Designing an Implementation Strategy for Delivering Routine Mental Health Screening and Treatment for Adolescents and Adults With Sickle Cell Disease

Study point of contact

Jude Jonassaint, RN
[email protected]
Sophy J Perdomo, PhD
[email protected]


1 United States site


16 to 30 Years



Study type








About the study

African Americans living with chronic health conditions are more likely to experience
depression and other mental health disorders than their healthy counterparts, and are more
likely to experience severe depression than whites, but less likely to be diagnosed or
receive treatment. One especially vulnerable group is patients with sickle cell disease
(SCD), a genetic blood disorder that primarily affects people of African descent, many of
whom live in disadvantaged circumstances and are cared for in under-resourced settings. SCD
causes severe acute and chronic pain, end-organ damage, and early mortality. Patients
transitioning from adolescence to adulthood (ages16-30) are at high risk for mental health
disorders and suicide.

Using mobile technology, the investigators can provide high-quality, evidence-based
behavioral mental health treatment that reaches patients in different settings. Digital
cognitive behavioral therapy (CBT) is effective for treating depression and anxiety and can
be brought to scale at low cost. Despite the promise of digital CBT, there are barriers to
its widespread use, particularly in low-resource settings serving minorities. Qualitative
data show that cultural factors-lack of relatability, representation, and perceived stigma
regarding mental health treatment-limit engagement with digital CBT programs. Population-and
setting-specific adaptations to interventions can lead to their successful implementation and
wider use. The investigators will work with a digital CBT program to decrease stigma and make
it more relatable and relevant to young adults with SCD, by devising changes to advertising
and promotion, and tailoring communication with an integrated health coach, Aim 1: Use
implementation science (ImS) and human-centered design methods to define the barriers to
delivering routine mental health screening and digital CBT to adolescents and young adults
with SCD. Aim 2: Rapidly iterate, test, and evaluate adaptations to the implementation
strategy for a coach-enhanced digital mental health service. Aim 3: Demonstrate that a
population-specific implementation strategy improves engagement with a digital CBT-based
mental health service.

The investigators will capitalize on our mobile technology tools, interdisciplinary
expertise, and community-based partnerships to investigate the implementation of digital CBT
into low-resource clinics and community-based organizations serving adolescents and adults
with sickle cell disease.

participation requirements

– have a diagnosis of SCD (any genotype)

– report significant depression or anxiety symptoms (i.e., Patient Health Questionnaire
[PHQ-9] or Generalized Anxiety Disorder Scale [GAD-7] > 10)

participation restrictions

– Unable to read English or understand the consent process

– Cognitively impaired adults as determined by their treating physician

– Any condition that in the opinion of the investigator would not allow the patient to
continue on the study


  • Pittsburgh, Pennsylvania, United States, University of Pittsburgh Medical Center, 15213