Trial Outcomes & Findings for The S.M.A.R.T. Project: Stress Management and Resilience Training for Teens (NCT NCT03270943)

NCT ID: NCT03270943

Last Updated: 2021-05-18

Results Overview

The Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric short form depression 8a: Raw Scores range from 0 - 32, with 0 being the lowest depression rating and 32 the highest depression rating. Analysis utilized t-score transformation with a population mean of 50 and standard deviation of 10. A score of 65 was used to indicate incident depression. The PROMIS measure used in lieu of the Short Mood and Feelings Questionnaire (SMFQ) due to increased measurement frequency. Higher scores indicate a greater level of depression.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

77 participants

Primary outcome timeframe

weekly for up to 36 weeks

Results posted on

2021-05-18

Participant Flow

\*Note: the first two groups (Period 1: Intervention Refinement) were not randomized. Participants enrolled in those groups received the intervention, but the intervention and logistics were adapted based on participant feedback. Hence, these participants are not included in statistical analyses.

Participant milestones

Participant milestones
Measure
Mindful Self-Compassion (MFY)
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Intervention Refinement
STARTED
6
9
Intervention Refinement
COMPLETED
6
6
Intervention Refinement
NOT COMPLETED
0
3
Randomized (Willingness to be)
STARTED
30
32
Randomized (Willingness to be)
COMPLETED
30
31
Randomized (Willingness to be)
NOT COMPLETED
0
1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The S.M.A.R.T. Project: Stress Management and Resilience Training for Teens

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Total
n=62 Participants
Total of all reporting groups
Age, Continuous
15.81 years
STANDARD_DEVIATION 1.08 • n=5 Participants
15.63 years
STANDARD_DEVIATION 0.97 • n=7 Participants
15.72 years
STANDARD_DEVIATION 1.02 • n=5 Participants
Sex: Female, Male
Female
21 Participants
n=5 Participants
22 Participants
n=7 Participants
43 Participants
n=5 Participants
Sex: Female, Male
Male
9 Participants
n=5 Participants
10 Participants
n=7 Participants
19 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
5 Participants
n=7 Participants
7 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
27 Participants
n=5 Participants
26 Participants
n=7 Participants
53 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Race (NIH/OMB)
White
19 Participants
n=5 Participants
21 Participants
n=7 Participants
40 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Region of Enrollment
United States
30 Participants
n=5 Participants
32 Participants
n=7 Participants
62 Participants
n=5 Participants
Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric short form depression 8a
52.7 T-score
STANDARD_DEVIATION 11.0 • n=5 Participants
58.1 T-score
STANDARD_DEVIATION 10.0 • n=7 Participants
55.5 T-score
STANDARD_DEVIATION 10.8 • n=5 Participants

PRIMARY outcome

Timeframe: weekly for up to 36 weeks

Population: 3 participants with high baseline scores were excluded from the analysis procedure.

The Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric short form depression 8a: Raw Scores range from 0 - 32, with 0 being the lowest depression rating and 32 the highest depression rating. Analysis utilized t-score transformation with a population mean of 50 and standard deviation of 10. A score of 65 was used to indicate incident depression. The PROMIS measure used in lieu of the Short Mood and Feelings Questionnaire (SMFQ) due to increased measurement frequency. Higher scores indicate a greater level of depression.

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=28 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=31 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Time to Incident Depression
36 weeks
Interval 0.71 to 36.0
18.86 weeks
Interval 2.86 to 36.0

SECONDARY outcome

Timeframe: Baseline, Week 8

Population: Analysis utilized multiple imputations to account for missing data.

The Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric short form depression 8a: Raw Scores range from 0 - 32, with 0 being the lowest depression rating and 32 the highest depression rating. Analysis utilized T-score transformation with a population mean of 50 and standard deviation of 10. Higher scores mean worse depression.

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Change in Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric Depression Scores
Post Intervention
51.6 T-score
Standard Error 2.46
53.6 T-score
Standard Error 2.18
Change in Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric Depression Scores
Baseline
52.7 T-score
Standard Error 2.02
58.1 T-score
Standard Error 1.77

SECONDARY outcome

Timeframe: Baseline, Week 8

Population: Analysis utilized multiple imputations (chained).

The Short Mood and Feelings Questionnaire-Child Version (SMFQ-C) is a measure of the level of depressive symptoms among youth. This analysis utilized the 13-item youth version. Items are symptoms of depression experienced over the past 2 weeks. Each item is scored on a 3-point Likert scale as follows: "True" (0), "Sometimes" (1), and "Not True" (2) with total scores of 0-26. Lower scores at each time point indicate improvement. Higher scores indicate a greater level of depression (worse outcome).

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Change in SMFQ Scores
Baseline
6.90 score on a scale
Standard Error 0.90
9.67 score on a scale
Standard Error 1.02
Change in SMFQ Scores
Post Intervention
6.26 score on a scale
Standard Error 1.35
7.95 score on a scale
Standard Error 1.05

SECONDARY outcome

Timeframe: Baseline, Week 8

Population: Analysis utilizes multiple imputations.

