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Completed

NCT Number: NCT03626103

Intervention to Prevent Peer Violence & Depressive Symptoms Among At-Risk Adolescents

The purpose of this investigation is to test the efficacy of "iDOVE2" (a brief emergency department introductory session and longitudinal automated text-message depression prevention program for high-risk teens), and to determine the most potent and parsimonious combination of intervention components for preventing peer violence and depressive symptoms among at-risk youth.

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Key information

Conditions

Depressive Disorder Behavior Behavioral Symptoms Depression Disease Attributes Emergencies Mental Disorders Mood Disorders Pathologic Processes Pathological Conditions, Signs and Symptoms Violence

Age range

13 year–17 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Yale New Haven Hospital, New Haven, Connecticut, United States

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About this study

Peer violence and depressive symptoms have mutual, reinforcing negative impacts on teens' emotional and behavioral regulation strategies.

The emergency department (ED) is the primary source of care for many high-risk teens. It provides an opportunity to initiate preventive interventions, to complement existing mental health treatment or to stand alone for those who may lack access to formal care. Personalized text-message interventions are accessible, feasible, and may be effective with these adolescents.

The purpose of this study is to expand on the PI's pilot randomized controlled trial (RCT) of iDOVE (K23 MH095866; PI: Ranney) by testing the efficacy of "iDOVE2" (a brief emergency department introductory session and longitudinal automated text-message depression prevention program for high-risk teens). The investigators will use a 2x2 factorial design to determine the most potent and parsimonious combination of intervention components for preventing peer violence and depressive symptoms among at-risk youth.

Participants will be identified in the course of usual clinical care in the ED. If eligible, parents will be consented and participants assented. Participants will complete a baseline assessment and will be randomized to one of four groups: Brief ED Intervention (BI) + Text; BI + No Text; No BI + Text; or No BI + No Text. Youth in the Text arm who show no signal of improvement at 7 days, per daily self-reported mood ratings, will be re-randomized to additional "LiveText" (once-weekly real-time micro-counseling via text) or to continue with standard, automated Text intervention curriculum.

At baseline and follow-ups at 2 months, 4 months, and 8 months, participants will complete assessments on depressive symptoms, violence, cognitive/behavioral skill-sets, and resource utilization.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • English-speaking
  • presenting to the emergency department for routine care
  • reporting past-year physical violence (using a modified version of The Revised Conflict Tactics Scales (CTS-2) score ≥1), as identified on a brief screen administered in the ED
  • reporting past 2-week mild-to-moderate depressive symptoms (using Patient Health Questionnaire (PHQ-9) score 5-19), as identified on a brief screen administered in the ED
  • Accompanied by a parent/guardian who is present and able to consent
  • Possession of a cell phone with text-messaging capability

Exclusion criteria

  • Chief complaint of suicidality, psychosis, sexual assault, or child abuse
  • In police or child protective services' custody (as per state law)
  • Unable to assent
  • In need of emergency psychiatric care

Treatment and study plan

+ Brief ED Intervention (BI)

Behavioral

Brief ED Intervention (BI): A 20-minute Motivational Interviewing- and Cognitive Behavioral Therapy-based in-Emergency Department session delivered by a bachelors'-level Research Assistant

+ Text

Behavioral

Text: 8 weeks of an automated, tailored, two-way text-message curriculum started after the ED visit, which reinforces cognitive reappraisal, emotional regulation, and self-efficacy skills. Those that do not show improvement in mood after 7 days will be randomized into LiveText.

Primary outcomes

  1. Conflict Tactics Scale-2, physical subset (CTS-2)

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Change from enrollment physical peer violence (score is summed, range 0 - 56)

  2. Center for Epidemiologic Studies Depression Scale Revised (CESD-R)

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Change from enrollment depressive symptoms (score is summed based on symptom group, range 0 - 80)

Secondary outcomes

  1. Change in ED Visits for Assault-Related Injury

    Time frame: 12 months before enrollment and 12 months after enrollment

    Review of hospital system-wide Electronic Medical Record and state-wide Health Information Exchange to identify ED visits for peer assault

  2. Conflict in Adolescent Dating Relationships Inventory, physical subset (CADRI)

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Change from enrollment other forms of peer violence (dating relationships)

  3. Illinois Bully Scale (IBS)

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Change from enrollment other forms of peer violence (bullying)

  4. Student School Survey

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Change from enrollment other forms of peer violence (bullying)

Other outcomes

  1. Self-Efficacy Questionnaire for Children (SEQ-C)

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Measures emotional self-efficacy (mean score)

  2. Emotional Regulation Questionnaire for Children and Adolescents (ERQ-CA)

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Measures cognitive reappraisal (score is summed, range 6 - 30)

  3. Bosworth Violence Self-Efficacy Scale

    Time frame: Enrollment, 2 months post-enrollment, 4 months post-enrollment, 8 months post-enrollment

    Measures self-rated ability to stay out of violence (mean score)

Sponsors and collaborators

Lead sponsor

Rhode Island Hospital

Other

Collaborators

  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Registry information

Official study title

A Technology-Augmented Intervention to Prevent Peer Violence & Depressive Symptoms Among At-Risk Emergency Department Adolescents

Acronym: iDOVE2

Important dates

Study start
2018
Primary completion
2025
Study completion
2025
First posted
Aug 10, 2018
Registry last updated
Apr 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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