Optimizing Technology Interventions for Help-Seeking for Depression and Suicidality in Sexual and Gender Minority Youth

优化技术干预措施，帮助性和性别少数青年寻求抑郁和自杀倾向

基本信息

批准号：
10487524
负责人：
Ana Radovic-Stakic
金额：
$ 19.88万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-10 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10487524
关键词：
Address Adolescent Adolescent Medicine Affect Age Analysis of Variance Anxiety Attention Attitude Behavior Therapy Behavioral Belief Cause of Death Clinic Clinical Trials Code Depression and Suicide Development Diagnosis Discover, Design, Build, and Test Framework Discrimination Electronic Mail Environment Evidence based treatment Feedback Fright Future Gender Identity Goals Health Health Personnel Health Professional Health Resources Health Services Accessibility Health Technology Healthcare Heterogeneity Homophobia Individual Intention Internet Intervention Intervention Studies Interview Knowledge Lead Lesbian Gay Bisexual Transgender Queer Literature Mainstreaming Maps Marketing Mental Depression Mental Health Mental Health Services Mental disorders Methods Modality Modeling Morbidity - disease rate Outcome Paper Physicians Population Preventive Primary Health Care Randomized Controlled Trials Reading Research Research Personnel Risk Route Sampling Schools Services Sex Orientation Sexual and Gender Minorities Sexual and Gender Minority Youth Social support Subgroup Suicide Techniques Technology Testing Text Messaging Work Youth age group anxiety symptoms anxiety treatment base behavior change care seeking child depression community based research community intervention computer human interaction depressive symptoms design digital health evidence base experience family support follow-up health knowledge help-seeking behavior improved multiphase optimization strategy online intervention preference prevent primary care setting prototype racial and ethnic recruit routine screening sexual health intervention social social media social stigma successful intervention support network systematic review theories therapy design therapy development tool transphobia uptake usability web-based intervention

Address Adolescent Adolescent Medicine Affect Age Analysis of Variance Anxiety Attention Attitude Behavior Therapy Behavioral Belief Cause of Death Clinic Clinical Trials Code Depression and Suicide Development Diagnosis Discover, Design, Build, and Test Framework Discrimination Electronic Mail Environment Evidence based treatment Feedback Fright Future Gender Identity Goals Health Health Personnel Health Professional Health Resources Health Services Accessibility Health Technology Healthcare Heterogeneity Homophobia Individual Intention Internet Intervention Intervention Studies Interview Knowledge Lead Lesbian Gay Bisexual Transgender Queer Literature Mainstreaming Maps Marketing Mental Depression Mental Health Mental Health Services Mental disorders Methods Modality Modeling Morbidity - disease rate Outcome Paper Physicians Population Preventive Primary Health Care Randomized Controlled Trials Reading Research Research Personnel Risk Route Sampling Schools Services Sex Orientation Sexual and Gender Minorities Sexual and Gender Minority Youth Social support Subgroup Suicide Techniques Technology Testing Text Messaging Work Youth age group anxiety symptoms anxiety treatment base behavior change care seeking child depression community based research community intervention computer human interaction depressive symptoms design digital health evidence base experience family support follow-up health knowledge help-seeking behavior improved multiphase optimization strategy online intervention preference prevent primary care setting prototype racial and ethnic recruit routine screening sexual health intervention social social media social stigma successful intervention support network systematic review theories therapy design therapy development tool transphobia uptake usability web-based intervention

