Article Text

Download PDFPDF
45 Reducing peer violence and depressive symptoms among at-risk youth through an ed-initiated text-message intervention
  1. Megan Ranney1,
  2. Sarah Pittman1,
  3. Shira Dunsiger2,3,
  4. Kate Guthrie2,3,
  5. Anthony Spirito4,
  6. Edward Boyer5,
  7. Rebecca Cunningham6
  1. 1US Dept of Emergency Medicine, Brown University
  2. 2US Centres for Behavioural and Preventive Medicine, The Miriam Hospital
  3. 3US Alpert Medical School of Brown University
  4. 4US Department of Psychiatry and Human Behaviour, Brown University
  5. 5US Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard University
  6. 6US Department of Emergency Medicine, University of Michigan


Purpose To evaluate feasibility and acceptability, obtain preliminary efficacy data, and evaluate predictors of improvement with iDOVE, a brief in-person +longitudinal text-message violence and depression prevention intervention for high-risk adolescents seen in the emergency department (ED).

Methods A pilot randomised controlled trial was conducted with English-speaking adolescents (ages 13 to 17), presenting to the ED for any reason, who reported past-year physical peer violence and current depressive symptoms. The CBT- and MI-based intervention consisted of a brief, computer-guided in-ED intervention; and 8 weeks of daily, automated text-message mood queries and daily, automated text-message curriculum (tailored based on daily mood and baseline gender and violence). Follow-up surveys (including CTS-2, BDI-2, and qualitative questions) were administered at 8 and 16 weeks. Descriptive statistics, mixed effects longitudinal regression models, and latent class models were calculated.

Results iDOVE had high acceptability and feasibility: 86% of eligible youth consented, 95% completed 8 week follow-up, and 91% completed 16 week follow-up. High quantitative and qualitative satisfaction was reported by both intervention and control participants. The intervention had high engagement (96% of intervention group responded to at least 1 daily query, with a mean of 47/56 daily responses per participant [84% of days]). Comparing intervention to control, improved depressive symptoms (p=0.07) and physical peer violence (p=0.01) were observed among the more symptomatic youth in the intervention group (but no difference in symptoms between the full intervention and control groups) at 8 weeks. Latent class modelling showed that lower mood (measured through daily text-messages) at day 7 of the intervention correlated with no improvement in symptoms at 8 week follow-up.

Conclusion and Significance This pilot RCT of an innovative technology-augmented intervention shows high feasibility and acceptability, a promising signal of reduced violence and depressive symptoms among the highest-risk participants, and a potential marker of non-response for future adaptive interventions.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.