Evidence map›Paper›PMID 42374535›Full record

ArticleChild and adolescent psychiatry and mental health2026

Implementation and effectiveness of the web‑based skills training START NOW in adolescents in residential youth care: a cluster randomized controlled trial.

Donja Brunner, Valentine Savary, David Bürgin, Linda Kersten, Janine Alfano, Nikki Rommers, Lelia Lanz, Chiara Chillà, Andreas Papageorgiou, Noortje Vriends and 2 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Child and adolescent psychiatry and mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05313581 (Implementation of an E-version of the Skills Training START NOW for Promoting Emotion Regulation and Resilience in Residential Youth Care and Correctional Institutions), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05313581 nacompletednot on this map

Implementation of an E-version of the Skills Training START NOW for Promoting Emotion Regulation and Resilience in Residential Youth Care and Correctional Institutions: a Cluster Randomized Controlled Trial

TypeinterventionalSponsorProf. Christina StadlerRan2022 to 2024Enrolled150ConditionsResilience, Emotion Regulation, Social Competence, StressArmsSTART NOW WebApp
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Donja BrunnerResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Valentine SavaryResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
David BürginResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland. david.buergin@upk.ch.
Linda KerstenResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Janine AlfanoResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Nikki RommersDepartment of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland.
Lelia LanzResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Chiara ChillàResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Andreas PapageorgiouResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Noortje VriendsResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
Christina StadlerResearch Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel, 4002, Switzerland.
START NOW Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdolescents and young adults in residential youth care (RYC) face cumulated adversity and high emotional and behavioral problems yet face structural barriers that limit access to evidence-based mental health care. While digital tools promise scalability and flexibility, real-world implementation and effectiveness in vulnerable youth in institutional care remain understudied.

objectiveThis study aimed to evaluate the implementation and effectiveness of a newly developed web-based self-help or group-facilitated version of the START NOW intervention in a three-arm cluster-randomized control trial for youth in RYC in Switzerland.

methods164 adolescents and young adults (M = 16.6 years, SD = 1.5; 43.8% female) from 27 RYC institutions were enrolled in a 9-week self-help or group-facilitated START NOW intervention tested against treatment-as-usual (TAU). Psychological inflexibility was the primary outcome; secondary outcomes included trait resilience, well-being, self-efficacy, functional impairment, and distress. Surveys were administered at baseline, post-intervention, 3-, and 6-month follow-up. Primary analyses employed linear mixed models in an intention-to-treat approach imputing missing data to estimate treatment effects at 3-month follow up. The trial was registered: ClinicalTrials.gov Identifier: NCT05313581; 6th April 2022.

resultsThe group-facilitated condition showed higher intervention compliance than the self-help help condition, over 50% of youth in the self-help group did not conduct a single session. Longitudinal follow‑up completion rates declined substantially, with only 37.8% providing data at T3 with the self-help group displaying the lowest levels (TAU 47.8%, 20.7% self-help, 48.3% facilitated group). No significant differences in psychological inflexibility or any secondary outcomes were found between study arms.

conclusionsIn contrast to prior evidence from group-based START NOW interventions with more intensive facilitator support, the web-based START NOW adaptation evaluated in this found no evidence for additional benefits over TAU in RYC settings. Findings highlight critical implementation barriers to high attrition and missing data. Successful adoption of digital interventions in RYC require tailored, blended approaches with active facilitation and adaptive support structures.

Indexed as

AdolescentsEmotion regulationInterventionPsychological flexibilityRandomized controlled trialResidential youth careResilience

Identifiers

PMID42374535
PMCPMC13591857

What Socratic holds

Textmetadata
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.