# Expanding minority youth access to evidence-based care: A pilot effectiveness trial of a digital mental health intervention

> **NIH NIH R34** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $249,162

## Abstract

PROJECT ABSTRACT
 The prevalence of anxiety and depression are high among adolescents. COVID-19-related stressors have
increases rates of internalizing disorders and risk for suicide, especially among ethnic minority adolescents
who have been disproportionately affected by the pandemic. Although evidence-based interventions are
effective, the vast majority ethnic minority adolescents do not access any MH care. School-based MH services
can address common barriers to care such as cost and transportation. However, even with access to school-
based MH services, capacity can be highly limited in schools, and some adolescents may be reticent to seek
services at school due to concerns about privacy, judgment, and academic disruption. Innovative approaches
to provide accessible, low-cost, evidence-based MH care to minority youth are urgently needed. Technology
creates an opportunity to treat youth in need of MH services and could expand the reach of school health
services. Despite the potential impact of digital care, to date there are no studies examining whether digital
mental health interventions improve service access for vulnerable youth served by school-based mental health
services. Consistent with NIMH Notice of Information MH-18-031 designating digital health technology as a
priority, this application proposes to determine the feasibility and acceptability of delivering SilverCloud, a
clinician-guided, empirically-supported, app-based, CBT program to vulnerable adolescents through school-
based health centers (SBHCs). In contrast to most MH apps, SilverCloud has demonstrated strong
engagement and medium-to-large effect sizes. Its features, including personalized feedback, stories from
relatable peers, and routine outcome assessment, directly promote engagement. This would be the first trial to
evaluate SilverCloud as a school-based intervention and refine it to meet the needs of low income, ethnic/racial
minority youth. We propose a four-phase study conducted at two diverse, public schools in Brooklyn. In Phase
I, participants who endorse internalizing symptoms (n=20) during routine MH screening at the SBHC will
participate in an open trial of SilverCloud. In Phase II, open trial participants will provide feedback that will be
used to refine the SilverCloud program. In Phase III participants will be screened (PHQ-9/GAD-7). Those who
endorse symptoms will be randomized (N=100) to SilverCloud or treatment as usual (TAU). Outcomes will be
evaluated each semester. In Phase IV, participant and stakeholder feedback will be collected systematically to
further inform program adaptations and implementation strategy refinement for a large effectiveness trial.
Primary aims are to establish the feasibility, acceptability, and preliminary effectiveness of SilverCloud among
minority youth served through SBHCs and to examine whether SilverCloud changes engagement (i.e.,
initiation, dose) and clinical (i.e., emotion regulation, negative cognitions, coping skills...

## Key facts

- **NIH application ID:** 10867368
- **Project number:** 5R34MH130639-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** ERUM NADEEM
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $249,162
- **Award type:** 5
- **Project period:** 2023-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10867368

## Citation

> US National Institutes of Health, RePORTER application 10867368, Expanding minority youth access to evidence-based care: A pilot effectiveness trial of a digital mental health intervention (5R34MH130639-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10867368. Licensed CC0.

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