| What the intervention is | The core program plus extra emphasis on cultural identity as barriers and facilitators to sustaining engagement. | A creative arts-based engagement program led by a clinician and professional peer, focusing on recovery, service use advantages, working with providers, stigma, and mental health literacy. | The core program with added focus on identity-based motivation and hope for ongoing engagement. | The core program combined with supplemental content addressing community and environment barriers to engagement and self-efficacy. | The core program plus both cultural identity and identity motivation supplements. | The core program with cultural identity and community environment supplements. | The core program supplemented with both community barriers and identity motivation elements. | The engagement program with cultural identity, identity motivation, and community barriers supplements added to the core. |
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| Role in trial | Experimental addition testing cultural identity as a supplement to the core. | Serves as active comparator, representing the base engagement intervention. | Experimental addition for identity motivation as a supplement. | Experimental addition for community barriers as a supplement. | Experimental test of combined cultural identity and motivation supplements. | Experimental test of combined cultural identity and community barrier supplements. | Experimental test of combined community barrier and motivation supplements. | Experimental test of all three supplements added to core. |
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| Primary use | Promotes engagement by addressing cultural identity factors that influence continued use of mental health services. | Designed to increase engagement of racial and ethnic minority young adults in outpatient mental health programs. | Promotes engagement by stimulating identity-based motivation and future hope for service use. | Promotes engagement by helping participants overcome community/environment barriers and self-efficacy issues. | Tests whether combining cultural identity and motivation interventions enhances engagement. | Tests whether combining cultural identity and community barrier interventions enhances engagement. | Tests whether combining community barriers and motivation interventions enhances engagement. | Tests whether delivering all three behavioral supplements maximizes engagement in services. |
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| How it is given or performed | Same as core intervention, with additional activities/discussions focusing on cultural identity. | Administered by a licensed clinician and professional peer as a creative arts-based group intervention. | Same as core intervention, with enhanced sessions centered on identity motivation. | Same as core intervention, with targeted sessions addressing community and environment barriers. | Same as core intervention, with combined supplemental elements focusing on cultural identity and motivation. | Same as core intervention, with combined supplemental elements focusing on cultural identity and environment barriers. | Same as core intervention, sessions combine motivation and community/environment barriers. | Same as core intervention, all supplemental content delivered in group sessions. |
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| Evidence status | Supplemental component under investigation, with trial assessing its added value for engagement in minority young adults. | Currently being tested in a randomized optimization trial; already established as the core for this multi-component engagement intervention. | Supplemental component under investigation, with trial assessing its added value for engagement in minority young adults. | Supplemental component under investigation, with trial assessing its added value for engagement in minority young adults. | Combined components under investigation, not yet established as superior to core intervention. | Combined components under investigation, not yet established as superior to core intervention. | Combined components under investigation, not yet established as superior to core intervention. | All three components combined are under investigation, not yet established as superior to core intervention. |
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| Important limitations | Added complexity may influence acceptability or adherence; actual impact of cultural identity supplement remains to be demonstrated. | The effectiveness and adherence of this engagement intervention in minority young adults with complex mental health needs are still being evaluated. Patient acceptability, real-world service utilization, and adherence are primary outcomes. | Effectiveness of motivational supplement, and potential for added complexity, have not been established in this population. | Community/environment supplement's effect, and real-world applicability, are not yet known for minority young adults with severe mental health needs. | Combined supplements may increase intervention complexity, and their separate or joint effects on engagement are not yet known. | Combined supplements may increase intervention complexity, and their separate or joint effects on engagement are not yet known. | Combined supplements may increase intervention complexity, and their separate or joint effects on engagement are not yet known. | The effects and acceptability of combining all three behavioral supplements with the core intervention remain unproven; complexity and engagement outcomes are under evaluation. |
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