Implementation of mental illness anti-stigma research evidence in the school system to promote help-seeking using a pilot hybrid type III trial with adaptive randomization and digital dissemination

PROJECT SUMMARY/ABSTRACT Less than 50% of adolescents with a mental illness receive care, resulting in enduring negative effects on health. Moreover, mental health burden is growing especially for racial/ethnic minority and lower socioeconomic youth. This unmet mental health treatment need persists after accounting for symptom severity and insurance/economic factors, suggesting there are other barriers to mental health care. Stigma, while preventable, has a moderate negative effect on help-seeking attitudes and behaviors that influence participation in mental health services. As effective treatments are available, addressing stigma early and head-on is a public health priority to narrow treatment gaps for youth. For youth, education-based anti-stigma interventions are efficacious to reduce stigma and promote help-seeking. Importantly, education-based anti-stigma interventions also eliminate race/ethnic and gender stigma disparities, thereby helping to address mental health disparities. Yet these efficacious anti-stigma interventions for youth are rarely integrated in typical mental health education. Given this, this project’s central goal is to generate new knowledge regarding implementation of anti-stigma research evidence in natural school settings by targeting principals and health educators and using digital technology to foster innovation in school health education. This K01 Mentored Research Scientist Development Award will provide critical knowledge and resources to help Dr. DuPont become an independent, interdisciplinary investigator conducting theory-driven implementation science that links the state-of-the-art in anti-stigma efficacy trials with mental health education. The project includes a rigorous evaluation of existing school mental health curricula using archival datasets and literature, an analysis of integrated qualitative–quantitative data from principals and health educators, and a pilot type III hybrid implementation trial using adaptive randomization, digital dissemination, and school leadership support strategies. These studies will identify viable strategies for supporting principals and educators in the real- world to adopt efficacious anti-stigma curricula. Currently few scientists exist who can inform strategic decision- making and resource allocation regarding the provision of efficacious anti-stigma education. Upon completion of the proposed activities, Dr. DuPont will have a unique combination of knowledge and skills in 1) implementation science focused on school change; 2) qualitative and mixed-methods research; 3) use of digital technology to advance health education; 4) creating sustainable academic–community partnerships; and 5) grant writing, data collection, and dissemination of results. The proposed research uniquely integrates methods across disciplines, using experimental design, adaptive randomization in natural school settings, and digital technology to yield vital generalizable information concerning real-world implementation of efficacious anti-stigma curricula. The research plan also elicits voices from schools to increase the likelihood of successful future interventions, promote school empowerment and engagement, focus on high-priority populations and settings, foster a promising collaborative framework for future school-based research, and lay a foundation for a future R01 grant.