Methods: AAW students at three colleges/universities in Massachusetts were recruited and screened using a demographic survey. Those who passed the screening (age 18 - 35, never married, self-identifying as AAW) were invited to participate in a baseline clinical assessment. Eligibility for the AWARE intervention included those who met any one of the following criteria: moderate to severe depression (Center for Epidemiologic Studies Depression Scale (CESD-R) ≥ 16), anxiety (Hospital Anxiety and Depression Scale (HADS-A) ≥ 11), post-traumatic stress diagnosis (PTSD CheckList - Civilian Version (PCL-C) ≥ 30), or childhood exposure to traumatic events (Adverse Childhood Events International Questionnaire (ACE-IQ), any item). Once enrolled, AWARE intervention sessions were conducted in small groups (n ≤ 11) led by the respective student health services centers’ staff therapists. Participants completed a post-intervention clinical assessment. Pre/post- intervention clinical outcomes were assessed using two tailed paired t-test. This study took place from August 2016 to December 2018.
Results: Across three higher education institutions, 174 AAW students voluntarily filled out the demographic screener, 75 students eligibilized for the study, 50 initiated the AWARE sessions, and 37 (74%) completed the pre- and post-intervention clinical assessments. Among those who completed, the median age was 21 years (IQR: 19-24 years). Post-intervention results indicated statistically significant improvements in depression (ΔCESD-R = -9.95 ± 10.86, p < 0.0001), anxiety (ΔHADS-A = -4.30 ± 3.36, p <.0001), and PTSD scores (ΔPCL-C = -8.95 ± 11.52, p < 0.0001). AWARE also significantly improved mental well-being, as assessed by the SF-12 Mental Health Composite Scale (ΔMCS-12 = 9.20 ± 10.71, p < 0.0001).
Conclusions and Implications: This study demonstrates AWARE’s high feasibility, acceptability, and clinical efficacy for young AAW in higher education settings. Culturally-grounded and empirically-based interventions such as AWARE may significantly improve the overall mental health of college and graduate students.