Program: CBITN

Examining Heterogeneity of Treatment Effects in a Pragmatic Randomized Controlled Trial Evaluating the Effectiveness of an App-based E-Mental Health Intervention for University Students

Health Research BC is providing match funds for this research project, which is co-funded by the Canadian Behavioural Intervention and Trials Network (CBITN) Doctoral Studentship. 

 

University is a transition period for students, a time when many students face significant mental health and substance use challenges. For many students, access to traditional treatments and interventions are limited. E-interventions for mental health and substance use disorders (MSUD) have shown promise in improving health outcomes for students and young adults. The Student E-Mental Health Project is conducted by the Mental Health Systems and Services Laboratory at the University of British Columbia and seeks to improve mental health and substance use outcomes for university students. As part of this initiative, the Minder mobile app was codeveloped with university students, and offers a suite of evidence-based interventions to support university students in managing their mental health and substance use. A pragmatic randomized controlled trial (RCT) was conducted with approximately 1500 university students at the University of British Columbia in Vancouver to assess the effectiveness of the mobile app to improve the mental health and substance use outcomes of university students. This project will use a precision medicine approach to investigate whether the multiple evidence-based e-mental health interventions within the Minder mobile app have differential effects on various subgroups of students based on demographic, clinical, and behavioral characteristics. We will build an understanding of how characteristics of individuals in the pragmatic trial can be used to predict intervention outcomes. Findings from this project will help identify population subgroups that benefit most from various components of the e-intervention, and will inform tailoring of the Minder app to provide personalized e-mental health services. It is also expected that these findings will advance the application of personalized medicine in the field of psychotherapy and in the context of pragmatic RCTs investigating the effectiveness of e-health interventions. 

End of Award Update – December 2024

 

Results

This research is elucidating how the effectiveness of the Minder app differs on outcomes of change in depression and anxiety scores based on participant characteristics, including gender and ethnicity. 

 

Impact

Research findings will be helpful to understand differential effectiveness of this e-mental tool on the diverse participants of a pragmatic trial. As such, findings may help inform tailoring of the Minder app to various population subgroups to improve mental health outcomes. 

 

Potential Influence

The development of e-mental health tools is a compliment to brick-and-mortar mental health services. Understanding how to improve and tailor these e-mental health tools to user characteristics (i.e. personalized e-mental health services) can lead to greater uptake and effectiveness. 

 

Next Steps

Outputs from this research are currently being interpreted and regression models revised. Once results are finalized, publications in scientific journals and/or at conferences will be explored. Findings may also inform future clinical/behavioural trials and/or support further implementation of the Minder app. 

Co-design a gender inclusive nutrition education intervention

Teens who participate in high school sports experience unique pressures over their dietary habits such as having energy to play, performing better, or developing certain muscles. These pressures can be harmful when teens’ dietary habits become focused on attaining a certain body shape over fueling for their sport. When this happens, an athlete has a greater risk of injury, poorer mental health, restricted growth. In high schools, ~30% of teens participate in school sports. At this time, there are no resources in place to help these athletes navigate their dietary habits, and these athletes typically do not have access to trained coaches or dieticians to help them decide what to eat. This places a large number of teens at risk for deciding what to eat based on appearance, having the potential to negatively impact their well-being. With the support of the CBITN & Michael Smith Health Research BC Doctoral Studentship 2023 Award, Alysha Deslippe (University of British Columbia, PhD candidate) is working with BC high school athletes and coaches to develop an app to support high school athletes’ dietary habits. Alysha is guided by the expertise of Dr. Tamara Cohen (UBC, director of dietetics and assistant professor) and Emilie Comtois-Rousseau (ECR Nutrition, sport dietitian). Using bi-monthly meetings with athletes and coaches over 12 months, the content and design of the app is being co-developed to ensure it meets athletes’ needs and is feasible to use in high schools. As teens’ dietary habits often carry forward, this app has the potential to help improve BC high school athletes’ life-long health by promoting a shift away from eating for body shape.

End of Award Update – December 2024

 

Results

By meeting with local athletes and coaches from around Vancouver over the past year, we created a new app called PLAYTE. PLAYTE aims to help high school athletes figure out what to eat while they are competing in their sports. The content and features of PLAYTE were decided on with local athletes and coaches to make sure that the app meet user needs. Some key features of PLAYTE include a series of 12 sport nutrition videos that were developed with dietitians to improve high school athletes’ nutrition knowledge. These videos were all taped with high level collegiate athletes. PLAYTE also includes a recipe library to help provide teen athletes with easy to make meals. Finally, PLAYTE has a space where athletes can track their meals and snacks using the ‘plate-based method’ by moving around sliders on a screen to mark down their protein, grain, fruit and vegetable intake. Each meal and snack entry asks an athlete to reflect on their mood, energy, and hunger, which helps them figure out what foods work well for them. Overall, PLAYTE is a nutrition resource that can be tailored to the unique needs of different athletes in different high schools.   

 

Impact

PLAYTE has already caught the attention of several local schools in the Greater Vancouver Area. At this time, we are working closely with these schools to test the usefulness of PLAYTE for high school athletes. We have also formed new partnerships with national level organizations to help us reach even more athletes. By doing this, we can gain a better understanding of how to support schools in taking up PLAYTE.   

 

Potential Influence

PLAYTE has the potential to help improve high school athletes’ health, well-being and performance. This is because teens who participate in high school sports have elevated nutrient needs and face unique pressures over their bodies that can make food choice difficult to navigate. When athletes do not meet their nutrient needs, they are more likely to get injured and perform worse, or even drop out, from sports. As there are no current resources in place in high school across British Columbia or Canada to help these athletes figure out what to eat, PLAYTE has the potential to fill a critical gap in high schools. 

 

Next Steps

PLAYTE is actively recruiting high school athletes to test out the app’s usability and safety. These athletes represent a wide range of sports, ages, ethnic backgrounds, schools, sexes and genders. This information is important in helping to improve features of PLAYTE to make sure all athletes can benefit as much as possible from using the app.  

 

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