• Composite health risk behavior score [ Time Frame: Measured at Months 6 and 12 ] [ Designated as safety issue: No ]
  

• Composite International Diagnostic Interview (CIDI) depression diagnosis [ Time Frame: Measured at Months 6 and 12 ] [ Designated as safety issue: No ]
  
• Satisfaction with care, as measured by the SF-12 health survey [ Time Frame: Measured at Months 6 and 12 ] [ Designated as safety issue: No ]
  

Depression is a common disorder among adolescents. If left untreated, it can cause significant disability, illness, and even death. Teens with depression often engage in risky health behaviors, such as smoking, drug and alcohol use, unprotected sex, and unhealthy eating and exercise patterns. By reducing these health risk behaviors, depressed adolescents may be able to avoid negative health consequences and improve their physical and mental health. This study will determine the effectiveness of a health education intervention in reducing risky health behaviors in adolescents with depression.

Participants in this study will be invited to enroll during a visit to a participating primary care clinic. Participants will be randomly assigned to either partake in a health education intervention or receive standard care. Both groups will continue to receive treatment through their primary care clinic. Those participants receiving standard care will be referred to special programs as needed to reduce their involvement in risky health behaviors. Participants assigned to the health education intervention will attend 10 weekly education sessions that will be led by trained health educators. Parents or guardians may be asked to attend sessions depending on their interest in the intervention and the age of the youth participant. Topics covered will include teenage smoking, alcohol and drug abuse, risky sexual behaviors, and obesity. Cognitive-behavioral strategies, role playing, and media clips will be used to stimulate discussion and involvement in the intervention. The intervention will be tailored to target the specific risky behaviors in which each participant engages. Motivational interviewing will also be used to build positive attitudes to support behavior change. All participants will attend follow-up visits to assess behavior change at Months 6 and 12 following study entry.

Inclusion Criteria:

• CIDI diagnosis of major depression or probable depression based on youth self report
• Availability of a family member to provide informed consent

Exclusion Criteria:

• Lacks contact information (e.g., address, telephone number)
• Any functioning deficits or other characteristics that might interfere with study participation
• Currently in a living situation that might interfere with study participation (e.g., lives over 1 hour away from the study site)
• Lacks family available to participate in the intervention
• Mental retardation
• Does not speak English or Spanish