Research

Resiliency Technologies, Inc. has created a mental health education service called Sharpen which is available through both mobile and desktop applications and is created using best practices in public health research, incorporating suicide prevention(1), resiliency(2) and mental health literacy(3). Through its modular content, Sharpen improves eight primary protective factors that were inspired by the research of Neumark-Sztainer(4) in 2006, Reupert(5) in 2017 and Burke-Harris in 2020(6). The evidence-based libraries are neutrally titled: Cope (improving SEL and coping skills); Thrive (decreasing stress); Nourish (nutritional support); and Heal (identifying signs, symptoms, and help).

Through data collection, focus groups and inter-disciplinary research collaborations using the platform, the Sharpen framework has shown to improve trauma-informed best practices(7) and overcome stigma through the use of peer-to-peer focused film content(8). Previous research on the foundations of the Sharpen app content has shown success in building resilience in those with disordered eating and improving safety in managing mental health disorders in K12 schools(9) (Anderson et al., 2017), improving coaching best practices regarding female athlete triad and disordered eating prevention(10), improving engagement, pride and resilience in urban-rich communities(11), and improving literacy, mindfulness and social-emotional skills in elementary, middle school and high school youth(12). Further, we have shown that providing access to gold-standard mental health screening(13), dramatically increases engagement with mental health treatment(14).

Sharpen has formed collaborations with an array of doctoral-level researchers over the last five years. At Edward Via College of Osteopathic (VCOM) Carolinas Campus the founders of Sharpen have collaborated with research teams to study the overall impact of the Sharpen service, and:

resilience in middle school volleyball athletes(15)(16)
mental health needs of medical students on the VCOM Carolinas campus(17)(18),
validating the Sharpen Resiliency Scale(19)
sleep outcomes among Division-1 athletes(20)

At University of West Georgia, the founders of Sharpen have collaborated with research teams to study:

College athlete resilience (23), (24), (25)
Foster parent resilience (26)
Mental health literacy of college students (27)
Sharpen as a peer mentoring and mental health literacy training tool (28)

In addition, these other research efforts are currently under way:

At Stanford Medical School, researchers are using Sharpen as a DBT intervention for adolescent youth (29)
Working in collaboration with New York State suicide prevention coalitions, Sharpen is being utilized as a suicide prevention tool for LGBTQIA+ youth (30)
At Kennesaw State University, researchers are utilizing Sharpen to improve college student mental health literacy (27)
With researchers from Spartanburg Regional Healthcare System, VCOM and Boston Children’s Hospital, Sharpen is engaged in an IRB study with medical students and residents to measure increased compliance, screening competence and reduction in stigma around the topic of eating disorders.
With South Carolina Forster Parent Association and United Way of the Piedmont, Sharpen is measuring parent stress reduction and increased knowledge of mental health literacy with foster parents throughout the state of South Carolina (26).

Through our collaborations with evidence-based, award-winning screening tools, Sharpen expands our impact:

nView M.I.N.I which has been cited in thousands of FDA-approved studies and clinical trials to accurately and efficiently identify, diagnose, and monitor individuals who need behavioral health assistance. An example of the nView screening integration occurred with 800 Limestone University athletes who were able to successfully access the nView mental health screening tool directly through the Sharpen app. Curated content was sent to the student athletes in response to the screening through the feed and through newsletter and email notifications (23).
Heads Up Checkup (HCU) which is a pediatric, self-report engaging children ages 9 and up into an innovative series of screenings. With HCU, Sharpen has impacted thousands of middle school, high school and college students (28), (31).

One differentiator with the app is that the researchers can create novel content and change it quickly, when targeted interventions become indicated. Sharpen makes it easy for organizations and providers to embed surveys and assessments into the mobile environment and receive results instantly.

