WED-048 - Accomplished: An Adolescent Community Health Worker Program Mental Health Curriculum Addendum

Brief Abstract Summary: Learn about a novel mental health curriculum, the Adolescents Caring for Community by Promoting Literacy on Insurance, Stroke, Health Education, Emergencies, and Dementia (ACComPLISHED) community health worker program based at Columbia University. ACComPLISHED began in Winter 2024 to improve health knowledge, attitude, and self-efficacy of local New York City teens. The program is directed by medical faculty in close collaboration with graduate students from allied health programs who serve as teachers and near-peer mentors through weekly online and monthly in-person meetings, weekly office hours, and a capstone public health event. A mental health curriculum was implemented in the summer 2024. This presentation will show the impact on knowledge of mental health disorders: mood, anxiety, and substance use disorders among 203 students completing validated instruments at baseline and post-intervention, demonstrating a 13.6% knowledge increase (p < 0.001).

Detailed abstract description:

Introduction: The increasing prevalence of the three most common mental health disorders (3MHDs) depression, anxiety, and alcohol/substance use disorders, have outpaced resources for treatment, particularly in disadvantaged communities. Key barriers to treatment include literacy and stigma, which contribute to low and delayed symptom reporting and treatment implementation. Community health interventions focused on mental health may improve related outcomes and quality of life. Community Health Workers (CHWs), are “lay health workers”—frontline health educators, healthcare navigators, and health screeners, who deliver community-based health services and interventions with demonstrated impact. Key CHWs attributes include local credibility and culturally aligned engagement. Traditionally CHWs are adults, but high school students may be a sizeable under-utilized population to serve as CHWs to peers, families, and local communities.


Methods: For the past 20 years our group has led multigenerational community health education programs including training adult CHW and elementary students to serve as health education conduits to their families and broader communities. In Winter 2024, we began ACComPLISHED, a 12-week CHW program that engages youth with public health topics to bolster health knowledge, attitudes, and self-efficacy; offer a longitudinal bidirectional mentorship opportunity; and provide a platform to practice community health education. A mental health curriculum (MHC) was developed and implemented in summer 2024 focused on knowledge and attitudes of 3MHDs. Student performance was measured quantitatively through validated instruments (MHLS, ADKQ, ALQ, AQ-SUD, VCQ) complemented by qualitative Likert scales and inductive thematic analysis.


Results: 329 high school students (10th -12th grade) from New York City were enrolled, 203 completed the core didactic programming. Programs were delivered as virtual synchronous didactics, asynchronous modules, standardized simulated patient interviews, and a community intervention project. Summative scores of the validated scales increased from 75.6% (n=240) at baseline to 89.2% at post-test (n=203), (p < 0.001, paired t-test) with similar trends after each individual program. Most notable were improvements in awareness of where to seek help, self-efficacy for seeking help, and sympathy for others with 3MHDs. There were no significant differences by race-ethnic, gender, or socioeconomic groups. Inductive thematic analysis highlighted themes of close relationships with friends and family and more openness to 3MHDs topics.


Conclusion: High School CHWs demonstrated significantly improved mental health knowledge and help-seeking self-efficacy in response to a novel mental health curriculum.