ABC Project
An online intervention that aims to reduce hopelessness and strengthen perceived agency in youth with anxiety and depression by teaching them to manage their mood via engagement in valued, enjoyable activities.
Program Outcomes
- Depression
- Mental Health - Other
Program Type
- Cognitive-Behavioral Training
- Skills Training
Program Setting
- Online
Continuum of Intervention
- Selective Prevention
Age
- Late Adolescence (15-18) - High School
- Early Adolescence (12-14) - Middle School
Gender
- Both
Race/Ethnicity
- All
Endorsements
Blueprints: Promising
Program Information Contact
Jessica Schleider, Ph.D., Director
Lab for Scalable Mental Health
Northwestern University
625 N. Michigan Avenue, Chicago IL 60611
jessica.schleider@northwestern.edu
jessica.schleider@gmail.com
For program access via Project Yes:
www.schleiderlab.org/yes
Program Developer/Owner
Jessica Schleider
Northwestern University
Brief Description of the Program
ABC Project is a self-guided, online, 20-30-minute intervention designed for youth showing symptoms of depression, anxiety, and COVID-19-related trauma. The program aims to reduce hopelessness and strengthen perceived agency among high-symptom youth by teaching them behavioral activation skills (i.e., the practice of managing one's mood via engagement in valued, enjoyable activities).
ABC Project is a self-guided, online, 20-30-minute intervention designed for youth showing symptoms of depression, anxiety, and COVID-19-related trauma. The program aims to reduce hopelessness and strengthen perceived agency among high-symptom youth by teaching them behavioral activation skills (i.e., the practice of managing one's mood via engagement in valued, enjoyable activities).
The program includes five elements: (1) an introduction to the program's rationale - that engaging in values-based activities that build pleasure and accomplishment can combat sad mood and low self-esteem, (2) psychoeducation about depression, including how behavior shapes feelings and thoughts, (3) a life values assessment, where youth identify key areas (family relationships, friendships, school, or hobbies) from which they draw (or once drew) enjoyment and meaning, (4) the creation of an activity action plan, where youth identify (from pre-generated lists) and personalize (in guided exercises) three activities to target for change, and (5) an exercise in which youths write about benefits that might result from engaging in each activity, an obstacle that might keep them from doing the activities, and a strategy for overcoming the identified obstacles.
Outcomes
Primary Evidence Base for Certification
Study 1
Schleider et al. (2022) found that, relative to the control group, students in the ABC Project intervention group showed significantly greater improvements in:
- Perceived agency (at posttest)
- Hopelessness (at posttest and three-month follow-up)
- Depressive symptoms (at three-month follow-up)
- Restrictive eating (at three-month follow-up)
Brief Evaluation Methodology
Primary Evidence Base for Certification
The one study Blueprints has reviewed meets Blueprints evidentiary standards (specificity, evaluation quality, impact, dissemination readiness). The study was done by the developer.
Study 1
Schleider et al. (2022) used a randomized controlled trial to compare a sample of 2,452 youth assigned to one of three conditions: (1) ABC Project; (2) Project Personality; and (3) control. Assessments at baseline, posttest, and three-month follow-up measured depression, anxiety, and COVID-19-related trauma symptoms, as well as perceived agency, hopelessness, and restrictive eating.
Study 1
Schleider, J. L., Mullarkey, M. C., Fox, K. R., Dobias, M. L., Shroff, A., Hart, E. A., & Roulston, C. A. (2022). A randomized trial of online single-session interventions for adolescent depression during COVID-19. Nature Human Behaviour, 1-11.
Gender Specific Findings
- Female
Subgroup Analysis Details
Subgroup differences in program effects by race, ethnicity, or gender (coded in binary terms as male/female) or program effects for a sample of a specific race, ethnic, or gender group.
Study 1 (Schleider, et al., 2022) found subgroup effects by using a homogenous sample with 75% or more of females.
Sample demographics including race, ethnicity, and gender for Blueprints-certified studies:
The sample for Study 1 (Schleider, et al., 2022) was predominantly female (88%) and 67% White, 13% Asian, 11% Black, 4% American Indian, 2% Native Hawaiian, and 19% Hispanic ethnicity.
Training Certification Process
No training is necessary as this is a fully self-guided, online, free-of-charge intervention that may be accessed anywhere, anytime by an individual with an internet-equipped device. ABC Project is available in English, Spanish, Turkish and Haitian Creole.
