The Effect of Caregiver Opinion Leaders to Increase Demand for Evidence-Based Practices for Youth Anxiety: A Randomized Controlled Trial

Abstract

Background: Despite implementation efforts, most anxious youth do not receive evidence-based treatment. Dissemination initiatives can increase consumer knowledge of evidence-based treatments. Opinion leaders (OLs) have been used in public health campaigns, but this strategy has not been examined for the dissemination of mental health treatments. This study uses the theory of planned behavior to test the dissemination strategies of (1) involving an OL and (2) using an educational presentation to increase caregiver demand for CBT for youth anxiety. Methods: Participants (N=262; 92% Female; 69% White, 82% non-Hispanic) were caregivers who registered for a virtual presentation on youth anxiety and how to seek treatment. Caregivers were cluster-randomized by school (N=25) to the OL condition (presented by a clinical researcher and local caregiver OL) or the researcher-only condition (presented by two clinical researchers). Presentations occurred from May 2021-May 2022. Measures were completed pre- and post-presentation, and at three-month follow-up. Results: One hundred and nine participants attended the presentations. Relative to the researcher co-presenter, participants rated the OL as significantly more relatable, familiar, similar, and understanding of their community, but significantly less credible. Across conditions, there was a significant increase in participants’ (a) knowledge of, (b) subjective norms related to, and (c) intention to seek CBT for youth anxiety, but no change in stigma or attitudes about CBT. Presentation conditions did not differ in change on these measures, or on rates of seeking youth anxiety CBT at three-month follow-up. Conclusion: Although involvement of a caregiver OL did not increase caregiver demand for EBT for youth anxiety, the overall outreach presentation was an effective dissemination strategy. Involving OLs may not be necessary for all consumer audiences, but may be beneficial for individuals with higher levels of stigma or scientific skepticism than participants in this study.