Duke IMPACT: Improving Med-Psyche Adolescent Care Together (2026-2027)

Background

Adolescents who experience both medical and psychiatric conditions often face greater health challenges than their peers. They have higher risks of premature mortality, loss of independence and reduced quality of life. When hospitalized, these adolescents tend to remain in care longer and require more support, which can increase strain on families and healthcare systems. Caregivers may feel overwhelmed and unsure how to manage their child’s symptoms at home, leading to frequent readmissions. Hospital staff also experience burnout from the emotional and logistical demands of treating these complex patients.

Integrated medical and psychiatric units are growing in number, but little is known about how these units function or how to best support adolescents during and after hospitalization. This project builds on Duke’s experience creating DukeLine, a text-based mental health support resource for students, to explore how undergraduate behavioral coaches can help adolescents build emotional skills and stay connected to supportive resources after discharge.

Project Description

This project team will address three major aims.

Aim 1: Understanding Integrated Medical-Psychiatric Units (IMPUs)
Team members will analyze interview data from more than 200 IMPU medical directors across the United States. Students will prepare a presentation for the American Academy of Child and Adolescent Psychiatry and collaborate on an academic manuscript describing findings about how these units operate and what challenges and opportunities they face.

Aim 2: Pilot Testing the Duke IMPACT Mental Health Curriculum
The team will conduct a pilot study with 24 adolescents hospitalized on Duke’s inpatient unit. Participants will complete daily digital diaries measuring affect, emotion regulation, loneliness and depressive symptoms. They will be assigned to one of three formats for a five-day intervention: measurement-only, self-guided curriculum or peer-coach guided curriculum led by trained DukeLine coaches. Students will help with recruitment, data collection and preliminary analysis of trends in emotional health across the 11-day study period.

Aim 3: Designing an App-Based Prototype
Working with computer science and visual arts students, the team will begin developing mock-ups for a gamified app that will eventually house the Duke IMPACT curriculum. Interviews with adolescent participants will inform design decisions and user experience.

The team will work in subgroups for each aim, with additional subgroups focused on recruitment, data collection and treatment monitoring. Weekly full-team meetings will allow groups to share updates and coordinate progress.

Anticipated Outputs

Academic conference presentation
Manuscript submission on findings from IMPU interviews
Pilot study data for future research grants
Revised mental health skills curriculum for use on IMPUs
Wireframe for a future app-based curriculum

Student Opportunities

Ideally, this project team will include 2 graduate students and 12 undergraduate students. Students from psychology, neuroscience, marketing, visual arts, economics and computer science are encouraged to apply.

Team members will gain experience in qualitative and quantitative research, survey development and implementation, database creation, data cleaning, codebook development, manuscript preparation and scientific communication. Students working on the pilot study will learn about recruitment and study coordination, daily diary administration, intervention monitoring and basic longitudinal data analysis. DukeLine coaches will have the opportunity to apply communication and peer-support skills in a clinical setting.

Students focusing on app development and design will gain experience in user interface and user experience design, branding and early-stage prototyping. Graduate students will mentor subteams, support manuscript preparation and assist with presentations and future grant development.

A project manager has already been identified and will support coordination across subteams. An optional summer component in Summer 2026 will allow interested students to refine curriculum materials and assist with institutional review board preparations.

In Fall 2026, the team will meet on Tuesdays from 4-5 p.m.

Timing

Summer 2026 – Spring 2027

Summer 2026 (optional):

Refine Duke IMPACT curriculum
Improve design elements
Finalize IRB submission for pilot trial

Fall 2026:

Analyze data from IMPU medical director interviews
Prepare presentation for October conference
Work on manuscript submission
Begin recruitment for pilot study

Spring 2027:

Continue recruitment and implementation of the Duke IMPACT curriculum on the inpatient unit

Crediting

Academic credit available for fall and spring semesters