Source: Washington State Institute for Public Policy
All benefit-cost ratios are the most recent estimates published by The Washington State Institute for Public Policy for Blueprint programs implemented in Washington State. These ratios are based on a) meta-analysis estimates of effect size and b) monetized benefits and calculated costs for programs as delivered in the State of Washington. Caution is recommended in applying these estimates of the benefit-cost ratio to any other state or local area. They are provided as an illustration of the benefit-cost ratio found in one specific state. When feasible, local costs and monetized benefits should be used to calculate expected local benefit-cost ratios. The formula for this calculation can be found on the WSIPP website.
Start-Up Costs
Initial Training and Technical Assistance
No training or materials are necessary as this is a fully self-guided, online, free-of-charge intervention that may be accessed anywhere, anytime by an individual with an internet-equipped device. ABC Project is available in English, Spanish, Turkish and Haitian Creole.
The Lab for Scalable Mental Health is available to offer guidance on technical support/implementation, although these needs are often non-existent, given the self-guided nature of the program.
Curriculum and Materials
No information is available
Licensing
No information is available
Other Start-Up Costs
No information is available
Intervention Implementation Costs
Ongoing Curriculum and Materials
No information is available
Staffing
No information is available
Other Implementation Costs
No information is available
Implementation Support and Fidelity Monitoring Costs
Ongoing Training and Technical Assistance
No information is available
Fidelity Monitoring and Evaluation
No information is available
Ongoing License Fees
No information is available
Other Implementation Support and Fidelity Monitoring Costs
No information is available
Other Cost Considerations
No information is available
Year One Cost Example
No information is available
Program Developer/Owner
Jessica SchleiderAssociate ProfessorNorthwestern UniversityLab for Scalable Mental Health625 N. Michigan AvenueChicago, IL 60611United Statesjessica.schleider@northwestern.edu
Program Outcomes
- Depression
- Mental Health - Other
Program Specifics
Program Type
- Cognitive-Behavioral Training
- Skills Training
Program Setting
- Online
Continuum of Intervention
- Selective Prevention
Program Goals
An online intervention that aims to reduce hopelessness and strengthen perceived agency in youth with anxiety and depression by teaching them to manage their mood via engagement in valued, enjoyable activities.
Population Demographics
The program targets youth aged 11-17 who display elevated symptoms of depression. Youth in the study certified by Blueprints were aged 13-16.
Target Population
Age
- Late Adolescence (15-18) - High School
- Early Adolescence (12-14) - Middle School
Gender
- Both
Gender Specific Findings
- Female
Race/Ethnicity
- All
Subgroup Analysis Details
Subgroup differences in program effects by race, ethnicity, or gender (coded in binary terms as male/female) or program effects for a sample of a specific race, ethnic, or gender group.
Study 1 (Schleider, et al., 2022) found subgroup effects by using a homogenous sample with 75% or more of females.
Sample demographics including race, ethnicity, and gender for Blueprints-certified studies:
The sample for Study 1 (Schleider, et al., 2022) was predominantly female (88%) and 67% White, 13% Asian, 11% Black, 4% American Indian, 2% Native Hawaiian, and 19% Hispanic ethnicity.
Other Risk and Protective Factors
Hopelessness, perceived agency, involvement in valuable and enjoyable activities
Risk/Protective Factor Domain
- Individual
Risk/Protective Factors
Risk Factors
Protective Factors
*Risk/Protective Factor was significantly impacted by the program
See also: ABC Project Logic Model (PDF)
Brief Description of the Program
ABC Project is a self-guided, online, 20-30-minute intervention designed for youth showing symptoms of depression, anxiety, and COVID-19-related trauma. The program aims to reduce hopelessness and strengthen perceived agency among high-symptom youth by teaching them behavioral activation skills (i.e., the practice of managing one's mood via engagement in valued, enjoyable activities).
Description of the Program
ABC Project is a self-guided, online, 20-30-minute intervention designed for youth showing symptoms of depression, anxiety, and COVID-19-related trauma. The program aims to reduce hopelessness and strengthen perceived agency among high-symptom youth by teaching them behavioral activation skills (i.e., the practice of managing one's mood via engagement in valued, enjoyable activities).
The program includes five elements: (1) an introduction to the program's rationale - that engaging in values-based activities that build pleasure and accomplishment can combat sad mood and low self-esteem, (2) psychoeducation about depression, including how behavior shapes feelings and thoughts, (3) a life values assessment, where youth identify key areas (family relationships, friendships, school, or hobbies) from which they draw (or once drew) enjoyment and meaning, (4) the creation of an activity action plan, where youth identify (from pre-generated lists) and personalize (in guided exercises) three activities to target for change, and (5) an exercise in which youths write about benefits that might result from engaging in each activity, an obstacle that might keep them from doing the activities, and a strategy for overcoming the identified obstacles.