展开

项目摘要

A. Abstract Only one-third of adolescents access treatment for depression, and many fail to interact with clinic-based men- tal health resources. Sexual and gender minority youth (SGMY) are at greater risk for severe mental health disorders and suicidality but even less likely to access mental health services, even when access is available. Widespread factors – stigma, negative beliefs about treatment, lack of mental health knowledge - contribute to not seeking services. Mainstream mental health interventions fail to address unique factors to SGMY that in- hibit help-seeking: double stigma (stigma around mental health as well as internalized homophobia and tran- sphobia), concern about revealing SGM status, low family support, lack of access to SGM affirming mental health professionals. Despite being hard-to-reach, SGMY at risk for depression are quite active online. Yet SGMY-specific evidence-based online interventions are lacking and community interventions do not enhance mental health help-seeking. Targeted online interventions are needed to address unique factors which prevent help-seeking but are themselves usable and engaging. The current proposal will use a user-informed efficient approach to technology intervention design considering the heterogeneity and specific needs of SGMY. We will use the Behavioral Intervention Technology Model to design and study several intervention principles (IPs), or theoretical concepts including intervention aims and behavioral strategies, to understand which mechanisms of action hold promise while being iterating design and potential modalities. We will use human computer interac- tion (HCI) framework, Discover, Design/Build, and Test to develop and study several IPs. Specifically we will (1a) conduct an internet-based qualitative study in SGMY to explore current use of online tools, perspectives on intervention targets (e.g. negative attitudes like stigma, social support, knowledge), and preferences for IP components and delivery modalities, (1b) use HCI techniques to develop initial prototypes and seek iterative user feedback and (2) evaluate 4 finalized low-fidelity prototypes using a factorial trial to understand each IP prototype’s individual and combined feasibility, usability, acceptability, and change in help-seeking intention in an online sample of diverse (racially, ethnically, age, gender identity, sexual orientation) SGMY. This will inform the development of a high-fidelity intervention which may include different components for specific SGMY sub- groups to be evaluated in a larger clinical trial. The PI, Dr. Radovic, is a physician researcher in adolescent medicine and has conducted years of research using stakeholder-informed methods and HCI techniques to inform intervention development. By working with experts in SGM health, stakeholder engagement, interven- tion design, qualitative analysis, HCI design, and BIT development and testing, we have an exciting opportunity to bridge the gap for SGM adolescents with depression and suicidality to motivate them to and equip them with the tools they need to access treatment. This proposal is responsive to NOT-MH-18-031 by conducting nimble iterative testing and NOT-MD-19-001 - testing stigma reduction interventions.

A.摘要只有三分之一的青少年可以接受抑郁症的治疗，许多人未能与基于诊所的男性相互作用 - TAL健康资源。性和性别少数青年（SGMY）面临严重心理健康的风险疾病和自杀性，但即使有可用的访问，也不太可能获得心理健康服务。广泛的因素 - 污名，对治疗的负面信念，缺乏心理健康知识 - 有助于不寻求服务。主流心理健康干预措施无法解决对SGMM的独特因素寻求帮助：双重污名（围绕心理健康以及内在的同性恋恐惧症和tran-的污名 SPHOBIA），担心揭示SGM状况，家庭支持低，无法获得SGM影响精神卫生专业人员。尽管难以触及，但处于抑郁症风险的SGMY在网上仍然很活跃。然而缺乏基于SGMY的特定循证在线干预措施，社区干预不会增强心理健康帮助。需要针对的在线干预措施来解决阻止的独特因素寻求帮助，但本身是可用和引人入胜的。当前建议将使用用户信息有效考虑SGMY的异质性和特定需求的技术干预设计方法。我们将使用行为干预技术模型设计和研究多种干预原则（IP）或理论概念在内，包括干预目的和行为策略，以了解哪些机制行动在迭代设计和潜在方式的同时保持承诺。我们将使用人类计算机Interac- （HCI）框架，发现，设计/构建和测试以开发和研究多个IP。特别是我们会的（1a）在SGMY中进行基于互联网的定性研究，以探索当前在线工具的使用，观点关于干预目标（例如，污名，社会支持，知识等负面参与）和IP的偏好组件和交付方式，（1B）使用HCI技术来开发初始原型并寻求迭代用户反馈和（2）使用阶乘试验评估4个最终确定的低保真原型，以了解每个IP 原型的个人且合并的可行性，可用性，可接受性和寻求帮助意图的变化一个在线样本，包括多样化（种族，年龄，性别认同，性取向）SGMY的样本。这将告知高保真干预的发展，该干预措施可能包括特定SGMY子的不同组成部分在较大的临床试验中进行评估的组。 PI，Radovic博士是青少年的物理研究人员医学并使用利益相关者信息的方法和HCI技术进行了多年的研究为干预开发提供信息。通过与SGM Health，利益相关者参与，介入专家合作 - 设计，定性分析，HCI设计以及位开发和测试，我们有一个令人兴奋的机会弥合SGM青少年患有抑郁和自杀的差距，以激励他们并为他们配备他们需要获得治疗所需的工具。该提案通过进行敏捷而对NOT-MH-18-031有反应迭代测试和非MD-19-001-测试污名降低干预措施。