Online system for identifying and addressing teen depression in primary care

用于识别和解决初级保健中青少年抑郁症的在线系统

• 批准号: 10433890
• 负责人: Barbara Jo Howard
• 金额: $ 48.95万
• 依托单位: TOTAL CHILD HEALTH, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10433890
• 关键词: 17 year old; Abnormal coordination; Address; Adolescent; Affect; Agreement; Algorithms; Appointment; Area; Artificial Intelligence; Caring; Child; Child Psychiatry; Childhood; Clinical; Computers; Consensus; Data; Data Collection; Depression and Suicide; Depression screen; Development; Evidence based treatment; Family; Feedback; Feeling; Focus Groups; Goals; Guidelines; Health; Health Professional; Individual; Information Systems; Intervention; Intervention Trial; Interview; Knowledge; Measures; Mental Depression; Mental Health; Mental Health Services; Modality; Moods; Office Visits; Online Systems; Parents; Patients; Phase; Primary Health Care; Process; Psychiatrist; Public Health; Qi; Qualitative Research; Questionnaires; Randomized Controlled Trials; Recommendation; Resources; Risk; Specialist; Specialty Boards; Supervision; Support System; Surveys; System; Teenagers; Testing; Texas; Text; Time; Training; Visit; Youth; adolescent health; barrier to care; base; behavioral health; care coordination; care providers; chatbot; checkup examination; child depression; depressive symptoms; follow-up; functional disability; implementation strategy; innovation; motivational enhancement therapy; programs; recruit; satisfaction; screening; shared decision making; single episode major depressive disorder; skills; success; suicidal risk; tool; volunteer

This proposal presents innovations to addressing teen depression during routine check-up visits through further development of an online clinical process support system called CHADIS. The primary care provider remains in the center of the process with his/her prior relationship with the family and humanity enabled with computer assistance prior to the encounter as well as moment of care reminders and teleprompted specific hints aimed at enhancing a patient focused balanced discussion of individual strengths and barriers to the teens goals known as a motivational interview. This is made feasible through pre-visit data collection providing relevant details to highlight as well as data to support omitting some traditional guidance areas with lower priority for the individual teen. Any conclusions coming from PCP recommendations and shared decision making is reinforced by a computer-based, always available chatbot guided by artificial intelligence that serves as a bridge to other helping professionals, strengths building resources, as well as conversations based on proven mental health therapies based on earlier pilot data for reducing depressive symptoms. These innovations will be tested via a cluster randomized control trial, demonstrating whether use of the system results in higher rates of screening, reductions in depressive symptoms, and accessing of evidence-based treatment for teen depression. Use of the system is reinforced by engagement of primary doctors and child psychiatrists in a related quality improvement program with data from their participation providing needed feedback for recertification of professional status requirements of their respective specialty boards. Success of the system would mean a new primary care workflow-friendly tool which could help adolescents avoid the significant functional impairment and increased risks that accompany teen depression. If this new paradigm for adolescent health supervision proves useful for depression, adaptations for other teen challenges might also be promising.

该提案为在常规检查访问期间解决青少年抑郁症提出了创新 通过进一步开发称为Chadis的在线临床过程支持系统。这 初级保健提供者与他/她先前与 在相遇之前，家庭和人类在计算机协助下以及 护理时刻提醒和远程提示，旨在增强以患者为目的的患者 平衡讨论个人优势和对青少年目标的障碍 励志采访。这是通过Visit数据收集提供的可行的 相关细节以突出显示以及支持省略某些传统指导领域的数据 个人青少年的优先级较低。来自PCP的任何结论 建议和共同的决策由基于计算机的加强，总是 由人工智能指导的可用聊天机器人，它是通往其他帮助的桥梁 专业人士，建立资源的优势以及基于可靠的心理的对话 根据早期的试点数据来减轻抑郁症状的疗法。这些 创新将通过群集随机对照试验进行测试，以证明是否使用 该系统会导致更高的筛查率，减少症状的减少和 获得基于证据的青少年抑郁症治疗。系统的使用被加强 主要医生和儿童精神科医生参与相关质量改进 与他们参与的数据有关的计划提供了所需的反馈，以重新认证 他们各自的专业委员会的专业地位要求。系统的成功 将意味着一种新的初级保健工作流友好的工具，可以帮助青少年避免 青少年抑郁症伴随着大量功能障碍和增加的风险。如果这个 青少年健康监督的新范式可证明对抑郁症有用，适应 其他青少年挑战也可能是有希望的。

项目成果

Suicidal Ideation in Adolescents: Understanding Results from Screening with the PHQ-9M and the PSC-17P.

• DOI: 10.1097/dbp.0000000000001063
• 发表时间: 2022-08-01
• 期刊: JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
• 影响因子: 2.4
• 作者: Holcomb, Juliana M.;Dutta, Anamika;Bergmann, Paul;Riobueno-Naylor, Alexa;Haile, Haregnesh;Benheim, Talia S.;Sturner, Raymond;Howard, Barbara;Jellinek, Michael;Murphy, J. Michael
• 通讯作者: Murphy, J. Michael