Implementation Research and Practice, Volume 6, Issue , January-December 2025.
BackgroundDissemination initiatives have the potential to increase consumer knowledge of and engagement with evidence-based treatments (e.g., cognitive behavioral therapy [CBT]). Opinion leaders (OLs) have been used in public health campaigns, but have not been examined for the dissemination of mental health treatments. This study uses the Theory of Planned Behavior to test the dissemination strategy of involving an OL in an educational presentation to increase caregiver demand for CBT for youth anxiety.MethodParticipants (N = 262; 92% female; 69% White, 82% non-Hispanic) were caregivers who registered for a virtual presentation on youth anxiety treatment through their child’s school. Schools within 1.5-hr drive of Philadelphia, PA were cluster-randomized (k = 25; two-arm prospective randomization) to the OL condition (presented by a clinical researcher and local caregiver OL; n = 119 participants) or the researcher-only condition (n = 143 participants). Presentations occurred from May 2021 to May 2022. Measures were completed pre- and post-presentation and at 3-month follow-up.ResultsRelative to the researcher co-presenter, participants rated the OL as significantly more relatable, familiar, similar, and understanding of their community, but less credible than the researcher co-presenter. In both conditions, there was a significant pre-post increase in participants’ knowledge of, attitudes about, subjective norms related to, and intention of seeking CBT for youth anxiety, but not stigma. Presentation conditions did not differ in change on these measures, or on rates of seeking youth anxiety CBT at follow-up.ConclusionsAlthough involvement of a caregiver OL did not increase caregiver demand for evidence-based treatment for youth anxiety, the outreach presentation was associated with increases in knowledge of, attitudes about, subjective norms related to, and intention to seek CBT for youth anxiety. Involving OLs in researcher-delivered dissemination efforts may not be necessary for all consumer audiences, but may be beneficial for engendering a sense of relatability, similarity, and connection with disseminators.Plain Language Summary Cognitive behavioral therapy (CBT) is an effective treatment for youth anxiety. However, most anxious youth do not receive CBT when they seek treatment. Research supports educational dissemination strategies to improve knowledge, attitudes, and stigma related to seeking treatment. It is unclear who is the best person to provide potential consumers with information about seeking treatment. Collaborating with opinion leaders (OLs) may be an effective dissemination strategy. OLs are trustworthy community members who use their influence to encourage others to make a change. This study tested use of a local caregiver OL versus a clinical researcher to deliver an educational presentation on youth anxiety for caregivers. We found that both types of presenters led to an increase in knowledge of, subjective norms about, attitudes about, and intention of seeking CBT. There was no difference between the two conditions on these factors. It is possible that the lack of difference between conditions was because the caregiver presenter may not have been a strong OL. Participants rated the OL as being more like them, more familiar to them, and more understanding of their community. They also thought that the OL was a less credible source of mental health information than the researcher. This study suggests that involving a local caregiver in dissemination efforts may not be necessary for many individuals. For people with low levels of stigma, presentations given by researchers may be effective at changing their attitudes about seeking treatment. Additionally, educational presentations are associated with improvements in knowledge, subjective norms, and intention to seek CBT among those who attend. More research is needed to identify ideal dissemination strategies to engage underserved populations.