(1)Karydi, A., Davis, T., Hussa-Farrell, R. The Spartanburg South Carolina suicide prevention task force was created and led by Robyn Hussa Farrell for 4 years in collaboration with the Office of Suicide Prevention, led by Dr. Alex Karydi and Taylor Davis, Ed.S. who wrote the suicide prevention plan for the state of South Carolina and for SC schools through the Department of Education. It was through this (and other) research and statewide collaborations that the Sharpen system was developed.

(2)Between 2017-2019 Sharpen was deployed to educators who participated in 3 day resiliency training including Adverse Childhood Experiences (ACEs) and primary prevention programs to build community resiliency, led by Dr. Jennifer Parker and the University of South Carolina Upstate Child Protection Training Center. Sharpen’s CEO served as the invited mindfulness / resiliency presenter on Day 3 of the Compassionate Schools / Resilient Schools summits between 2016-2019. The 5 Minute Mindfulness training for educators that is currently in the Sharpen service, was a 1.5 hour component of the 3rd day of the Compassionate Schools initiative. After each workshop, educators received access to Sharpen to explore more topics on childhood trauma and resilience, along with tools to increase their own self-care, mental health literacy and best practices for prevention mental health and substance use disorders in the school setting. (Parker, J., Olson, S. & Bunde, J. The Impact of Trauma-Based Training on Educators. Journ Child Adol Trauma 13, 217–227 (2020). https://doi.org/10.1007/s40653-019-00261-5.)

(3)Every module in Sharpen’s course library is created using the MHL framework and (1) improves understanding of how to obtain / maintain good mental health; (2) improves understanding of various mental disorders and their treatments; (3) decreases stigma related to mental disorders through peer documentary film stories; (4) increases connection to treatment and help-seeking (Kutcher, S., Wei, Y., Costa, S., Gusmão, R., Skokauskas, N., & Sourander, A. (2016). Enhancing mental health literacy in young people. European Child and Adolescent Psychiatry, 25(6), 567-569. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27236662)

(4)Neumark-Sztainer, D. R., Wall, M. M., Haines, J. I., Story, M. T., Sherwood, N. E., & van den Berg, P. A. (2007). Shared risk and protective factors for overweight and disordered eating in adolescents. American journal of preventive medicine, 33(5), 359–369. https://doi.org/10.1016/j.amepre.2007.07.031

(5)Reupert A. A socio-ecological framework for mental health and well-being. Adv Ment Health. 2017;15(2):105–7.

(6)Bhushan D, Kotz K, McCall J, Wirtz S, Gilgoff R, Dube SR, Powers C, Olson-Morgan J, Galeste M, Patterson K, Harris L, Mills A, Bethell C, Burke Harris N, Office of the California Surgeon General. Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. Office of the California Surgeon General, 2020. DOI: 10.48019/PEAM8812.

(7)Hussa-Farrell, R, Farrell, T, Witt, H. (2021). Sharpen Family: Building Resilience Through Trauma-Informed Technology and Rich Community Engagement. Southeastern School Behavioral Health Annual Conference (led by Dr. Mark Weist and the Behavioral Alliance of South Carolina), virtual abstract presentation, Myrtle Beach, April, 2021.

(8)Data obtained through Sharpen’s 2020 year-end participant and client survey (n=57) and community based participatory research conducted between 2013-2020 through the Way to Wellville – Spartanburg initiative, Northside Development Group (Purposebuilt) initiative, and the Video Village initiative, funded through Bloomberg Philanthropies.