Theoretical Rationale
The program is based on Self-Determination Theory, which suggests that people can become self-determined when their needs for competence, connection, and autonomy are fulfilled, and relies on behavioral activation (a skill often taught as part of Cognitive Behavioral Therapy that encourages engagement in valued, enjoyable activities to manage one's mood).
Theoretical Orientation
- Skill Oriented
- Cognitive Behavioral
Brief Evaluation Methodology
Primary Evidence Base for Certification
The one study Blueprints has reviewed meets Blueprints evidentiary standards (specificity, evaluation quality, impact, dissemination readiness). The study was done by the developer.
Study 1
Schleider et al. (2022) used a randomized controlled trial to compare a sample of 2,452 youth assigned to one of three conditions: (1) ABC Project; (2) Project Personality; and (3) control. Assessments at baseline, posttest, and three-month follow-up measured depression, anxiety, and COVID-19-related trauma symptoms, as well as perceived agency, hopelessness, and restrictive eating.
Outcomes (Brief, over all studies)
Primary Evidence Base for Certification
Study 1
Schleider et al. (2022) found that, relative to the control group, students in the ABC Project intervention group showed significantly greater improvements in perceived agency and hopelessness from baseline to posttest, and depressive symptoms, restrictive eating, and hopelessness from baseline to three-month follow-up.
Outcomes
Primary Evidence Base for Certification
Study 1
Schleider et al. (2022) found that, relative to the control group, students in the ABC Project intervention group showed significantly greater improvements in:
- Perceived agency (at posttest)
- Hopelessness (at posttest and three-month follow-up)
- Depressive symptoms (at three-month follow-up)
- Restrictive eating (at three-month follow-up)
Effect Size
Study 1 (Schleider et al., 2022) reported effect sizes for ABC Project that were small in size and ranged from d = 0.15 (past-month restrictive eating at three-month follow-up) to 0.31 (perceived agency at posttest).
Generalizability
One study meets Blueprints standards for high-quality methods with strong evidence of program impact (i.e., "certified" by Blueprints): Study 1 (Schleider et al., 2022). The sample included youths ages 13-16 with elevated depression symptoms who were recruited from all 50 U.S. states, and the study compared the treatment group to a supportive therapy control group.
Notes
Study 1 (Schleider et al., 2022) randomized youth to three groups: 1) ABC Project, 2) Project Personality, and 3) control. This evaluation methodology write-up reports on youth assigned to ABC Project versus control.
Project Personality has also been certified as Promising by Blueprints.
Endorsements
Blueprints: Promising
Program Information Contact
Jessica Schleider, Ph.D., Director
Lab for Scalable Mental Health
Northwestern University
625 N. Michigan Avenue, Chicago IL 60611
jessica.schleider@northwestern.edu
jessica.schleider@gmail.com
For program access via Project Yes:
www.schleiderlab.org/yes
References
Study 1
Certified
Schleider, J. L., Mullarkey, M. C., Fox, K. R., Dobias, M. L., Shroff, A., Hart, E. A., & Roulston, C. A. (2022). A randomized trial of online single-session interventions for adolescent depression during COVID-19. Nature Human Behaviour, 1-11.
Study 1
Summary
Schleider et al. (2022) used a randomized controlled trial to compare a sample of 2,452 youth assigned to one of three conditions: (1) ABC Project; (2) Project Personality; and (3) control. Assessments at baseline, posttest, and three-month follow-up measured depression, anxiety, and COVID-19-related trauma symptoms, as well as perceived agency, hopelessness, and restrictive eating.
Schleider et al. (2022) found that, relative to the control group, students in the ABC Project intervention group showed significantly greater improvements in:
- Perceived agency (at posttest)
- Hopelessness (at posttest and three-month follow-up)
- Depressive symptoms (at three-month follow-up)
- Restrictive eating (at three-month follow-up)
Evaluation Methodology
Design:
Recruitment: The study was conducted from November 2020 to March 2021. Participants across all 50 states were recruited using Instagram advertisements, which linked to an eligibility screener. Youth inclusion criteria were: (1) 13-16 years old; (2) comfort reading and writing in English; (3) internet and computer, laptop, or smartphone access; and (4) endorsement of elevated depressive symptoms. To maintain youth confidentiality and minimize access barriers, parent permission to participate was not required. Of the 6,884 youth who completed eligibility screening, 3,851 were eligible and agreed to participate, though only 2,452 youth completed the baseline survey and were assigned to condition.