.The BRS defines resiliency as the ability to "bounce back" and recover from stress; the items reflect a sense of personal agency. Six items are rated on a scale from 1 (strongly disagree) to 5 (strongly agree). Scores are summed and totals divided by the number of questions answered resulting in a mean score of 1-5. Higher scores at each time point indicate increasing resilience.

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Change in Brief Resiliency Scale (BRS) Scores
Baseline
3.03 score on a scale
Standard Error 0.13
3.05 score on a scale
Standard Error 0.16
Change in Brief Resiliency Scale (BRS) Scores
8 weeks
3.26 score on a scale
Standard Error 0.17
3.40 score on a scale
Standard Error 0.19

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 36 weeks

Population: Longitudinal mixed effects model

The Short Mood and Feelings Questionnaire-Child Version (SMFQ-C) is a measure of the level of depressive symptoms among youth. This analysis utilized the 13-item youth version. Items are symptoms of depression experienced over the past 2 weeks. Each item is scored on a 3-point Likert scale as follows: "True" (0), "Sometimes" (1), and "Not True" (2) with total scores of 0-26. Lower scores at each time point indicate improvement. Higher scores indicate a greater level of depression (worse outcome). This measure was collected at baseline and at weeks 4, 8, 22, and 36.

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Trajectory of SMFQ-C Depression Score Change
Baseline
6.9 score on a scale
Standard Error 1.0
9.8 score on a scale
Standard Error 1.0
Trajectory of SMFQ-C Depression Score Change
4 weeks
7.2 score on a scale
Standard Error 1.0
8.8 score on a scale
Standard Error 1.0
Trajectory of SMFQ-C Depression Score Change
8 weeks
6.9 score on a scale
Standard Error 1.0
7.9 score on a scale
Standard Error 1.0
Trajectory of SMFQ-C Depression Score Change
22 weeks
6.6 score on a scale
Standard Error 1.2
7.3 score on a scale
Standard Error 1.1
Trajectory of SMFQ-C Depression Score Change
36 weeks
5.4 score on a scale
Standard Error 1.1
8.6 score on a scale
Standard Error 1.1

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 36 weeks

Population: Intent to treat analysis

The Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric short form depression 8a: Raw Scores range from 0 - 32, with 0 being the lowest depression rating and 32 the highest depression rating. Analysis utilized t-score transformation with a population mean of 50 and standard deviation of 10. Higher scores indicate a greater level of depression. Model predicted mean at Baseline and 36 weeks is reported based on the longitudinal mixed effects model.

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Trajectory of PROMIS Depression Score Change
Baseline
53.5 score on a scale
Standard Error 1.8
55.9 score on a scale
Standard Error 1.8
Trajectory of PROMIS Depression Score Change
36 weeks
47.5 score on a scale
Standard Error 2.0
53.9 score on a scale
Standard Error 2.0

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 36 weeks

Population: Longitudinal mixed effects model

The BRS defines resiliency as the ability to "bounce back" and recover from stress; the items reflect a sense of personal agency. Six items are rated on a scale from 1 (strongly disagree) to 5 (strongly agree). Scores are summed and totals divided by the number of questions answered resulting in a mean score of 1-5. Higher scores at each time point indicate increasing resilience. This measure was collected at baseline and at weeks 4, 8, 22, and 36.

Outcome measures

Outcome measures
Measure
Mindful Self-Compassion (MFY)
n=30 Participants
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=32 Participants
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
Trajectory of BRS Score Change
Baseline
3.03 score on a scale
Standard Error 0.15
3.05 score on a scale
Standard Error 0.15
Trajectory of BRS Score Change
4 weeks
3.22 score on a scale
Standard Error 0.15
3.10 score on a scale
Standard Error 0.15
Trajectory of BRS Score Change
8 weeks
3.36 score on a scale
Standard Error 0.16
3.28 score on a scale
Standard Error 0.15
Trajectory of BRS Score Change
22 weeks
3.01 score on a scale
Standard Error 0.18
3.41 score on a scale
Standard Error 0.17
Trajectory of BRS Score Change
36 weeks
3.65 score on a scale
Standard Error 0.17
3.38 score on a scale
Standard Error 0.16

Adverse Events

Mindful Self-Compassion (MFY)

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Healthy Lifestyles (HLG)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Mindful Self-Compassion (MFY)
n=36 participants at risk
An 8-week mindfulness self-compassion course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. MFY: Mindful Self-Compassion course for teens
Healthy Lifestyles (HLG)
n=41 participants at risk
An 8-week healthy lifestyles course for teens. 6 monthly continuation sessions will occur following completion of the 8-week course. HLG: Healthy Lifestyles course for teens
General disorders
Hospitalization for Unknown Reason
2.8%
1/36 • Number of events 1 • Collected weekly from the beginning of the intervention through the 36-week follow-up.
0.00%
0/41 • Collected weekly from the beginning of the intervention through the 36-week follow-up.

Other adverse events

Adverse event data not reported

Additional Information

Christine Lathren, MD, MPH

University of North Carolina at Chapel Hill

Phone: 919-966-8586

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place