(9)Anderson C, Holody K, Flynn M, Hussa-Farrell R. An exploratory evaluation of the feasibility, acceptability, and efficacy of the mental fitness disordered eating program in schools. Eating Disorders: J of Treat & Prev. 2017 May-Jun;25(3):230-245.PMID: 28441121

(10)In 2013, Sharpen’s founder and CEO assembled “Think Strong, Eat Well, Play Hard” advisory committee with over 25 researchers in disordered eating prevention and female athlete triad syndrome, to collaboratively create an evidence-based female athlete triad intervention for school coaches. As part of the initiative, the advisory committee built a survey for coaches. Data were obtained through an online survey of high school coaches (n = 227). Significant differences were found between male and female coaches in certain attitudes and communication behaviors related to eating and menstrual irregularity. School or district level policies may help reduce these differences and may help mitigate the health consequences for athletes related to possible differential prevention and detection of the comorbidities of the Female Athlete Triad. These training tools and protocols are delivered to college coaches and athletes through Sharpen. (Kroshus, E., Sherman, R.T., Thompson, R.A., Sossin, K., & Austin, S.B. (2014). Gender difference in high school coaches’ knowledge, attitudes and communication about the female athlete triad. Eating Disorders, 22, 193-208.)

(11)Between 2015 and 2017 the co-Founders of Sharpen served as co-Directors in a Bloomberg Philanthropies-funded $1 million dollar grant through the City of Spartanburg and Chapman Cultural Center. As co-Directors of the “Video Village” public art installation, the directors converted 52 windows in an abandoned public housing project into video displays for community-based documentary films. The project focused in the Highland neighborhood of Spartanburg, SC. Hussa and Farrell gathered over 100 resident and police interviews, and created over 2 hours of documentary films alongside the residents. One outcome of the work was that, after deep, personal interviews with their neighbors, the Highland Community Association rejected additional high-density public housing and received funding from the City of Spartanburg to create a neighborhood planning commission. In addition, one of the documentaries created with the residents and police officers has become a required tool for new officer training in the City of Spartanburg, as part of community-based policing practices. The equipment used to create Video Village was repurposed for a computer lab and code school training facility in the local community center. That lab is still in operation (called “Innovation Village”). Finally, as an additional outcome of this project, we saw evidence that asking residents to serve as their own experts increases collaboration and engagement. Over 100 residents of Highland participated in the project and it inspired our Way to Wellville to engage in a “listening campaign” to learn more from residents. Our team was asked to present at several national conferences as a result of this work alongside leaders from Way to Wellville – Spartanburg. The Bloomberg Public Art program across the US is currently being evaluated by researchers at Brookings Institution. The Video Village project was evaluated by Dr. Michelle Covington, researcher in public safety at University South Carolina Upstate.

(12)Sharpen was deployed in several school districts in the Upstate of South Carolina as a professional development tool for educators and school professionals. After the training, educators had access to mindfulness and MBSR videos that they played for students across multiple age ranges. The work was held in Title I schools, alternative schools and through vocational rehabilitation programs and led to state and national conference presentations featuring Sharpen’s CEO. See, also, Resilient Schools detail above and Parker, J., Olson, S. & Bunde, J. The Impact of Trauma-Based Training on Educators. Journ Child Adol Trauma 13, 217–227 (2020). https://doi.org/10.1007/s40653-019-00261-5.

(13)With our partners at National Center for Performance Health, our team has collaborated to offer Sharpen as a successful sports medicine component as a mental health assessment, resource and referral app for university athletes since 2018. We successfully screened 800 athletes for mental disorders using the nView screening. See Sheehan citation below.

(14)Burnette, C., Hall, C., Hussa Farrell, R., Farrell, T. (2017). Sharpen Warrior beta test through survey evaluation of 160 veterans and VA clinicians. Sharpen Up Colleges focus group and survey evaluation of 400+ college students at University of South Carolina Upstate and Wofford College was led, in part, by Dr. Andrew Beer at University of South Carolina, Upstate.

(15)Patrizi, J., Jones, A., Bishop, B., Stoner, AM., Fadel, NM., Bendyk, H. Courtside Mindfulness—Keep Your Head in the Game: The Effects of 8-Week Mindfulness Training on Adolescent Volleyball Athletes. American Psychiatric Association Annual Conference, San Francisco. Poster
Presentation. May 2019.

