More Background:
In recent years, racial disparities in risk for suicidal thoughts and behaviors (STBs) have become increasingly evident, with Black and Hispanic adolescents experiencing a faster increase in suicide rates than White youth in the U.S. Thus, there is a need for culturally appropriate interventions that target risk factors for STBs among a growing population of racially diverse youth. Anhedonia, defined as the loss of interest or pleasure in enjoyable or valued activities, is a core feature of depression and an independent risk factor for STBs in youth. Behavioral Activation (BA) therapy is a cognitive behavioral intervention that directly targets anhedonia, by decreasing avoidance and isolation behaviors, using positive reinforcement to increase engagement in valued activities, and increase the experience of reward. Growing evidence supports the effectiveness of BA for adolescents in the traditional face-to-face psychotherapy format, and BA has shown promise in the few preliminary investigations that included racially diverse youth. A key advantage of the BA model is that the focus on behavioral strategies is well suited for adaptation to digital platforms that incorporate mobile sensing and can generate objective data on activity. As the digital BA approach allows for real-time feedback to both users and providers on treatment goals and behavioral targets, it offers a significant advantage over traditional face-to-face intervention. To date, no studies have tested digital BA in a diverse study population that includes Black and Hispanic youth. The goal of this study, therefore, is to tailor and test a health coach supported, digital BA intervention with mobile sensing, to target anhedonia in a diverse sample of youth. The study has the potential to offer a low-cost and scalable behavioral intervention that may decrease risk of suicide among at-risk youth.
