*Content has been updated based on feedback/comments and reorganized its information to fit the suggested structure, but the original submission is below for transparency.
Description of Project:
This project will support an academic-community collaboration between members of the Osher community and Community Well to create educational content on complementary health approaches (CHAs) to support youth mental health and well-being through a participatory action-inspired approach. Community Well is a SF Excelsior District (District 11)-located community-based holistic health center experienced in supporting the health of its diverse, under-resourced community and has a successful history working within SF public schools. Youth (n=30-40, age 12-18) will be recruited from 3 SFUSD middle and high schools to discuss mental health care and CHA knowledge/usage in focus groups. Findings will inform the creation of short, tailored, and youth-oriented educational materials (e.g., digital handouts, social media posts) on CHAs (e.g., how-to instruction, local area resources) addressing identified needs to support youth use/access of CHAs for mental health. Materials will be field-tested before community-wide dissemination.
Project Deliverables: Short, tailored, and youth-oriented educational materials (e.g., digital handouts, social media posts) covering 5-10 CHAs (as informed by focus groups) in terms of how-to instruction, local area resources, etc.
Project Significance: Youth mental health is in crisis. As existing mental health services struggle to meet current demands, CHAs offer promising, youth-approved solutions (Cunningham et al., 2021). Many CHAs have growing evidence-bases for mental health and are practices youth can engage in independently. For example, mind-body techniques (e.g., meditation, guided imagery, self-expression via art and words, forest bathing) have been linked to increased mental well-being, happiness, and emotional regulation in youth, as well as reduced stress and depressive symptoms (Aalsma et al., 2020; Keller et al., 2023; Nagpal and Radliff, 2024). Yet, youth CHA usage remains low, especially for those of color and low income. Barriers to engagement include limited CHA access and low health literacy (Clayton-Jones et al, 2021). Mindfulness may foster positive psychological outcomes in many ways, including eliciting self-compassion, positive mind states, and lower psychological distress (Keng et al., 2011; Inwood et al., 2018; Creswell et al., 2019; Crosswell et al., 2023), as well as via the “stress buffering framework” wherein “regulatory” brain activity is increased while “reactivity” pathways are decreased (Creswell et al., 2019), so modulating physiological stress responses (e.g., the HPA axis) to support resilience and health (Creswell et al., 2019; Creswell et al., 2014).
Anticipated Impact, including on the Osher Community: Successful completion of this project will result in educational content (e.g., digital downloads, social media posts) that can empower youth to use and access CHAs to support their mental health and well-being, so promoting integrative mental health equity. Content/materials will be disseminated to youth tapped for focus groups and may extend also to the general youth population attending public schools in SF and the larger Bay Area as well as youth seen at Osher. The academic-community collaboration formed here could catalyze similar and more partnerships of this variety for youth mental health programming and beyond as well.
Project Innovation: Youth participatory action approaches are increasingly recognized as an effective means for community health promotion for youth, including for mental health, given its ability to amplify and empower youth voices (Smith et al., 2024). This project will utilize this innovative strategy to harness diverse SF public school youth perspectives and inform the comprehensive development of educational content that will help promote mental health through CHAs. It will also create a novel partnership between the community and integrative academic clinical and research staff to tackle a critical public health issue.
Timeline:
July-Aug 2025: Project Planning and Preparation
Aug-Sept 2025: Youth Recruitment at 3 SFUSD school sites (2 high schools, 1 middle school)
Oct-Dec 2025: Conduct Focus Groups, Start Data Analysis
Jan-March 2026: Finish Data Analysis, Creation of Educational Content
April-May 2026: Youth testing of Educational Content and Revision Based on Youth feedback
May-June 2026: Dissemination of Educational Content through Youth-friendly Channels
Team Members and Roles
Dorothy Chiu, Osher Research Project Lead
Jennifer Moran, Community Well Co-Founder and Community Lead
Fatima Barragan, Integrative Pediatrician - will provide project oversight and guidance
Julia Burns, Communications Specialist - will support the development and creation of youth-friendly content and dissemination strategies through youth-friendly channels.
