Helped in developing and presenting on our lessons learned from implementing an adolescent-focused RCT in a mental health setting. This presentation was developed on the intervention, Practice Self-Regulation, and it's evaluation in the Teen Health Study. The presentation focused on our low enrollment numbers and the steps we took to improve them. This was presented at the 2018 Adolescent Health Initiative Conference.

1. N OVEMBER 9 T H , 2 01 7
STEPHANIE HALL
JANICE MCFARLANE
ALETHIA GREGORY
T HE POL I CY & R ESEAR CH GR OU P
DONNA LUCERO
AL L FAI T HS
Lessons Learned from Implementing
an Adolescent-focused RCT
in Mental Health Settings

2. Federal Funding Acknowledgementand Disclaimer
The project described was supported by the
Office of Adolescent Health. Its contents are
solely the responsibility of the authors and do not
necessarily represent the official views of HHS.

3. Teen Health Study
• Purpose
 Evaluate effectiveness of innovative teen pregnancy
prevention program
 Program Partners:
 Office of Adolescent Health (OAH)
 The Policy & Research Group
 Joann Schladale, Resources for Resolving Violence
 Trained Master’s level therapists

4. Study Overview
 Randomized controlled trial
 Therapy intervention
 Target population
 14-19 year-old who have experienced trauma
 Setting
 Mental health clinics or private practitioner
 Total enrollment goal: 600 participants
 Implementation regions
 California, New Mexico, Maine, Michigan, Louisiana

5. Intervention Overview
 Intervention: Practice Self-Regulation (PS-R)
 Purpose
 Increase self-regulation and change behavior to
achieve desired outcomes
 Implementation structure
 10 sessions implemented over 18 weeks
 Roughly one session per week
 Extra weeks to allow for missed appts. or other
issues

6. Mental Health Setting
 Research in a mental health setting
 All Faiths: partner implementation site
 Mental health clinic serving children and young
adults
 Therapist challenges
 Providing the full PS-R intervention within the 18-
week intervention period
 Only providing PS-R to youth assigned to
treatment group

7. Key Challenge
 Low enrollment
 Barriers to enrollment
 Ambivalence of agency therapists towards study
 Low caseload turnover rates
 Turnover among therapists at agencies
 Unrealistic recruitment targets per therapist

8. Solutions
 Increase number of therapists trained in PS-R
 Shift the focus to private practitioners
 Introduced MOU’s
 Applications
 Assessed caseloads of practitioners
 Expand study to additional states
 New states: Maine, Louisiana, and California
 Incentivize therapists
 Training stipends and CEUs

9. Data Monitoring
 Examined enrollment patterns
 Determined that we need 100 therapists to
each enroll at least 4 participants into the
study over an 18-month period
 Monitor therapist to participant ratio weekly
 Monitor monthly enrollment targets
 Monitor fidelity of PS-R implementation

10. Emerging Challenges and Lessons
 Decentralized data collection
 PDF forms, check-in emails, remote management
 Increased costs
 Training
 Time managing more therapists
 Administration of contracts

11. Emerging Challenges and Lessons (cont.)
 Decentralized communication and decision
making
 No oversight/accountability
 Improved communication and flexibility
 Keeping therapists engaged after initial
enrollments

12. Current Status of Study
 Outcome: enrollment significantly increased
 56 youth enrolled in first 9 months of enrollment
 133 youth enrolled in the following 6 months
 Currently have 93 therapists working on project