Background: In the United States, millions of adolescents report poor mental health, where 1 in 5 teenagers considers suicide. Reducing stigma and fostering peer support remains critical for positive mental health interventions and programs. Increasingly, digital mental health tools have emerged with great promise, leveraging social networks. Despite the potential, limited understanding of such comprehensive programs and their implementation exist. Objective: The objective of this study investigates a piloted digital mental health training program (Be Present) for youth, specifically describing the impact on youth behavioral outcomes and user engagement and identifying high-risk youth in the early phases of prevention. Methods: Eligibility included Ohio residents (aged 14 to 22 years) to be enrolled as either a Friend or a Peer Advocate. From May 1 to June 1, 2019, participants completed the Advocate training course, taking pretest and posttest surveys. Single-arm descriptive analyses measured youth outcomes (self-efficacy, intentions, behaviors, social support, knowledge, and sources of strength) and engagement and assessed risk based on survey responses. Results: A total of 65 adolescents participated, with 54 completing both pretest and posttest surveys. The majority of participants included non-Hispanic White females. Findings illustrated a significant increase in self-report of referrals for mental health services as well as in perceptions that youth had of experiencing social support; however, no significant differences were found for measures of self-efficacy, knowledge, and sources of strength between pretest and posttest surveys. Roughly two-thirds of the participants completed all of the Advocate training modules, and we observed a gradual decline in engagement. Most respondents who received escalated high-risk response messages identified as female. Conclusions: The pilot presented promise for implementing a digital mental health program focused on peer support, specifically observing reported youth behavioral outcomes and user engagement and identifying high-risk youth. Various limitations exist given the small nonrepresentative sample and lack of control group. All findings should be considered preliminary to a larger trial and underscore the feasibility of delivering online training programs to bolster adolescent mental health. Such formative evaluation proved critical for future implementation and research, offering opportunity for substantial improvements for real-world digital mental health programs.

中文翻译：

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为俄亥俄州青年实施同伴倡导者心理健康数字干预计划：描述性试验研究

背景：在美国，数百万的青少年报告其心理健康状况不佳，其中五分之一的青少年认为自杀。对于积极的精神卫生干预措施和计划，减少耻辱感并促进同伴的支持仍然至关重要。利用社交网络，越来越多的数字心理健康工具应运而生。尽管潜力很大，但对此类综合计划及其实施的理解仍然有限。目的：本研究的目的是调查针对青少年的数字心理健康培训试点计划（现阶段），特别描述对青少年行为结果和用户参与的影响，并在预防的早期阶段识别高危青少年。方法：参加资格的俄亥俄州居民（14至22岁）可以作为朋友或同伴倡导者参加。从2019年5月1日至6月1日，参与者完成了倡导者培训课程，并进行了前测和后测调查。单臂描述性分析测量了青年的结局（自我效能，意图，行为，社会支持，知识和力量来源）和敬业度，并根据调查结果评估了风险。结果：共有65名青少年参加，其中54名完成了测试前和测试后的调查。大多数参与者包括非西班牙裔白人女性。研究结果表明，转介精神保健服务的自我报告显着增加，以及对青年人正在获得社会支持的看法；然而，在测验前和测验后的自我效能，知识和力量来源的测量上均未发现显着差异。大约三分之二的参与者完成了所有倡导者培训模块，并且我们发现参与度逐渐下降。收到逐步升级的高风险响应消息的大多数受访者被确定为女性。结论：试点项目为实施以同伴支持为重点的数字心理健康计划提供了希望，特别是观察报告的青年行为结果和用户参与度，并确定高风险青年。考虑到样本量少且缺乏对照组，存在各种局限性。所有调查结果应被认为是较大规模试验的初步结果，并强调提供在线培训计划以增强青少年心理健康的可行性。事实证明，这种形成性评估对于未来的实施和研究至关重要，为实际数字精神卫生计划的实质性改进提供了机会。