(PS5-42) Optimizing CBT Implementation Among Youth Mental Health Providers in Low Resource Settings Through Internet-based Consultation and Networking (i-CAN)

Background: Cognitive-behavioral therapy (CBT) is one of the strongest evidence-based treatments for youth psychopathology, including anxiety. However, it is not consistently implemented by licensed mental health providers. Youth residing in rural and low-income settings are even less likely to receive CBT for anxiety. Barriers to providers implementing CBT in therapeutic settings include lack of access to support and consultation from other providers as well as insufficient training and skills. Providers also lack infrastructural support and insufficient access to internet-based materials (e.g. disjointed access, adaptations to diverse client needs, etc.) in low-resource settings. i-CAN is a virtual platform delivered via Slack for peer-to-peer networking consultation with mental health providers in Alabama aimed at increasing intentions to use CBT for youth anxiety.

Method: A community workgroup of local practitioners informed the design the i-CAN platform. With their input, the i-CAN was developed, and the pilot trial is underway. The goal of this randomized clinical trial is to increase community providers’ use of CBT for youth anxiety problems through remote peer engagement, consultation, and enhanced resource access.  To evaluate the implementation, including barriers and facilitators, of i-CAN semi-structured interviews were conducted with a purposive sample (n=9) of youth providers in Alabama who were part of the trial. The interviews were coded in NVivo and thematic analysis was guided by the Consolidated Framework for Implementation Science (CFIR). 

Results:   Provider participants from qualitative interviews acknowledge that consultation keeps you accountable as a provider and helps more geographically isolated providers. They also perceived i-CAN participation to increase their willingness to use CBT for anxiety and other evidence-based interventions. In describing its implementation, i-CAN participants found weekly emails and slack notifications to be helpful, along with the ability to access the platform outside of traditional work hours.  Participants described difficulty with onboarding onto the slack platform and a desire to know more about the other providers on i-CAN and feel part of the online clinician community.  

Conclusion:   Overall, results from qualitative interviews with provider participants found i-CAN useful and suggested that more providers have access to the platform.  Lessons learned from the implementation of this internet-based consultation and networking will be shared, along with suggestions for future adaptations and sustainability.