The Ethical Implications of Using Social Media to Engage and Retain Justice-Involved Youth in Behavioral Health Research

Given its popularity among youth ages 13–17, social media is a promising avenue for engaging and retaining historically hard-to-reach youth in longitudinal research. Social media use in longitudinal research involving youth, however, has preceded development of best practices for ethical use. This article describes the ethical challenges and considerations of using social media to engage and retain youth within the context of a randomized controlled trial of a group-based adolescent substance use intervention. Best practices for addressing ethical challenges are also provided using the Belmont Principle as a guiding framework. As social media becomes more commonly used to engage and retain youth in clinical research studies, researchers must address emerging ethical concerns within project protocols.

Disaster Behavioral Health Research Involving Military Facilities and Populations after Mass Violence: Insights from the 2013 Washington Navy Yard Shooting

Research on disaster behavioral health presents significant methodological challenges. Challenges are even more complex for research on mass violence events that involve military members, families, and communities, due to the cultural and logistical considerations of working with this population. The current article aims to inform and educate on this specialized area of research, by presenting a case study on the experience of designing and conducting disaster behavioral health research after a mass violence event in a military setting: the 2013 mass shooting at the Washington Navy Yard, in Washington, D.C. Using the case example, the authors explore methodological challenges and lessons learned from conducting research in this context, and provide guidance for future researchers.

Accelerating the conceptual use of behavioral health research in juvenile court decision-making: study protocol

Background The youth criminal-legal system is under heavy political scrutiny with multiple calls for significant transformation. Leaders within the system are faced with rethinking traditional models and are likely to benefit from behavioral health research evidence as they redesign systems. Little is known about how juvenile court systems access and use behavioral health research evidence; further, the field lacks a validated survey measure of behavioral health research use that can be used to evaluate the effectiveness of evidence dissemination interventions for policy and system leaders. Conceptual research use is a particularly salient construct for system reform as it describes the process of shifting awareness and the consideration of new frameworks for action. A tool designed to measure the conceptual use of behavioral health research would advance the field’s ability to develop effective models of research evidence dissemination, including collaborative planning models to support the use of behavioral health research in reforms of the criminal-legal system. Methods The ARC Study is a longitudinal, cohort and measurement validation study. It will proceed in two phases. The first phase will focus on measure development using established methods of construct validity (theoretical review, Delphi methods for expert review, cognitive interviewing). The second phase will involve gathering responses from the developed survey to examine scale psychometrics using Rasch analyses, change sensitivity analyses, and associations between research use exposure and conceptual research use among juvenile court leaders. We will recruit juvenile court leaders (judges, administrators, managers, supervisors) from 80 juvenile court jurisdictions with an anticipated sample size of n = 520 respondents. Discussion The study will introduce a new measurement tool for the field that will advance implementation science methods for the study of behavioral health research evidence use in complex policy and decision-making interventions. To date, there are few validated survey measures of conceptual research use and no measures that are validated for measuring change in conceptual frameworks over time among agency leaders. While the study is most directly related to leaders in the youth criminal-legal system, the findings are expected to be informative for research focused on leadership and decision-making in diverse fields.

A scoping review of patient-facing, behavioral health interventions with voice assistant technology targeting self-management and healthy lifestyle behaviors

Engaging in positive healthy lifestyle behaviors continues to be a public health challenge, requiring innovative solutions. As the market for voice assistants (Amazon Alexa, Google Assistant, and Apple Siri) grows and people increasingly use them to assist their daily tasks, there is a pressing need to explore how voice assistant (VA) technology may be used in behavioral health interventions. A scoping review of literature was conducted to address a PICO (Population, Intervention, Comparison, and Outcome) question: across populations, how does the use of voice assistants in behavioral health research/interventions influence healthy lifestyle behaviors versus control or comparison interventions? To inform the science, a secondary aim of this review was to explore characteristics of VAs used in behavioral health research. The review was conducted following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines with scoping review extension (PRISMA-ScR). Ten studies satisfied the inclusion criteria, representing research published through February 2019. Studies spanned pediatric to elderly populations, covering a vast array of self-management and healthy lifestyle behaviors. The majority of interventions were multicomponent, involving more than one of the following behavior change techniques grouped by cluster: shaping knowledge, self-belief, repetition and substitution, feedback and monitoring, goals and planning, antecedents, natural consequences, comparison of behavior, and identification. However, most studies were in early stages of development, with limited efficacy trials. VA technology continues to evolve and support behavioral interventions using various platforms (e.g., Interactive Voice Response [IVR] systems, smartphones, and smart speakers) which are used alone or in conjunction with other platforms. Feasibility, usability, preliminary efficacy, along with high user satisfaction of research adapted VAs, in contrast to standalone commercially available VAs, suggest a role for VAs in behavioral health intervention research.

