Digital health platform (DHP) to deliver Mindfulness as a Stress Management Intervention Leveraging Electronic (SMILE) health records for racial and ethnic populations during the COVID-19 pandemic

数字健康平台 (DHP) 在 COVID-19 大流行期间利用电子 (SMILE) 健康记录为种族和族裔人群提供正念作为压力管理干预措施

• 批准号: 10365266
• 负责人: Maria I Davila
• 金额: $ 42.61万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-17 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10365266
• 关键词: Accountability; Address; Affect; Anxiety; Anxiety Disorders; Arousal; Behavioral; Biofeedback; Biological; Black Populations; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 stress; Communities; Computer software; Conflict (Psychology); Data; Effectiveness; Electronic Health Record; Engineering; Environment; Equilibrium; Ethnic group; Evidence based intervention; Face; Frequencies; Goals; Health; Health Promotion; Health Services; Health Services Accessibility; Health Technology; Healthcare; Healthcare Systems; Heart Rate; Human; Improve Access; Institutes; Integrative Medicine; International; Internet; Intervention; Latino Population; Link; Measures; Medical; Mental Health; Mindfulness Training; Minority; Minority Groups; Mobile Health Application; Modeling; Outcome; Participant; Patient Self-Report; Personal Satisfaction; Persons; Physiological; Population; Prognosis; Psychiatry; Psychophysiology; Public Health; Quality of life; Race; Randomized; Randomized Controlled Trials; Regulation; Reporting; Research; Resources; Scientist; Self Administration; Stress; Symptoms; Tablets; Technology; Testing; Time; Training; Treatment Efficacy; Vision; Waiting Lists; anxiety symptoms; arm; authority; barrier to care; base; clinically significant; coronavirus disease; digital; digital health; emotional distress; ethnic minority; ethnic minority population; experience; follow-up; group intervention; health disparity; health equity; health equity promotion; health record; heart rate monitor; heart rate variability; improved; inclusion criteria; indexing; innovation; insight; instructor; mHealth; mindfulness; mindfulness-based stress reduction; multidisciplinary; pandemic disease; patient oriented; patient portal; perceived stress; personalized medicine; physical conditioning; post intervention; precision medicine; programs; psychologic; racial and ethnic; racial population; recruit; resilience; satisfaction; screening; sensor; service member; social; stress management; stressor; targeted delivery; treatment effect; underserved minority; wearable sensor technology

PROJECT SUMMARY/ABSTRACT The current COVID-19 pandemic is disproportionately affecting Black and Latino individuals and increasing existing health disparities. These racial/ethnic populations are facing magnified stress and lack access to patient- oriented health services. Thus, utilization of Digital Health Platforms (DHP) has the potential to address reach, delivery, effectiveness, scalability, and sustainability to decrease COVID-19 related stress in these populations. The proposed study builds on our previous DHP, the Biofeedback Assisted Resilience Training (BART), that targeted improving physiological metrics of Heart Rate Variability (HRV) as a measure of autonomic regulation to manage stress in service members. Now, we incorporate UNC Health patient portal (UNCH- PHRs), Mindfulness-Based Stress Reduction program tailored for COVID-related stress, wearable heart rate sensor, and mobile health app (mHealth) to collect physiological and psychological scales of mental health, into our DHP model to deliver a culturally sensitive Stress Management Intervention Leveraging Electronic health records (SMILE). The overall objective of this proposal is to investigate effectiveness and sustainability of our DHP model, to delineate mindfulness-related mechanisms of action by measuring changes in psychological self-reported metrics and autonomic balance using HRV, and to examine associations between COVID-19 related stress and mental health outcomes, resilience, and HRV. Understanding these interrelationships with a focus on racial/ethnic groups is of utmost importance to provide personalized treatment. The central hypothesis is that SMILE will mitigate COVID-19 related stress. We will test our central hypothesis with a 3-arm randomized controlled trial. Participants will be randomized to one of three arms: 1) an internet-delivered, instructor- administered Mindfulness-Based Stress Management training (MTIA), 2) self-administered Mindfulness training through the commercially available mHealth app Headspace (MAPP), or 3) Waitlist control (WLC). The DHP will capture progress at various points of the study (baseline, weekly during the 08 weeks and at 3-months follow- up). Our rationale is that our DHP model enables access to a wide range of populations, facilitating the promotion and delivery of targeted DHP interventions, such as mindfulness, while collecting psychophysiological metrics to assess treatment efficacy and predictors of mental health. The broader impact is that our proposed DHP could be used to assess new treatment effects and increase health equity for racial/ethnic populations.

项目概要/摘要 当前的 COVID-19 大流行对黑人和拉丁裔个人造成了不成比例的影响，并且不断增加 现有的健康差距。这些种族/族裔人口面临着更大的压力，并且缺乏接触患者的机会 定向健康服务。因此，数字健康平台 (DHP) 的利用有可能解决覆盖范围、 交付、有效性、可扩展性和可持续性，以减少这些人群中与 COVID-19 相关的压力。 拟议的研究建立在我们之前的 DHP（生物反馈辅助弹性训练 (BART)）的基础上， 有针对性地改善心率变异性 (HRV) 的生理指标，作为自主调节的衡量标准 管理服役人员的压力。现在，我们合并了 UNC Health 患者门户网站 (UNCH- PHRs)， 针对新冠肺炎相关压力量身定制的基于正念的减压计划、可穿戴心率传感器、 和移动健康应用程序 (mHealth)，将心理健康的生理和心理量表收集到我们的 DHP 中 利用电子健康记录提供文化敏感的压力管理干预的模型 （微笑）。 该提案的总体目标是调查我们的 DHP 模型的有效性和可持续性，以 通过测量心理自我报告的变化来描绘正念相关的行动机制 使用 HRV 测量指标和自主平衡，并检查与 COVID-19 相关的压力和压力之间的关联 心理健康结果、复原力和 HRV。理解这些相互关系，重点关注 种族/族裔群体对于提供个性化治疗至关重要。中心假设是 SMILE 将减轻与 COVID-19 相关的压力。我们将用 3 臂随机模型来检验我们的中心假设 对照试验。参与者将被随机分配到三个组之一：1）由互联网提供的讲师 - 进行基于正念的压力管理培训（MTIA），2）自我管理的正念培训 通过商用移动医疗应用 Headspace (MAPP)，或 3) 候补名单控制 (WLC)。 DHP 将 捕捉研究各个阶段的进展情况（基线、第 8 周每周以及随后 3 个月的进展） 向上）。我们的理由是我们的 DHP 模型能够接触到广泛的人群，从而促进推广 并提供有针对性的 DHP 干预措施，例如正念，同时收集心理生理指标 评估治疗效果和心理健康的预测因素。更广泛的影响是我们提议的 DHP 可以 可用于评估新的治疗效果并提高种族/族裔人口的健康公平性。