Supporting Mental Health in Underserved Youth: Engagement with Digital Mental Health Technologies in Pediatric Primary Care

支持服务不足的青少年的心理健康：在儿科初级保健中使用数字心理健康技术

• 批准号: 10488219
• 负责人: Colleen Stiles-Shields
• 金额: --
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-13 至 2022-09-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10488219
• 关键词: Address; American; Appointment; Caring; Chicago; Child; Childhood; Clinic; Clinical; Collaborations; Communities; Crime; Data; Decision Making; Detection; Development; Development Plans; Diagnosis; Disease; Educational Materials; Educational workshop; Environment; Ethics; Evaluation; Evidence based treatment; Face; Family; Feedback; Foundations; Future; Goals; Health; Health Services Accessibility; Health Technology; Individual; Insurance Coverage; Intervention; Interview; Knowledge; Language; Life; Link; Logistics; Medical; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Mind; Mobile Health Application; Modeling; National Institute of Mental Health; Observational Study; Outcome; Parents; Patients; Pediatrics; Perception; Population; Preparation; Primary Health Care; Privacy; Process; Productivity; Public Health; Race; Randomized; Recommendation; Reporting; Research; Risk; Scientist; Service setting; Sexual and Gender Minorities; Side; Symptoms; System; Teenagers; Testing; Time; Training; Transportation; Underserved Population; Well Child Visits; Youth; base; behavioral health; brief intervention; career; career development; child services; clinical care; computerized; data format; design; digital mental health; dissemination science; evidence base; feasibility trial; healing; health care service; health disparity; health inequalities; implementation outcomes; implementation science; improved; innovation; low socioeconomic status; mHealth; organizational readiness; pediatrician; primary care setting; programs; psychoeducation; psychoeducational; racial and ethnic; randomized trial; remediation; research and development; satisfaction; screening; service delivery; skills; social stigma; uptake; usability; user centered design

Project Summary/Abstract Mental health disorders are the most common disease of childhood. Yet, millions of teens do not receive mental health care. Most at risk are teens from underserved populations (e.g., low socioeconomic status; racial/ethnic and/or gender/sexual minority), who face a myriad of barriers to mental health screening and care. As such, traditional methods for reaching underserved teens with mental health disorders are not working, resulting in life-long health disparities and a significant public health impact. Consistent with the recommendations made in the NIMH National Advisory Mental Health Council Workgroup report, the goal of this K08 application is to use and adapt existing digital mental health technologies to advance the engagement, assessment, detection, treatment, and delivery of services for pediatric mental health. Specifically, the Accelerated Creation-to-Sustainment Model will guide the development and implementation of the Teen Assess, Check, and Heal (TeACH) System into a pediatric primary care clinic serving teens and families from the West Side of Chicago. In Aim 1, the PI and her mentorship team will collaborate with underserved teens (n=20) and their parents (n=20) to identify strategies to target top barriers to engagement as well as top ethical concerns and requirements for cultural relevance, usability, and usefulness of the TeACH System. In Aim 2, the plan for implementing the TeACH System will be refined through observations, interviews, and co-design workshops with pediatric primary care pediatricians and staff. In Aim 3, the TeACH System will be implemented into a primary care clinic and evaluated in a randomized trial for: 1) engagement and implementation outcomes; and 2) assessment of remediation of health disparities by analyzing differential outcomes (e.g., race, insurance status, individual perceptions of mental health) in a randomized trial. This innovative research will inform general digital mental health technology engagement adaptations needed for underserved teens and identify implementation practices to support the TeACH System in pediatric primary care settings. The PI and her mentorship team will also determine the feasibility and satisfaction of the TeACH System in preparation for the PI’s planned expansion of the System across multiple primary care clinics in a future R01 proposal. The proposed research and career development plans logically build from the PI’s foundational training in pediatrics/behavioral health, user-centered design, and mobile health (mHealth) evaluation to provide opportunities to gain knowledge and skills in: 1) pediatric health disparities; 2) dissemination and implementation science; and 3) ethics specific to deploying digital mental health technologies for underserved populations. Supported by an interdisciplinary team of experts and in institutional environment invested in supporting innovative initiatives to improve the mental and behavioral health of underserved populations, this K08 will launch the PI into a successful career as an independent clinical scientist.

项目摘要/摘要 心理健康障碍是最常见的儿童疾病。然而，数百万的青少年没有得到 心理保健。大多数处于危险中的是服务不足的人口（例如，社会经济地位低下； 种族/族裔和/或性别/性少数群体），面临无数的心理健康筛查和护理障碍。 因此，传统的患有精神疾病的青少年无法正常工作的传统方法， 导致终身健康差异和重大的公共卫生影响。与 NIMH国家咨询精神卫生委员会工作组报告中提出的建议，目的 此K08应用程序是使用和调整现有的数字心理健康技术来提高参与度， 评估，检测，治疗和提供儿科心理健康服务。具体来说， 加速的创建到养育模型将指导青少年的发展和实施 评估，检查和治愈（教学）系统到儿科初级保健诊所，为青少年和家庭提供服务 芝加哥西侧。在AIM 1中，PI和她的Mentalship团队将与服务不足的青少年合作 （n = 20）及其父母（n = 20），以确定针对参与最高障碍以及最高道德的策略 教学系统的文化相关性，可用性和实用性的关注和要求。在AIM 2中， 实施教学系统的计划将通过观察，访谈和共同设计来完善 小儿初级保健儿科医生和工作人员的讲习班。在AIM 3中，教学系统将是 在一家初级保健诊所实施，并在随机试验中评估：1）参与和 实施结果； 2）通过分析差异来评估健康差异的修复 在随机试验中，结果（例如种族，保险状况，对心理健康的个人看法）。这 创新的研究将为一般数字心理健康技术参与所需的适应性提供信息 服务不足的青少年并确定实施实践以支持小儿主要的教学系统 护理设置。 PI和她的攻击团队还将确定教学的可行性和满意度 系统为PI计划扩展在多个初级保健诊所的计划扩展 未来的R01建议。拟议的研究和职业发展计划从PI的逻辑上构建 儿科/行为健康，以用户为中心的设计和移动健康（MHealth）的基础培训 评估以提供获得知识和技能的机会：1）儿科健康差异； 2） 传播和实施科学； 3）特定于部署数字心理健康的道德规范 服务不足人群的技术。由专家跨学科团队和机构的支持 环境投资于支持创新计划，以改善 服务不足的人群，该K08将把PI推向成功的职业生涯 科学家。