Increasing the Number of Underrepresented Minority Behavioral Health Researchers Partnering With Underresourced Communities: Lessons Learned From a Pilot Research Project Program

To address critical health equity issues facing racially and ethnically diverse populations, it is essential to have researchers from similarly diverse backgrounds. Such researchers provide different perspectives that may lead to distinct research questions, novel interpretation of findings, and innovative recommendations for health promotion practice. There is a continuing need to increase the number of researchers leading health research studies who are from underrepresented minority populations (URMs). The literature demonstrates the effectiveness of mentoring for career development and the need to hone existing mentoring models. The TREE Center developed an innovative model for building capacity among early stage investigators, with a focus on URMs, to increase the inclusivity of the research pipeline. Our model involves community-engaged behavioral health research mentoring, career development, training for grantspersonship, and guidance for manuscript development and submission. A pilot project program provided opportunities for 10 early stage investigators to develop relationships with public health practitioners and other community partners, to obtain funding, to manage a complex pilot research project, and to generate preliminary data. Awardees worked with an academic mentor, a community mentor, and TREE Center faculty to conduct and disseminate their research. Lessons learned include the need to account for funding cycle timing, address challenges of recruiting URMs, consider overutilization of senior URM mentors, and overcome institutional bureaucracies that hinder transdisciplinary research across campuses. We discuss strategies for addressing these challenges. Our model is replicable and could be implemented, especially by academic programs interested in cultivating early stage URM investigators to conduct behavioral health research.

mHealth Research Applied to Regulated and Unregulated Behavioral Health Sciences

Behavioral scientists are developing new methods and frameworks that leverage mobile health technologies to optimize individual level behavior change. Pervasive sensors and mobile apps allow researchers to passively observe human behaviors “in the wild” 24/7 which supports delivery of personalized interventions in the real-world environment. This is all possible because these technologies contain an incredible array of sensors that allow applications to constantly record user location and can contextualize current environmental conditions through barometers, thermometers, and ambient light sensors and can also capture audio and video of the user and their surroundings through multiple integrated high-definition cameras and microphones. These tools are a game changer in behavioral health research and, not surprisingly, introduce new ethical, regulatory/legal and social implications described in this article.

Patients as Agents in Behavioral Health Research and Service Provision: Recommendations to Support the Learning Health System

Authentic inclusion and engagement of behavioral health patients in their care delivery and in the process of scientific discovery are often challenged in the health care system. Consequently, there is a growing need to engage with and better serve the needs of behavioral health patients, particularly by leveraging health information technologies. In this work, we present rationale and strategies for improving patient engagement in this population in research and clinical care. First, we describe the potential for creating meaningful patient–investigator partnerships in behavioral health research to allow for cocreation of knowledge with patients. Second, in the context of behavioral health services, we explore the utility of sharing clinical notes to promote patients' agency in care delivery. Both lines of inquiry are centered in a Learning Health System model for behavioral health, where patients are agents in enhancing the therapeutic alliance and advancing the process of knowledge generation. Recommendations include genuinely democratizing the health care system and biomedical research enterprise through patient-centered information technologies such as patient portals. In research and technology development, we recommend seeking and tailoring behavioral health patients' involvement to their abilities, promoting patient input in data analysis plans, evaluating research and informatics initiatives for patients and clinicians, and sharing success and research findings with patients. In clinical practice, we recommend encouraging patients to read behavioral health notes on portals, engaging in proactive communication regarding note content, assessing outcomes including stress and anxiety in response to note content, and working with technology providers to support note-sharing governance and deployment.