A Brief Engagement Intervention Adapted for Racial and Ethnic Minority Young Adults in Mental Health Services: Protocol for a Pilot Optimization Trial
Bibliographic record
Abstract
Background Young adults from racial and ethnic minority (REM) groups are at greater risk of disengaging from vital mental health services than their majority group peers. Emerging research suggests developmentally tailored interventions that enable personalized exploration of cultural and structural contexts; encourage trust in relationships with service providers; enhance hope for recovery; and increase self-efficacy to adhere to treatment can improve engagement among underserved REM young adults with mental health disorders. Objective Just Do You is a brief young adult treatment engagement intervention. Although Just Do You showed evidence of efficacy with medium effect sizes in a previous clinical trial, not all participants benefited, and some of the proposed mediators were not changed. Grounded in the multiphase optimization strategy (MOST), we propose to improve the provision and effects of Just Do You by testing a set of new candidate intervention components that complement the original Just Do You program. This can potentially enhance its effects on engagement and mental health service use for REM young adults. Methods A total of 3 new candidate behavioral intervention components and their putative mediators were designed in collaboration with REM young adults and other key informants. The new candidate components and their mechanisms of action are (1) cultural identity (perceived cultural competency), (2) future self (hope), and (3) understanding environments (self-efficacy). A pilot optimization randomized controlled trial will be conducted in an outpatient mental health setting with REM participants aged 18-34 years (N=80). The candidate components will be tested in a 23-factorial design where all participants will receive Just Do You and be randomly assigned to one of 8 experimental conditions, each composed of a unique combination of candidate components. We will assess the new components’ acceptability and feasibility, and explore preliminary evidence of their effects on the primary outcome (engagement in mental health care) and mediators at a 3-month follow-up assessment. Results The study began recruitment in December 2024 and is planned to continue through December 2026. Final study completion is planned for March 2027. The results will be disseminated via professional and scientific publications, presentations, and social media, as well as to members of the participant community. Conclusions Findings from this study will supply critical deployment-focused evidence to inform a future randomized controlled trial as the next step in this program of research. We ultimately aim to create an effective, efficient, and scalable intervention to improve engagement and mental health outcomes among REM young adults. Trial Registration ClinicalTrials.gov NCT06508450; https://clinicaltrials.gov/study/NCT06508450 International Registered Report Identifier (IRRID) DERR1-10.2196/68885
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.018 |
| Meta-epidemiology (narrow) | 0.004 | 0.003 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.004 | 0.008 |
| Insufficient payload (model declined to judge) | 0.072 | 0.010 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".