(16)Fadel NM, Stoner AM, Patrizi J, Bendyk H. The Effects of Mindfulness Training on Adolescent Volleyball Athletes: A Pilot Trial (7/2018-present). Study completed and journal submission in progress. Program design and findings were presented at the American Psychiatric Association annual conference in May 2019 and VCOM research day.

(17)Fadel NM, Garner, H, Stoner, AM, Ridgeway, L, Cheng, N, Hussa-Farrell, R, Farrell, T, Berreta, K, Afkinich, K. A Mental Health and Wellness App For Osteopathic Medical Students. (6/2019-present). Initial results and program presented virtually at the 2020 American Association of Colleges of Osteopathic Medicine (AACOM) Annual Educating Leaders Conference.

(18)Fadel NM, Stoner AM, Rountree B, Hussa-Farrell R, Farrell T. The Usability Of A Mental Health App Among Osteopathic Medical Student (10/2017-present) and validation of the Sharpen Resiliency Scale. Final data evaluation being completed in Spring, 2021 with anticipated journal publication.

(19)Fadel NM, Stoner AM, Rountree B, Hussa-Farrell R, Farrell T. The Usability Of A Mental Health App Among Osteopathic Medical Student (10/2017-present) and validation of the Sharpen Resiliency Scale. Final data evaluation being completed in Spring, 2021 with anticipated journal publication.

(20)Aldret, S., Aldret, R., Fadel, N., Stoner, A., Lipka, J., Turnbull, J., Smith, T., Farrell, T, Hussa-Farrell, R. Using the Sharpen app to improve sleep quality and mental health among college athletes. Research Eureka Accelerator Program (REAP) grant -- Edward Via College of Osteopathic Medicine (5.2021).

(21)De-identified data gathered using Google Analytics and Sharpen CMS dashboard between May 1, 2019 and May 24, 2021.

(22)Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of clinical psychiatry, 59 Suppl 20, 22–57.

23)Cerino, M., Mehra, R., Hussa Farrell, R., Farrell T. (2020). 800 student athletes at Limestone University participated in mental health screening through nView integration with the Sharpen app. Students accessed the mental health screening and received mental health literacy and resiliency content immediately after. See Fireside Chat featuring Dr. Mehra and Coach Cerino at SharpenMinds.com/Chats. De-identified Sharpen data results are available upon request.

(24) Biber, D. D. (2022, October). Division II Student-Athlete Perceptions of Mental Health: A Qualitative Investigation. Presentation in review for the 2022 International Organization for Health, Sports, & Kinesiology 5th International Conference, Las Vegas, NV.

(25) Biber, D. D., Hussa-Farrell, R., Farrell, T. (2022). Division II student-athlete perceptions of mental health: A qualitative investigation. International Journal of Sport Psychology. (in review, September, 2022).

(26) Biber, D. D. (2022). Evaluation of Sharpen® program to improve foster parent resilience. 9,000 foster parents trained in a 5 hour Sharpen course. Anticipated manuscript submission December, 2022.

(27) Biber, D. D. (2022). Evaluation of Sharpen mental health literacy program for college students at University of West Georgia and Kennesaw State University. Anticipated manuscript submission December, 2022.

(28) Biber, D. D., Hussa, R., Abel, C., & Rothman, R. (2022). Assessing the effectiveness of the Sharpen® Mental Health Literacy training in college females, Evaluation and Program Planning. (in review, August, 2022).

(29) Cosgrove, V., Van Meeter, A. (2022). Assessing the effectiveness of Sharpen® to deliver DBT intervention to middle school and high school patients. Anticipated manuscript completed in December, 2022.

(30) Karydi, A. et al. Grant funded through NY State to deploy Sharpen® to LGBTQIA+ youth and create strength-based suicide prevention content. Anticipated completion date December, 2023.

(31) Biber, D. D. & Stewart, B. (in review). The impact of the Heads up Checkup behavioral health screening and Sharpen® mental health literacy training for college athletes. Presentation in review for the 2023 American College Health Association Annual Meeting, Boston, MA.