Hack2Health: Developing A Teen-Led Digital Intervention for Reducing Negative Social Comparison on Social Media

/Abstract Most youth use social media (SM) every day, and many concerns have been raised about how SM use may be driving the alarming increases in anxiety and depression among adolescents. However, current research suggests that not all youth are equally impacted by SM, and some SM users are at higher risk than others for negative health outcomes. Emerging research suggests that one likely individual difference that may account for the disparate outcomes is youths’ tendency towards engaging in negative social comparisons (i.e., evaluating their own lives or selves negatively in comparison to others) while using SM. Negative social comparison is thus a promising target for intervention, particularly interventions delivered digitally to youths’ smartphones, where they are most likely to be using SM. As youth are the experts on their own digital technology and SM use, it is critical to center youths’ voices in all stages of developing such an intervention. Thus, the present study empowers older adolescents (ages 15-18) to design, pitch, and create (with collaboration from technical experts) a brief digital intervention that targets negative social comparison on SM to reduce anxiety and depression in teens. This study focuses on older adolescents specifically as they are becoming more independent users of SM and at high risk for the development of anxiety and depression. In Phase 1, 25 teens will receive expert training and mentorship to design and pitch their intervention in a full-day hackathon. In Phase 2, 10 teens will develop the most promising intervention pitched in Phase 1 and it will be programmed in collaboration with professional developers. In Phase 3, the final intervention will be tested in a small randomized controlled trial with 40 new teens high in anxiety and/or depression symptoms who report a tendency toward negative social comparison on SM. Objective data on SM content engagement and ecological momentary assessment (EMA) data on clinical symptoms and other socio-emotional variables (e.g., self- esteem, social avoidance) will be collected for ~five weeks from pre-intervention to post-intervention. Phase 3 will allow for preliminary tests of the intervention’s feasibility, acceptability, and target engagement (i.e., impact on the target mechanism: negative social comparison), as well as candidate mechanisms that might help explain the intervention’s effects on reducing negative social comparison (i.e., changes in interpretation biases or youths’ SM engagement patterns) and clinical outcomes (i.e., changes in rumination, social behaviors, and/or body image concerns), which will set the stage for a future, full-scale clinical trial. Project Number: 1R21MH142319-01 | Fiscal Year: 2025 | NIH Institute/Center: National Institute of Mental Health (NIMH) | Principal Investigator: Stefanie Sequeira (+1 co-PI) | Institution: UNIVERSITY OF VIRGINIA, CHARLOTTESVILLE, VA | Award Amount: $441,430 | Activity Code: R21 | Study Section: Special Emphasis Panel[ZRG1 BP-E (55)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11265878