Civic Engagement Intervention for Mental Health Wellness

(I-ACTED Trial)

Overseen By Parissa J. Ballard, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Wake Forest University Health Sciences

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

2500 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Participating in Action Civics program for mental health wellness?

Research on similar citizenship interventions shows they can improve quality of life and reduce substance use for people with serious mental illness, although some negative effects like increased anxiety were noted. Additionally, a school-based civic empowerment program showed a small improvement in physical health, suggesting that civic engagement can have positive health impacts. ^{1 2 3 4 5}

Is the Civic Engagement Intervention for Mental Health Wellness safe for participants?

Research suggests that participating in civic engagement programs like Generation Citizen is generally safe and may even have positive effects on physical health, especially for those with lower civic self-efficacy (confidence in their ability to engage in civic activities). ^{3 6 7 8 9}

How does the Civic Engagement Intervention for Mental Health Wellness treatment differ from other treatments for mental health?

This treatment is unique because it focuses on engaging young people in civic activities, which can enhance their sense of empowerment and community involvement, potentially improving their mental health. Unlike traditional mental health treatments that may involve medication or therapy, this approach uses civic participation to promote well-being and self-efficacy. ^{3 6 10 11 12}

What is the purpose of this trial?

The purpose of this research is to understand how participating or not participating in an action civics curriculum may affect the health and wellbeing of young people. Participants will be chosen from students who attend certain schools that choose to participate in the action civics curriculum. Participation in this research involves completing surveys during class time in the Spring and Fall 2021-2022 semesters and then completing online surveys outside of class in the future.

Research Team

Parissa J Ballard, PhD

Principal Investigator

Assistant Professor

Eligibility Criteria

This trial is for middle or high school students enrolled in a course with a teacher from a school that's participating in the study. It's designed to see how being involved in an action civics curriculum impacts their health and wellbeing.

Inclusion Criteria

I am a student in Middle or High School.

Enrolled in a course with a teacher from a school participating in the study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants engage in the Action Civics program, which includes choosing a local issue, learning strategies for civic action, and implementing an action plan.

Spring and Fall 2021-2022 semesters

In-class participation

Follow-up

Participants complete online surveys to assess health and wellbeing outcomes.

1 year following baseline

Online surveys

Long-term Follow-up

Participants are monitored for long-term effects on health and wellbeing.

1 year following baseline

Treatment Details

Interventions

• Participating in Action Civics program
• Participating in Generation Citizen's action civics program

Trial Overview The I-ACTED study is testing whether taking part in an Action Civics program can influence young people's mental wellness, social interactions, and attitudes towards health. Students will complete surveys during class time and online at later dates.

Participant Groups

Group I: Action Civics program Experimental Treatment 1 Intervention

Students in this arm will take part in an Action Civics (AC) program. AC delivers action civics programming to young people from diverse backgrounds nationwide. AC offers a school-based action civics curriculum in which classes collectively choose a local issue, learn strategies and skills for taking civic action, develop an action plan, and take action on their selected local issue. Students, as a class, tackle topics ranging from health-related (e.g., health of school lunches) to safety-related (e.g. lack of crosswalks) to community social issues (e.g., community-police relations).

Group II: No Action Civics program Active Control 1 Intervention

Students in this arm will receive no intervention.

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials

1,432

Recruited

2,506,000+

Robert Wood Johnson Foundation

Collaborator

Trials

161

Recruited

697,000+

Findings from Research

The citizenship intervention significantly improved quality of life and reduced substance use among 114 adults with serious mental illness and criminal justice involvement over a four-month period.

While the intervention had positive effects, it also led to increased anxiety, depression, and negative symptoms at 12 months, indicating a need for ongoing support after the intervention ends.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Citizenship Project part II: impact of a citizenship intervention on clinical and community outcomes for persons with mental illness and criminal justice involvement. Clayton, A., O'Connell, MJ., Bellamy, C., et al.[2013]

The evaluation of a national training program for patient and public involvement (PPI) in mental health services showed that participants reported significant learning gains, with an average score of 3.97 out of 5, indicating very good to excellent outcomes.

The training emphasized the importance of co-production among all stakeholders, including service users and health professionals, to effectively design and deliver PPI initiatives, highlighting the need for collaboration in mental health service development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a national training programme to support engagement in mental health services: Learning enablers and learning gains. Frawley, T., Carroll, L., Casey, M., et al.[2020]

Participation in the Generation Citizen program led to a small but statistically significant improvement in self-reported physical health among 364 middle and high school students, although there was no significant change in mental health.

The program's benefits appeared to be more pronounced for students with lower civic self-efficacy, suggesting that empowering youth in civic engagement can enhance their health outcomes, particularly for those who may initially feel less capable in contributing to their communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can a school-based civic empowerment intervention support adolescent health? Ballard, PJ., Cohen, AK., Duarte, CDP.[2020]

A study involving 111 patients from 36 multidisciplinary care networks found that higher perceived patient involvement is positively associated with greater satisfaction and empowerment in mental health care.

