as endorsing >1 past-year episode of technology-mediated victimization)

Exclusion criteria

• being cognitively or emotionally unable to take part in the intervention as determined by the pediatric attending clinician
• suspected by clinical staff of being a victim of child abuse
• currently incarcerated or under police custody

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

77 participants in 3 patient groups

iPACT Intervention

Experimental group

Description:

1. In-clinic brief session, introducing basic principles of cognitive behavioral theory and the structure of the text-message portion of the intervention. 2. Eight-week longitudinal tailored CBT-based text-message program.

Treatment:

Behavioral: iPACT Intervention

Control: Enhanced Usual Care (EUC)

Active Comparator group

Description:

The investigators will provide participants with a standard resource sheet with information on bullying and mental health resources.

Treatment:

Other: Control: Enhanced Usual Care (EUC)

iPACT Intervention- App

Experimental group

Description:

1. In-clinic brief session, introducing basic principles of cognitive behavioral theory and the structure of the message portion of the intervention delivered via app. 2. Eight-week longitudinal tailored CBT-based message program delivered via app.

Treatment:

Behavioral: iPACT Intervention- app