Preventing Depression in Disconnected African American Adolescents & Young Adults

预防与世隔绝的非裔美国青少年的抑郁症

• 批准号: 8124947
• 负责人: PHILIP J LEAF
• 金额: $ 19.65万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-10 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8124947
• 关键词: Adolescence; Adolescent; Affect; African American; Age; Anxiety; Area; Attention; Award; Baltimore; Chronic; Cities; Cognitive; Cognitive Therapy; Collaborations; Communities; Community Actions; Community Participation; Control Groups; Data; Development; Economics; Education; Educational Intervention; Employment; Endogenous depression; Enrollment; Epidemiologic Studies; Federal Government; Funding; Goals; Health; Incidence; Intervention; Intervention Studies; Life; Location; Low income; Manuals; Measures; Mental Depression; Mental Health; Mental Health Services; National Institute of Mental Health; Neurobehavioral Manifestations; Outcome; Participant; Population; Population Heterogeneity; Post-Traumatic Stress Disorders; Prevention strategy; Preventive Intervention; Protocols documentation; Public Health; Quality of life; Randomized; Readiness; Relative (related person); Research; Research Infrastructure; Schools; Services; Site; Societies; Symptoms; Testing; Time; Training; Training Programs; United States; Universities; Workplace; Youth; age group; aged; base; coping; depressive symptoms; design; experience; follow-up; inner city; innovation; juvenile justice system; peer; post intervention; prevent; programs; public health relevance; randomized trial; skills; young adult

DESCRIPTION (provided by applicant): This application for an R34 award proposes to refine and conduct a pilot RCT of a peer-led cognitive-behavioral intervention to determine the feasibility, acceptability, and outcomes for preventing depression and other negative outcomes among out-of-school inner-city adolescents and young adults in a community-based employment training program. The specific aims of this study are: (1) to refine the intervention protocol for the peer-led cognitive behavioral intervention, develop an intervention fidelity checklist, develop a training manual for peer leaders who deliver the intervention, and train peer leaders to deliver the intervention; (2) to conduct a pilot RCT of 142 adolescents and young adults, aged 16-22, that compares outcomes for youth involved with our peer-led cognitive-behavioral intervention with outcomes from youth participating in an attention control condition; and (3) to obtain the information and experiences required for designing and implementing a larger randomized trial. To achieve Specific Aim 1, will refine our peer-led intervention, develop an intervention fidelity checklist, develop a training manual for peer interventionists, and train peer interventionists. To achieve Specific Aim 2, we will conduct a pilot RCT of our peer-led cognitive behavioral intervention. 142 adolescents and young adults with elevated depressive symptoms but without a current depressive episode will be randomized to our 9-session intervention or a 9-week life skills attention control. Assessments post- intervention, 6 months, and 12 months post-intervention will measure depressive symptoms, depressive episodes, anxiety and PTSD symptoms, cognitive appraisals, engaged coping strategies, quality of life, and education and employment milestones. To achieve Specific Aim 3, we will use findings from our pilot RCT (e.g., implementation fidelity, recruitment, attendance) to develop a R01 application to be submitted during the final year of our R34 project. The public health significance of this project is substantial. Given consistent evidence that depression is a debilitating and chronic condition, interventions must attempt to prevent initial depressive episodes from occurring. Adolescence and young adulthood is an ideal time for preventive interventions to occur given the high depression incidence rate in this age group. The innovation of this project is also notable, as it brings mental health services to employment training programs that are being promulgated with new federal funding initiatives. These employment training programs serve large numbers of adolescents and young adults who are not reached by existing mental health interventions. This project is consistent with the goal of the R34 mechanism to encourage research on the development and/or pilot testing of new or adapted interventions and with two high priority areas of NIMH'S Division of Services and Intervention Research to develop innovative interventions and personalize them for optimal use in diverse populations and to employ strategic partnerships and community participation to enhance research capacity and infrastructure. PUBLIC HEALTH RELEVANCE: Depression is a significant public health problem, with adolescents and young adults among the most affected. This project tests a peer-led intervention that aims to prevent the onset and worsening of depression in adolescents and young adults (16-22) who are out-of-school and not in the workforce and enrolled in an employment training program-a group that has not been the focus of previous mental health research. Our intervention may have great benefits to society, as preventing depression among this population has the potential to increase the employability, and ultimately, economic self-sufficiency of participants.

描述（由申请人提供）：本 R34 奖项申请建议完善并开展一项同伴主导的认知行为干预试点随机对照试验，以确定预防抑郁症和其他负面结果的可行性、可接受性和结果。 -学校内城青少年和年轻人参加基于社区的就业培训计划。本研究的具体目标是：（1）完善同伴主导的认知行为干预的干预方案，制定干预保真度检查表，为实施干预的同伴领导者制定培训手册，并培训同伴领导者实施干预措施。干涉; (2) 对 142 名 16-22 岁的青少年和年轻人进行试点随机对照试验，比较参与同伴主导的认知行为干预的青少年的结果与参与注意力控制条件的青少年的结果； (3) 获得设计和实施更大规模随机试验所需的信息和经验。为了实现具体目标 1，将完善我们的同伴主导干预，制定干预保真度检查表，制定同伴干预人员培训手册，并培训同伴干预人员。为了实现具体目标 2，我们将对同行主导的认知行为干预进行试点随机对照试验。 142 名抑郁症状加重但目前没有抑郁发作的青少年和年轻人将被随机分配接受为期 9 次的干预或为期 9 周的生活技能注意力控制。干预后、干预后 6 个月和 12 个月的评估将测量抑郁症状、抑郁发作、焦虑和 PTSD 症状、认知评估、积极应对策略、生活质量以及教育和就业里程碑。为了实现具体目标 3，我们将利用试点 RCT 的结果（例如，实施保真度、招聘、出勤）来开发 R01 申请，并在 R34 项目的最后一年提交。该项目对公共卫生具有重大意义。鉴于一致的证据表明抑郁症是一种使人衰弱的慢性疾病，干预措施必须试图防止最初抑郁发作的发生。鉴于该年龄段抑郁症发病率较高，青春期和成年早期是进行预防性干预的理想时期。该项目的创新也值得注意，因为它将心理健康服务纳入了新的联邦资助计划正在颁布的就业培训计划中。这些就业培训计划为大量现有心理健康干预措施无法覆盖的青少年和年轻人提供服务。该项目符合 R34 机制的目标，即鼓励对新的或适应性干预措施的开发和/或试点测试进行研究，并符合 NIMH 服务和干预研究部的两个高度优先领域，以开发创新干预措施并对其进行个性化以实现最佳效果。在不同人群中使用，并利用战略伙伴关系和社区参与来增强研究能力和基础设施。 公共卫生相关性：抑郁症是一个重大的公共卫生问题，青少年和年轻人受影响最严重。该项目测试了一项同伴主导的干预措施，旨在防止失学且未参加就业培训计划（一组）的青少年和年轻人（16-22 岁）抑郁症的发作和恶化。这并不是之前心理健康研究的重点。我们的干预措施可能会给社会带来巨大好处，因为预防这一人群的抑郁症有可能提高参与者的就业能力，并最终提高参与者的经济自给自足。