Total budget request: $13,500.
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phase 1 submission, fyi, for reference:
Project Lead: Dorothy Chiu
Key Team Members: Jennifer Moran (Community Well), others welcome/pending.
Project Description:
Youth mental health is in crisis. As existing mental health services struggle to meet current demands, complementary health approaches (CHAs) offer promising solutions. Many CHAs have evidence-bases for mental health and are practices youth can engage in independently. Yet, youth CHA usage is low, and lower in youth of color and low income. Barriers to engagement include low knowledge of and access to CHA and low health literacy. Hyperlocal factors likely play a role, though are understudied. This project seeks to conduct focus groups among local and/or underserved youth to better understand knowledge, attitudes, and barriers surrounding CHA usage. Based on focus group findings, tailored educational material(s) will be created to provide instruction, local area resources, and other key information to support youth in their use/access of CHAs for mental health. Possible editorial input from Osher’s expert providers will be pursued, and materials will be youth field-tested before community-wide dissemination.
Statement of Project Feasibility and Anticipated Impact:
The project lead honed her qualitative skills throughout graduate and postdoctoral training and previously crafted public health educational materials for diverse youth audiences. SF’s Community Well is a community-based holistic health center with expertise in supporting health and well-being in diverse, under-resourced communities. The project lead and Community Well have collaborated on grants and share professional interests. (Please note the team welcomes more team members with interests in health communications/graphic design and integrative pediatrics/mental health!)
Project completion will entail creation of a youth-oriented, expert-reviewed, and disseminable booklet that provides actionable information on how youth can engage in CHAs (e.g., meditation, acupressure, nature therapy, etc.) for mental health promotion. Content will also address common needs and concerns and include local resources for support. Empowering youth with CHAs will promote integrative health equity. Anticipated benefits are expected for youth seen at Osher and UCSF and living in the San Francisco Bay Area.
Estimated budget: $15,000.
Comments
Community Well & Osher seem
Community Well & Osher seem ideally positioned for more collaboration. What ages of youth are you aiming to recruit for this project?
thanks, Ariana! I was
thanks, Ariana! I was thinking 6th graders and up through high school (so maybe age 12-18) and writing the booklet an 8th grade reading level.
and, yes - agree! I think Community Well's philosophies are well-aligned with Osher's. Hope this may be a way to spark collaboration!
Hi Dorothy -- great proposal!
Hi Dorothy -- great proposal! I'd love to be involved with this project. I'm interested in learning what content and channels resonate with youth, and I could help with the development of materials.
Thanks! - I would love your
Thanks! - I would love your communications expertise, Julia! Welcome!
Great point about finding content and channels that resonate with youth - I had originally been thinking along more traditional lines of dissemination for the booklet (e.g., through Osher and zSFGH waiting rooms/providers that are youth facing, SFUSD health professionals (e.g., school nurses, health teachers, administrative offices), through Community Well and their events/contacts with other community-based organizations, etc.), but it would definitely behoove "reach" to push content and/or ways to access the booklet through social media and other means that reach youth directly!
also, considering the diverse
also, considering the diverse youth that Community Well serves as well as those in the SFUSD community, it would make sense to have translations of the booklet available - spanish for sure, and can explore other options. It's nice to know there's a translation service/resource at UC Davis!
Great idea! Any thought on
Great idea! Any thought on partnering with local schools?
thanks, Jen!Yes, schools
thanks, Jen!
Yes, schools would be key! Offering the materials once done to San Francisco Unified School District had definitely come to mind, and it would be nice to find ways to work with them more - for example, to identify integrative strategies (e.g., nature therapy, acupressure, diet/nutrition, art/music therapy, breathwork) that would be particularly appealing/fitting to youth as well as to learn of barriers that might exist that would be pragmatic to address in what we develop. Some piloting could also happen with students in addition to what Community Well could do with their base. (Community Well is a technical assistance partner with San Francisco's Dept of Child, Youth, and Their Families so they have been working at some SFUSD sites that way.)
