Geospatial and Ecological momentary assessment Technology and Activity Engagement for at-risk youth

地理空间和生态临时评估高危青少年的技术和活动参与

基本信息

批准号：
10435008
负责人：
Charles Richard Jonassaint
金额：
$ 13.46万
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：
2018
资助国家：
美国
起止时间：
2018-07-17 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10435008
关键词：
Accelerometer Address Administrator Adolescence Adolescent Affect African American Age Anhedonia Arasena-A Attitude Behavior Behavioral Behavioral trial Belief Black race Caregivers Cellular Phone Childhood Cognitive Therapy Communities Consolidated Framework for Implementation Research Data Ecological momentary assessment Effectiveness Enrollment Feedback Feeling suicidal Focus Groups Goals Health Health Disparities Research Home Individual Intervention Interview Investigation Mental Depression Mental Health Mental Health Services Mental disorders Methodology Methods Modeling Monitor Multimedia Outcome Population Heterogeneity Positive Reinforcements Primary Health Care Provider Psychotherapy Qualitative Methods Race Randomized Research Personnel Rewards Risk Risk Behaviors Risk Factors Sampling Severities Social isolation Suicide Suicide attempt Symptoms System Technology Technology Assessment Testing Therapeutic Time Youth aged base clinically significant cohort depressive symptoms digital experience health equity high risk human centered design implementation framework implementation science implementation strategy interest mobile computing mobile sensing pleasure prevent racial disparity racial diversity racial population randomized trial recruit secondary outcome smartphone Application study population suicidal adolescent suicidal behavior suicidal individual suicidal risk suicide rate tool treatment program trial comparing uptake usability

项目摘要

Adolescence is associated with high risk for suicidal thoughts and behaviors (STBs). In recent years, racial disparities in risk for STBs have become increasingly evident, with African American and other Black-identifying adolescents (herein, Black) experiencing higher rates of suicidal behavior than any other racial group of youth in the U.S. Thus, there is a need for culturally appropriate interventions that target risk factors for STBs among a growing population of racially diverse youth. Anhedonia, defined as the loss of interest or pleasure in enjoyable or valued activities, is a core feature of depression and an independent risk factor for STBs in youth. Behavioral Activation (BA) therapy is a cognitive behavioral intervention that directly targets anhedonia, by decreasing avoidance and isolation behaviors, using positive reinforcement to increase engagement in valued activities and the experience of reward. Growing evidence supports the effectiveness of BA for adolescents in the traditional face-to-face psychotherapy format, and BA has shown promise in the few preliminary investigations that included racially diverse youth. A key advantage of the BA model is that the focus on behavioral strategies is well suited for adaptation to digital platforms that incorporate mobile sensing and can generate objective data on activity. As the digital BA approach allows for real-time feedback to both users and providers on treatment goals and behavioral targets, it offers a significant advantage over traditional face-to-face intervention. To date, no studies have tested digital BA in a diverse study population that includes Black youth. The goal of this study, therefore, is to tailor and test a health coach supported, digital BA intervention to target anhedonia in a diverse sample of youth, using leading implementation science frameworks. The initial BA platform was developed by the investigators to collect mobile accelerometer and geospatial activity data using smartphone technology that is shared with a health coach or clinician to provide feedback and push BA intervention content via a smartphone app. We will first use the Consolidated Framework for Implementation Research (CFIR) to collect and analyze qualitative data from focus groups with racially diverse adolescents, caregivers, providers, and administrators on their perspectives of intervention needs and barriers and facilitators to BA intervention and implementation strategies. Next, using human-centered design methods, we will iteratively develop and adapt the BA intervention to the needs of racially diverse, at-risk adolescents. We will then conduct a pilot randomized trial comparing the digitally delivered BA intervention to passive, smartphone-based activity monitoring alone. A group of 75 adolescents (35% Black), ages 12-18, with moderate depression and elevated anhedonia symptoms will be recruited from the Signature R01. We will examine feasibility, acceptability, and impact on anhedonia (primary target); secondary outcomes include activity, depression, and STB risk. This project will inform a larger randomized trial of BA and has the potential to directly address a critical gap in mental health disparities research.

青春期与自杀想法和行为 (STB) 的高风险相关。近年来，种族机顶盒风险的差异变得越来越明显，非裔美国人和其他黑人认同青少年（此处为黑人）的自杀行为发生率高于任何其他种族青年群体因此，需要采取文化上适当的干预措施，针对机顶盒的风险因素种族多元化的年轻人口不断增长。快感缺失，定义为对享受事物失去兴趣或快乐或有价值的活动，是抑郁症的核心特征，也是青少年 STB 的独立危险因素。行为方面激活（BA）疗法是一种认知行为干预，直接针对快感缺乏，通过减少回避和孤立行为，利用积极强化来增加对有价值的活动的参与，奖励的经验。越来越多的证据支持 BA 对传统青少年的有效性面对面的心理治疗形式，BA 在少数初步调查中显示出了希望，其中包括种族多元化的青年。 BA 模型的一个关键优势是关注行为策略非常适合用于适应包含移动传感并可以生成客观活动数据的数字平台。由于数字 BA 方法可以向用户和提供者提供有关治疗目标和治疗目标的实时反馈行为目标，它比传统的面对面干预具有显着优势。迄今为止，还没有研究在包括黑人青年在内的多元化研究人群中测试了数字学士学位。因此，本研究的目标是是定制和测试健康教练支持的数字BA干预措施，以针对不同样本中的快感缺失青年，使用领先的实施科学框架。最初的 BA 平台是由研究人员使用智能手机技术收集移动加速度计和地理空间活动数据与健康教练或临床医生共享，以提供反馈并通过智能手机推送 BA 干预内容应用程序。我们将首先使用实施研究综合框架（CFIR）来收集和分析来自不同种族青少年、照顾者、提供者和管理人员的焦点小组的定性数据他们对干预需求以及 BA 干预和实施的障碍和促进因素的看法策略。接下来，我们将利用以人为本的设计方法，迭代开发和调整BA干预满足不同种族、高危青少年的需求。然后我们将进行一项随机试验，比较仅对基于智能手机的被动活动监控进行数字化 BA 干预。 75人一组 12-18 岁的青少年（35% 黑人），有中度抑郁症和快感缺失症状加重从 Signature R01 招募。我们将研究可行性、可接受性以及对快感缺失（初级目标）;次要结果包括活动、抑郁和 STB 风险。该项目将告知更大范围的 BA 的随机试验有可能直接解决心理健康差异研究中的一个关键差距。