(PS5-D83) Adaptation of an Online Single-session Intervention for Greek Adolescents During the COVID-19 Pandemic

Background: The COVID-19 pandemic saw a spike in symptoms of depression and anxiety among Greeks including adolescents (Kornilaki et al., 2021; Giannopoulou et al., 2021). Mental health centers are understaffed or shut down and despite the transition to telemedicine, many discontinued treatment (Giannopoulou & Tsobanoglou, 2020). Given this gap in services, it is an epidemiological imperative to develop and adapt low-cost evidence-based interventions to promote the mental health of Greek youth. Our study had 3 objectives: a) to adapt an online single-session intervention (SSI) that is culturally-sensitive to Greek adolescents’ needs, b) to conduct a preliminary randomized controlled trial to assess the SSI’s perceived utility, acceptability, and appropriateness, c) to assess the impact of the SSI on secondary control.

Method: The SSI, adapted based on previous work conducted in youth (Wasil et al., 2021), included 4 evidence-based modules: cognitive restructuring, gratitude, behavioral activation, self-compassion. We conducted multiple iterations of revisions to include all stakeholders (e.g., schools), including adapting the module content, translating, and piloting the SSI. Participants were randomized to the SSI (n = 109) or an active control (n = 121) group. Acceptability and appropriateness (measures: Acceptability of Intervention Measure [AIM], Intervention Appropriateness Measure [IAM]) were assessed after completion of all modules for both conditions. Perceived utility (PU) was assessed after each module, using 3 items to assess helpfulness, engagement, and applicability. Secondary control was measured by the Secondary Control Scale (SCS-3) pre-post intervention.

Analysis: Because the ratings on the 3 PU items demonstrated high internal consistencies (as > .78), we used their means. Overall acceptability, appropriateness, and PU of the SSI and the control were determined by operationalizing mean AIM/IAM/Perceived Utility scores > 3 (Schleider et al., 2020; Wasil et al., 2021). To compare pre-post changes in secondary control, we used hierarchical linear models. The model included time, condition, the time*condition interaction term, and a random intercept for participant ID.

Results: All modules were endorsed as useful by the majority of the sample; 58.2% endorsed the behavioral activation module as useful, 60.6% the gratitude module, 78.3% the self-compassion module, and 59.3% the cognitive restructuring module. The SSI was deemed acceptable by 93.3% of the sample and appropriate by 85.6%, but it was no more acceptable [t(206.57) = 1.27, p = .21] nor appropriate [t(199.45) = -.48, p = .63] than the control. Those in the intervention group experienced greater improvements in secondary control than those in the control group (F(1, 221) = 9.78; p < .01).

Discussion: Our study exemplifies how SSIs can be adapted for the Greek culture, even in the context of major public health crises. The present SSI was deemed acceptable, appropriate and helpful by Greek adolescents, and showed preliminary efficacy in improving secondary control. Thus, SSIs are a promising venue for mental health promotion and prevention during adversity. Future research could examine the SSI’s effectiveness in reducing mental health symptoms.