STEP-UP Project

Project Description 

Anxiety and mood disorders in youth are prevalent and impairing, with high current and lifetime comorbidity in part due to shared etiologic factors. Untreated, these disorders lead to sustained functional impairment and convey increased risk for recurrent disorder and suicide. Only 1 in 5 anxious and 2 in 5 depressed youth report any lifetime mental health use, the lowest treatment rates for any youth mental health condition. In addition, there are notable disparities in care, with families experiencing high social determinants of health (SDOH) burden and minoritized youths significantly less likely to receive mental health services than similarly affected, but less disadvantaged, youths. 

This study is a hybrid type 1 randomized effectiveness-implementation trial that tests the effects of brief behavioral therapy (STEP-UP) for youths (ages 8-16 years) with anxiety and/or depression recruited from low-resource primary care community health centers (CHCs). A previous face-to-face version of this program (BBT) was effective, and this study tests if the program works well when delivered in a telehealth format to families traditionally underserved by mental health. Specific aims include testing the clinical effectiveness of STEP-UP and engagement of the intervention mechanism (Aim 1), probing cost effectiveness (Aim 2), testing SDOH predictors and moderators to evaluate robustness of effects (Aim 3), and identifying target mechanisms for future implementation trials using the Consolidated Framework for Implementation Research (Aim 4). Results may help move effective treatments for these serious problems into widespread community practice.

Please see our study brochure or visit the STEP-UP website for more information. This research is supported by an award from the National Institute of Mental Health (MH131698).