1 - (SYM 39) The Kids FACE FEARS Trial: Overview, Methods, and Sample Demographics

Despite the efficacy of CBT for treating pediatric anxiety, most anxious youth do not seek or receive help, and among those who do, long delays between disorder onset and treatment utilization are the norm. Service barriers further disproportionately affect minoritized youth. Such failures, delays, and disparities in treatment utilization underscore problems in the availability, accessibility, and acceptability of care. Technology-based strategies for extending CBT reach show promise for overcoming barriers.

Building on the evidence, the Kids FACE FEARS trial compared two CBT delivery formats that vary in therapist intensity, differentially draw on technology, and show promise for expanding CBT reach—i.e., Therapist-Led CBT (telehealth, office-based, or hybrid) vs iCBT (with minimal therapist involvement). The Kids FACE FEARS trial was a type 1 hybrid effectiveness/implementation pragmatic study comparing these two treatment formats in usual care settings.

This presentation provides an overview of the rationale, methods, and sample demographics of the Kids FACE FEARS trial. Youth were universally screened as part of routine pediatric care across health networks in 4 metropolitan regions. Youth with elevated anxiety were randomized to 1 of the 2 treatments. Several trial features elevate the study’s generalizability: exclusion criteria were minimal, services were offered in English & Spanish, and study treatment was incorporated into the natural flow of usual pediatric care (e.g., clinical care not funded by the study grant, research therapists not used, anxiety specialty clinics not involved in clinical care). Major assessments were held at baseline, mid- & post-treatment, and 12-month follow-up. Investigator partnerships with community-, family-, and stakeholder-advisory boards informed all study activities. The trial’s sample was ethnically diverse and offers one of the largest and more representative trials of CBT for pediatric anxiety (N=305 youth; Mean age=11.7, 61.3% female; 52.1% Hispanic; 33.1% non-Hispanic White). About half spoke a non-English language at home, ~40% had foreign-born caregivers, and almost 1/4 were experiencing resource insecurity.