It'd also be great to reach out to Oakland Unified and Berkeley Unified and others as well, for dissemination at least, if not more... I I have a couple of contacts for some of these already so could start there. I am envisioning the final product to provide a section listing Bay Area/local resources that youth and families could tap into as needed.
as the materials are being developed as well to make sure it's in line with known needs.
From Perry Lang:Intriguing
From Perry Lang:
Intriguing idea. However, I would need to know more about CHA (complementary health approach) evidence-based methodologies. I would also like to know more about recruitment goals, plans and numbers of participants.
Thank you Perry! and, yes,
Thank you Perry! and, yes, you raise important points.
For recruitment goals, plans, and numbers of participants, we would aim to recruit 30-40 diverse youth across San Francisco and surrounding Bay Area to participate in brief and targeted focus groups of about 2-3 people each in the Fall. (Per the literature on sample size estimates for qualitative studies to reach saturation, a minimum of 30 should be adequate [Hennick and Kaiser, 2022; Sharma et al., 2024]). Community Well would help lead recruitment efforts as would other community-based organizations as needed. For later stages of the project (Spring 2026), a subset of youth that participated in the focus groups would be asked to review the developed materials. Community Well would help lead those efforts as well.
For the evidence base for various CHAs to support youth mental health -- Yes! it is ever expanding and increasing, which is super exciting and what motivates this project. For example, a primary study of forest bathing (contemplative time in nature-based settings often coupled with a structured walk) in 16-18 year olds observed increased their mental well-being and happiness and reduced stress (Keller et al., 2023). Another study amongst teens with depression found they viewed mind-body techniques (e.g., guided imagery, meditation, mindful eating, self-expression via art and words) to be helpful and acceptable means to treat depression symptoms (Cunningham et al., 2021). Relatedly, a systematic review of mindfulness or yoga-based school interventions in youth age 11-18 found generally consistent benefits on self-management and emotional regulation (Nagpal and Radliff, 2024). Ways by which mindfulness may foster positive psychological outcomes include the elicitation of self-compassion, perspective shifts, acceptance skills, positive states of mind, emotion regulation, lower perceived stress and psychological distress, and enhanced psychological well-being attributable to being in a restorative state of “deep rest” (Keng et al., 2011; Inwood et al., 2018; Creswell et al., 2019; Crosswell et al., 2023) Also, through the stress buffering framework, mindfulness practices may 1) increase functional activity in the prefrontal cortex via the “regulatory” pathway while 2) decreasing functional connectivity in the amygdala or body’s stress alarm via the “reactivity” pathway. (Creswell et al., 2019) Together, this modulates activation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axis to increase stress resilience and support mental (and physical) health. (Creswell et al., 2019; Creswell et al., 2014).
I like this idea and love the
I like this idea and love the collaboration with Community well. I'm curious about additional potential partnerships with organizations that work with youth such as LYRIC or Umoja Health.
Thanks Marliese! Yes, for
Thanks Marliese! Yes, for sure - it would be great to reach out to more community organizations with experience or priorities serving youth for this. Thanks for putting LYRIC and Umoja on my radar! It looks like their service areas don't really overlap with Community Well's and also extend into San Mateo and other parts of SF and Oakland, potentially enabling access to more youth.
Possible avenues of collaboration include: We could explore ways to partner -- like Community Well, maybe they could help source more focus group participants who could bolster the identification of integrative strategies of interest as well as unique practice barriers that we could then be sure to address in the material(s) we develop through this. The community-based orgs could also recruit youth to serve as test audiences for the material(s) to help refine readability, clarity, presentation, appeal, etc. and get it "youth-approved". Translation to other languages could also be explored if identified as a need. Last, working with more community partners could help broaden dissemination of this project as well!
This is just a start though, and it'd be nice to explore ways to collaborate and/or expand partnerships with discussion with Community Well too.