Category: Child / Adolescent - Anxiety

Symposium

Self-Administered Cognitive Bias Modification for Youth Anxiety Disorder: Implications for Dissemination and Uptake

Sunday, November 19
8:30 AM - 10:00 AM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: Anxiety | Dissemination | Diversity
Presentation Type: Symposium

The ReThink trial enrolls youth seeking treatment for clinically diagnosed anxiety disorders, and who are confirmed via research evaluation to have social phobia (SP), generalized anxiety disorder (GAD), and/or separation anxiety disorder (SAD). Enrolled youth are randomized to: (1) low dose (LD) CBM, (2) high dose (HD) CBM, or (3) high dose CBM with brief adherence promotion (AP) phone calls. All CBM program variants are installed on a home Windows PC, and are indistinguishable to users. As of March 2017 we have attained 73% (n=365) of the ultimate enrollment goal of 498. Families approached for recruitment have been unreachable (959, 54%), explicitly declined (572, 32%) or consented (239, 14%). 


To better understand the generalizability of results, we compared sociodemographic and diagnosis characteristics for (a) those participants who were unreachable to those who were reached (explicitly declined + consented), and (b) those who explicitly declined to those who consented. We examined continuous outcomes with t-tests and categorical outcomes with Fishers Exact Test.


Unreachable youth were not appreciably different from reached youth on most demographic characteristics, including age (15.4 vs 15.3 years, p=.61), sex (33% vs 32% male, p=.54), race (86% vs 89%, p=.05), Hispanic ethnicity (35% vs 33%, p=.65), number of anxiety diagnoses (86% vs 83% had only one diagnosis, p=.06), or type of qualifying anxiety diagnosis (p=.54


Compared to consenting youth, declining teens were older (15.5 yrs vs 14.9 yrs, p<.001), more likely to be Hispanic (38% vs 23%, p=.02), less likely to have GAD qualifying diagnosis (16% vs 23%) and more likely to have SP (5% vs 2%; p=.03). Consenting and declining teens were not significantly different on race (89% vs 91% white, p=.60), sex (31% vs 33% male, p=.62), or number of anxiety diagnoses (83% vs 82% had only one diagnosis, p=.72).


Discussion will address implications for dissemination, and possible approaches to more broadly reach subgroups of anxious youth who are under-represented in the adopting group; e.g., Hispanic and older youth.

Greg Clarke

Senior Investigator
Kaiser Permanente Center for Health Research

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