Harnessing Mobile Technology to Reduce Mental Health Disorders in College Populations

利用移动技术减少大学生的心理健康障碍

• 批准号: 10360967
• 负责人: Daniel Eisenberg
• 金额: $ 9.31万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-23 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360967
• 关键词: Address; Anxiety; Behavioral Sciences; Clinical; Counseling; Disease; Disease Progression; Eating Disorders; Economics; Effectiveness; Enrollment; Health; Health Technology; Healthcare; Individual; Internet; Intervention; Investments; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Monitor; Outcome; Performance; Population; Prevalence; Prevention; Prognosis; Quality of life; Randomized; Relapse; Service delivery model; Services; Students; Symptoms; System; Testing; Universities; Work; base; care delivery; clinical anxiety; college; comorbidity; cost; cost effectiveness; evidence base; health care delivery; health economics; high risk; improved; improved outcome; mHealth; mobile computing; novel strategies; personalized intervention; personalized screening; population based; programs; screening; screening program; service delivery; service engagement; service uptake; treatment as usual; university student; uptake

PROJECT SUMMARY/ABSTRACT The prevalence of mental health problems among college populations has risen steadily in recent decades, with one-third of college students struggling with anxiety, depression, or an eating disorder. Yet, only 20-40% of college students with mental disorders receive treatment. Inadequacies in mental health care delivery result in prolonged illness, disease progression, poorer prognosis, and greater likelihood of relapse, highlighting the need for a new approach for detecting mental health problems and engaging college students in services. We have developed a transdiagnostic, low-cost mobile health targeted prevention and intervention platform that uses population-level screening for engaging college students in tailored services that address common mental health problems. This care delivery system represents an ideal model for service delivery given its use of our promising, evidence-based mobile programs, a transdiagnostic approach that addresses comorbid mental health issues, and personalized screening and intervention to increase service uptake, enhance engagement, and improve outcomes. Further, our service delivery model harnesses the expertise of our team of leaders in behavioral science, college student mental health, technology, and health economics, and bridges our team’s work over the past 25 years in successfully implementing a population-based screening program in over 160 colleges and demonstrating the effectiveness of Internet-based programs for targeted prevention and intervention for anxiety, depression, and eating disorders in over 40 colleges. We propose to test the impact of this mobile mental health platform for service delivery in a large-scale trial across 20 colleges. Students who screen positive or at high-risk for clinical anxiety, depression, or eating disorders (excluding anorexia nervosa, for which more intensive medical monitoring is warranted), which account for a substantial proportion of the mental health burden on college campuses, and who are not currently engaged in mental health services (N=7,884; of 146,000 initially screened) will be randomly assigned to: 1) intervention via the mobile mental health platform; or 2) referral to usual care (i.e., campus health or counseling center). We will test whether the mobile mental health platform, compared to usual care, is associated with improved uptake (i.e., individuals beginning treatment) (Aim 1), reduced clinical cases and disorder-specific symptoms (Aims 2a, 2b), and improved quality of life and functioning (Aim 2c). We will also test putative targets/mechanisms, other mediators, predictors, and moderators of improved mental health outcomes (Aim 3) as well as stakeholder- relevant outcomes, including cost-effectiveness and academic performance (Aim 4). Our comprehensive mental health care platform can yield clinical benefit to students, appeal to university stakeholders, minimize barriers to implementation sustainability on campuses, and produce an economic return on investment compared to usual care. This population-level approach to service engagement has the potential to improve mental health outcomes for the 20+ million students enrolled in U.S. colleges and universities.

项目概要/摘要 近几十年来，大学生心理健康问题的患病率稳步上升， 三分之一的大学生患有焦虑、抑郁或饮食失调，但这一比例仅为 20-40%。 患有精神障碍的大学生接受了心理保健服务的不足。 在急性疾病、疾病进展、预后较差和复发可能性较大的情况下，强调 需要一种新方法来检测心理健康问题并让大学生参与服务。 开发了一种跨诊断、低成本的移动健康针对性预防和干预平台 使用人群水平的筛查让大学生参与针对常见心理问题的定制服务 鉴于其使用我们的服务，该护理提供系统代表了一种理想的服务提供模式。 有前途的、基于证据的移动程序，一种解决共病心理问题的跨诊断方法 健康问题以及个性化筛查和干预，以提高服务利用率、增强参与度、 此外，我们的服务交付模式利用了我们领导团队的专业知识。 行为科学、大学生心理健康、技术和健康经济学，并弥合我们团队的 过去 25 年来，我们在 160 多个国家成功实施了基于人群的筛查计划 大学并展示基于互联网的有针对性的预防和预防计划的有效性 我们建议在 40 多所大学对焦虑、抑郁和饮食失调进行干预，以测试其影响。 这个移动心理健康平台在 20 所大学的学生中进行了大规模试验。 临床焦虑、抑郁或饮食失调筛查呈阳性或处于高风险（不包括神经性厌食症、 需要进行更密集的医疗监测），这占了相当大的比例 大学校园的心理健康负担以及目前未从事心理健康服务的人 （N=7,884；最初筛选的 146,000 人）将被随机分配到：1) 通过移动心理干预 健康平台；或 2) 转介至常规护理（即校园健康或咨询中心）。 与常规护理相比，移动心理健康平台与提高的吸收率有关（即个人 开始治疗）（目标 1），减少临床病例和疾病特异性症状（目标 2a、2b），以及 改善生活质量和功能（目标 2c）。我们还将测试假定的目标/机制等。 改善心理健康结果（目标 3）的中介因素、预测因素和调节因素以及利益相关者 相关成果，包括成本效益和学业成绩（目标 4）。 心理健康保健平台可以为学生带来临床益处，吸引大学利益相关者，最大限度地减少 校园可持续实施的障碍，并产生投资经济回报 与常规护理相比，这种人口层面的服务参与方法有可能得到改善。 美国学院和大学 20 多万学生的心理健康结果。