Demographic factors had little impact on satisfaction or empowerment, except that men reported higher empowerment scores than women, highlighting the importance of patient involvement in improving mental health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is perceived patient involvement in mental health care associated with satisfaction and empowerment? Tambuyzer, E., Van Audenhove, C.[2021]

The citizenship framework emphasizes the importance of social inclusion and participation for individuals with mental illnesses, highlighting the need for access to resources and recognition of rights within society.

Research on citizenship in mental health care focuses on both individual experiences and broader social-environmental factors, suggesting that community psychology plays a crucial role in promoting the social integration of people with mental health challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Citizenship and Community Mental Health Care. Ponce, AN., Rowe, M.[2022]

Civic engagement among adolescents and young adults is linked to significant health and developmental benefits, highlighting its importance in their lives.

Providers can play a crucial role in fostering civic engagement by identifying issues that matter to youth and connecting them with community resources and opportunities for participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Civic Engagement to Empower Young People to Impact Health and Well-Being. Korich, F., Fields, EL.[2023]

Volunteering is the most common form of civic engagement among California high school students, but Latino teens and those from low-income families participate at lower rates.

Increased civic engagement is linked to better health outcomes, improved academic performance, and a higher likelihood of attending college, suggesting that promoting such activities could support healthier adolescent development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Civic Engagement Among California High School Teens. Babey, SH., Wolstein, J.[2021]

The health citizenship movement encourages active participation from both healthy individuals and those with illnesses in discussions with researchers, industry, and regulators.

This movement aims to create a collaborative platform that enhances communication and engagement in health-related research and policy-making.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rx for Innovation: A path forward for us all. Anderson, M.[2018]

This study aims to explore how youth with mental health challenges experience citizenship and its impact on their recovery, using a mixed methods approach that includes both quantitative surveys and qualitative interviews.

The research will identify predictors of citizenship and assess the extent to which youth are receiving care that promotes their sense of belonging, potentially leading to the development of more citizenship-oriented healthcare practices in Canada.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Mixed Methods Study Examining Citizenship Among Youth With Mental Health Challenges. Jordan, G., Burke, L., Bailey, J., et al.[2023]

A civic engagement training program implemented at an alternative school successfully increased students' awareness of social and political issues, leading to greater civic participation and advocacy skills.

Students reported a desire to share their newfound knowledge and experiences with their peers and families, indicating a positive impact on their understanding of citizenship and voting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Civic engagement training at a school for youth with a history of dropping out. Balcazar, FE., Garcia, M., Venson, S.[2023]

Civic engagement (CE) can significantly improve mental health services in South East Asia, but it is crucial to adapt Western models to fit local cultures and values for successful implementation.

The review identified four key mechanisms that influence the effectiveness of CE in mental health, highlighting the importance of community-level approaches and addressing barriers like stigma and distrust in services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing civic engagement within mental health services in South East Asia: a systematic review and realist synthesis of current evidence. James, K., Brooks, H., Susanti, H., et al.[2022]

A study of 621 noncollege young adults found that civic engagement is linked to improved well-being, with civic efficacy and meaning acting as important mediators in this relationship.

Different types of civic engagement, such as activism and online participation, have varying impacts on well-being, suggesting that tailored support and resources are needed to help young adults effectively engage in civic activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Civic engagement and well-being among noncollege young adults: Investigating a mediation model. Fenn, N., Yang, M., Pearson-Merkowitz, S., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

The Citizenship Project part II: impact of a citizenship intervention on clinical and community outcomes for persons with mental illness and criminal justice involvement. [2013]

2. England pubmed.ncbi.nlm.nih.gov

Evaluation of a national training programme to support engagement in mental health services: Learning enablers and learning gains. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Can a school-based civic empowerment intervention support adolescent health? [2020]

4. England pubmed.ncbi.nlm.nih.gov

Is perceived patient involvement in mental health care associated with satisfaction and empowerment? [2021]

5. England pubmed.ncbi.nlm.nih.gov

Citizenship and Community Mental Health Care. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Civic Engagement to Empower Young People to Impact Health and Well-Being. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Civic Engagement Among California High School Teens. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Rx for Innovation: A path forward for us all. [2018]

9. Switzerland pubmed.ncbi.nlm.nih.gov

A Mixed Methods Study Examining Citizenship Among Youth With Mental Health Challenges. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Civic engagement training at a school for youth with a history of dropping out. [2023]

11. England pubmed.ncbi.nlm.nih.gov

Implementing civic engagement within mental health services in South East Asia: a systematic review and realist synthesis of current evidence. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Civic engagement and well-being among noncollege young adults: Investigating a mediation model. [2023]