1 - (SYM 39) Expanding Access to Behavioral Activation: Preliminary Findings from a Statewide, Lay-delivered Behavioral Activation Telehealth Program for Teens

Rates of youth depression present a critical public health problem (Shorey et al., 2021). Despite this increased need, there is a mental health provider shortage. Over half of U.S. youth with major depression report that they did not receive mental health services (Mental Health America, 2024). Further in the state of Texas, nearly every county is classified as either a full or partial mental health professional shortage area (Rural Health Information Hub, 2024). Behavioral Activation (BA) is treatment that has been found to be efficacious for adolescent depression, and the use of lay interventionists serves as an unstudied, promising avenue to increase adolescent access to BA.

Activ8 is a brief BA telehealth program that is developmentally adapted for adolescents (ages 12 - 18 years old) with depression and is conducted by lay interventionists.  Activ8 is delivered across 11 Health Related Institutions (HRIs) across rural and urban regions in the state of Texas. To date, 65 participants have been enrolled and 37 have completed participation in the program (73% Female, 73% White, 33% Hispanic). Adolescents and their participating caregivers completed the Patient Health Questionnaire Adolescent Version (PHQ-A) and Behavioral Activation for Depression Short Form (BAD-SF) weekly as part of each intervention session.  A subset of adolescents (n = 18) and their caregivers (n = 20) also completed a post-intervention feedback survey at program completion.

The adolescents and their caregivers reported decreases in PHQ-A (child D M = -2.86; caregiver D M = -4.00) and increases in BAD-SF (child D M = 4.06; caregiver D M = 4.50) from baseline to the last visit. However, most participants reported mild depression at baseline, limiting the possible range for symptom improvement. Most participants completed all eight sessions (68%; M = 6.7 sessions). On the feedback surveys, almost all caregivers and teens reported that Activ8 improved the adolescent’s depression (adolescent = 63%; caregiver = 74%) and improved their activity level (adolescent = 89%; caregivers = 84%). Almost all caregivers reported that Activ8 was helpful for them (89%). Overall, preliminary data from Activ8 suggests promising feasibility, acceptability, and effectiveness. Implications for future research and clinical care will be discussed.