Attention Bias Training for Youth with Anxiety from a Rural Latine Community

Scant research exists for interventions that are accessible and effective for rural Latine youth with mental health needs. The current study examines the feasibility and preliminary effectiveness of a community health worker-facilitated, attention bias modification (ABM) intervention for rural Latine youth with anxiety. Sixty-nine Latine youth (M_age = 11.74; 67% males; 44.5% low-income) with clinical levels of anxiety were randomized to either ABM (n = 34) or to an attention control condition (ACC) (n = 35). ABM included the dot-probe attention training task, where probes appeared in the location of neutral faces on 100% of trials. For ACC, probes appeared in the location of neutral faces on 50% of trials. Participants completed questionnaires, measures of attention bias and attention control, and clinician administered interviews at baseline, post-treatment, and 3-month follow-up. Findings revealed low attrition, excellent training adherence, and favorable treatment satisfaction. There were no statistically significant differences between groups, but both groups showed significant decreases in anxiety symptoms at post-treatment. Clinician ratings of global improvement were 51% and 53% for the ABM and ACC groups respectively. Exploratory analyses examining attention bias and attention control as mechanisms of change on treatment outcomes were not significant. This is the first feasibility study of ABM in a rural Latine community, using a novel mode of delivery. Findings are promising, given excellent rates of engagement and significant decreases in anxiety over time. However, additional research is necessary to optimize anxiety improvement and identify the mechanisms of change in ABM interventions.