TY - JOUR
T1 - A mixed methods evaluation of a pilot open trial of a mentor-guided digital intervention for youth anxiety
AU - Wolfe, Emma C.
AU - Werntz, Alexandra
AU - Michel, Audrey
AU - Zhang, Yiyang
AU - Rucker, Mark
AU - Boukhechba, Mehdi
AU - Barnes, Laura E.
AU - Rhodes, Jean E.
AU - Teachman, Bethany A.
N1 - Publisher Copyright:
Copyright: © 2026 Wolfe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2026/2
Y1 - 2026/2
N2 - Digital mental health interventions (DMHIs), such as cognitive bias modification for interpretations (CBM-I), offer promise for increasing access to anxiety treatment among underserved adolescents, but data regarding their efficacy are mixed. Paraprofessionals and other caring adults in youth’s lives, such as non-parental adult mentors, may be able to support the use of DMHIs and increase teen engagement. The present mixed methods evaluation of a pilot open trial tested the feasibility, acceptability, and preliminary efficacy of implementing MindTrails Teen (an app-based, youth-adapted version of the web-based MindTrails CBM-I intervention) within mentor/mentee dyads. Thirty participants (composed of 15 dyads) participated in remote data collection for 5 weeks. A subset of participants (n=7 mentors; n=7 mentees) also provided qualitative feedback. Intervention outcomes (change in anxiety symptoms, and positive and negative interpretation bias), feasibility, and acceptability were assessed via a mix of qualitative interviews, quantitative change in questionnaire scores, and program completion and fidelity metrics. Outcomes were compared to pre-registered benchmarks. Large effect sizes were observed for changes in anxiety among youth. Small to medium effects were observed for change in positive interpretation bias, and no change was found for negative interpretation bias. Intervention outcomes should be considered with caution given very low internal consistency of the interpretation bias measure and the lack of a control comparison group. Acceptability of the intervention was rated positively by mentors and youth. Feasibility benchmarks were met for mentors but not for youth. Qualitative feedback indicated mentors perceived the app as helpful to their mentees, found that it either improved or did not affect their relationship, but also identified implementation challenges. Youth overall perceived the app as helpful but identified barriers to engagement.
AB - Digital mental health interventions (DMHIs), such as cognitive bias modification for interpretations (CBM-I), offer promise for increasing access to anxiety treatment among underserved adolescents, but data regarding their efficacy are mixed. Paraprofessionals and other caring adults in youth’s lives, such as non-parental adult mentors, may be able to support the use of DMHIs and increase teen engagement. The present mixed methods evaluation of a pilot open trial tested the feasibility, acceptability, and preliminary efficacy of implementing MindTrails Teen (an app-based, youth-adapted version of the web-based MindTrails CBM-I intervention) within mentor/mentee dyads. Thirty participants (composed of 15 dyads) participated in remote data collection for 5 weeks. A subset of participants (n=7 mentors; n=7 mentees) also provided qualitative feedback. Intervention outcomes (change in anxiety symptoms, and positive and negative interpretation bias), feasibility, and acceptability were assessed via a mix of qualitative interviews, quantitative change in questionnaire scores, and program completion and fidelity metrics. Outcomes were compared to pre-registered benchmarks. Large effect sizes were observed for changes in anxiety among youth. Small to medium effects were observed for change in positive interpretation bias, and no change was found for negative interpretation bias. Intervention outcomes should be considered with caution given very low internal consistency of the interpretation bias measure and the lack of a control comparison group. Acceptability of the intervention was rated positively by mentors and youth. Feasibility benchmarks were met for mentors but not for youth. Qualitative feedback indicated mentors perceived the app as helpful to their mentees, found that it either improved or did not affect their relationship, but also identified implementation challenges. Youth overall perceived the app as helpful but identified barriers to engagement.
UR - https://www.scopus.com/pages/publications/105030719038
UR - https://www.scopus.com/pages/publications/105030719038#tab=citedBy
U2 - 10.1371/journal.pdig.0001187
DO - 10.1371/journal.pdig.0001187
M3 - Article
C2 - 41729998
AN - SCOPUS:105030719038
SN - 2767-3170
VL - 5
JO - PLOS Digital Health
JF - PLOS Digital Health
IS - 2 February
M1 - e0001187
ER -