Development of an Intervention for Managing Adolescent Anxiety Using Community-Based Participatory Methods: Protocol.

Background: Youth of color who live in urban communities face disproportionate anxiety levels due to systemic inequities, including exposure to violence, economic instability, and neighborhood disadvantage. Despite increased need, these communities often lack accessible mental health interventions. Objective: This study presents a protocol for an anxiety prevention intervention developed through a community-based participatory approach that is tailored to urban youth of color using community-based participatory research methods. Methods: The intervention, co-developed with a community partner and guided by a youth advisory board, includes 5 structured weekly sessions on psychoeducation, coping skills, and role-playing exercises. Facilitators trained in social work or psychology will deliver the intervention, with at least 1 facilitator from the target community ensuring cultural relevance. Recruitment will occur through collaboration with a local high school, with counselors identifying high-risk youth. We will enroll a sample of 30 high school-aged youth at minimum (maximum 50 youth) into the study. Two cohorts of youth will participate in the study. The groups will be separated by sex (male and female). The primary outcome is reduction in anxiety, measured by the Generalized Anxiety Disorder-7 scale. Data will be collected at baseline, after the intervention, and during follow-up assessments (3 months after). Statistical analyses will include parametric tests (eg, repeated measures ANOVA and 1-tailed t tests) to compare anxiety reduction across groups. Results: This pilot intervention is a part of a larger study that began in September 2020 and ended in August 2025. Enrollment for the pilot intervention began in May 2025. The anxiety intervention is expected to reduce anxiety among a high-risk group of youth. Methods to improve facilitator fidelity to the intervention model are expected to support high fidelity to the curriculum. Conclusions: This study highlights the development of a new anxiety intervention using a community-based participatory approach. Findings will be reported and used to scale up the pilot intervention into a larger clinical trial to serve a larger population of youth in the targeted community. In addition, the results will contribute to knowledge on improving mental health accessibility for marginalized youth. If effective, this model could be expanded to support youth in other underresourced communities.