Assignment: Adolescents were randomly assigned to one of three conditions: (1) ABC Project (n = 821); (2) Project Personality (n = 813); or (3) active control (n = 818). Randomization was achieved using a Qualtrics-embedded randomizer; both adolescents and experimenters were blind to condition until data collection was complete. All three conditions utilized self-administered, online, single-session interventions that were length-matched. ABC Project teaches behavioral activation, whereas Project Personality teaches a growth mindset. Control youth received a supportive therapy program that encouraged them to express emotions to close others but did not teach specific skills.
Assessments/Attrition: Assessments occurred at baseline, post-intervention, and three-month follow-up. Of the 2,452 youth who completed the baseline assessment, 2,054 (84%) completed the post-test, and 1,766 (72%) completed the three-month follow-up (see Figure 2, p. 263).
Sample:
At baseline, 86.2% of youths reported clinically elevated depressive symptoms. The sample was 88.1% female, 3.8% American Indian, 12.6% Asian, 10.5% Black, 1.6% Native Hawaiian, 19.2% Hispanic, and 66.6% White. Approximately 80% identified as a sexual minority, and participating youths lived in all 50 states.
Measures:
Adolescents self-reported on measures of hopelessness and perceived agency at all three time points, as well as measures of mental health at baseline and three-month follow-up only; thus, all measures came from an independent source. Six outcomes were computed for analysis: (1) depressive symptoms; (2) generalized anxiety symptoms; (3) COVID-19-related trauma symptoms; (4) perceived agency; (5) hopelessness; and (6) restrictive eating. Depression symptom severity was the primary outcome; the remaining measures were all considered as secondary outcomes. The perceived agency and hopelessness intermediate outcomes represent risk & protective factors, whereas trauma symptoms and restrictive eating can be viewed as measures of mental health - other. In the current sample, scale derived alphas ranged from .73 (trauma symptoms) to .90 (anxiety symptoms).
Analysis:
Analyses used a series of linear regressions to test for intervention effects. Intervention condition was included as a categorical predictor variable, and baseline outcome controls were used as covariates. In addition, the false discovery rate (FDR) was applied to two-tailed tests of pre-registered outcomes (i.e., three-month depressive symptoms, post-intervention perceived agency and hopelessness).
Intent-to-Treat: All available data were used in the main analysis. Missing data were handled through imputation using "the expectation-maximization and bootstrapping algorithm implemented with Amelia II in R" (p. 266). The authors imputed as many datasets as there were percentage points of missing data for a particular outcome, rounding to the next-highest percentage (e.g., if 5.4% of data was missing on an outcome, six imputed datasets were created). Additionally, the sensitivity analyses, which used two alternative approaches to handling missing data (i.e., listwise deletion and multiple imputation), represent completers-only analyses, but in both cases the results were comparable to those of the main analysis, showing only minor differences with respect to secondary outcomes (see pp. 262-263).
Outcomes
Implementation Fidelity:
Approximately 84% of youth completed the program to which they were assigned in full. Adolescents rated all three single-session interventions as acceptable across all program feedback scale items, as indicated by the item-level means, all of which were above 3.5/5 (see Table 2, p. 261).
Baseline Equivalence:
The authors stated only that "no group differences emerged on demographic factors or baseline depressive symptoms" (p. 259) for the assigned sample, but no significance tests were reported. However, Table 1 (p. 260) presents counts for baseline demographic variables and means for baseline depressive symptoms, which appear similar across the treatment and control groups. The authors did not report findings from tests for other baseline outcomes beyond depressive symptoms (their primary outcome).
Differential Attrition:
Attrition rates from baseline to three-month follow-up were similar in the intervention (30.7%) and control (26.2%) groups. There were no differences between completers and attritors, either during the intervention or at three-month follow-up, in baseline depressive symptoms, age, gender identity, sexual orientation, romantic/sexual attraction, or race. There were no tests of baseline-by-condition attrition.
Posttest:
Relative to the control group, youth in the ABC Project intervention group showed significantly greater improvements in perceived agency and hopelessness from baseline to posttest, as well as depressive symptoms, restrictive eating, and hopelessness from baseline to three-month follow-up. These significant effects all held in complete case sensitivity analyses and, additionally, the model comparing change in COVID-19-related trauma symptoms from baseline to three-month follow-up was significant in the analysis using imputation for follow-up data.
Long-Term:
Not examined.