Web-based Intervention for Disaster-affected Adolescents and Families

针对受灾青少年和家庭的网络干预

• 批准号: 8081837
• 负责人: Kenneth J Ruggiero
• 金额: $ 59.75万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-19 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8081837
• 关键词: Acute; Address; Adolescent; Adult; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Area; Behavior; Behavioral; Characteristics; Child; Cigarette; Communities; Costs and Benefits; Counseling; County; Data; Data Analyses; Development; Diagnostic; Digit structure; Disasters; Drug usage; Early treatment; Economic Burden; Education; Epidemiologic Studies; Event; Family; Focus Groups; Fostering; Funding; General Population; Geographic Locations; Goals; Health; Health Care Costs; Household; Human Resources; Internet; Intervention; Interview; Knowledge; Learning; Life; Marijuana Smoking; Measures; Mental Depression; Mental Health; Minority; Minority Groups; Natural Disasters; New York City; Online Systems; Outcome; Parent-Child Relations; Parents; Participant; Pattern; Phase; Pilot Projects; Population; Post-Traumatic Stress Disorders; Prevalence; Public Health; Randomized; Reaction; Recommendation; Recording of previous events; Recovery; Recruitment Activity; Relative (related person); Research; Research Design; Resources; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Scientific Evaluation; Secondary to; Series; Services; Social support; Stress; Structure; Substance abuse problem; Supervision; Symptoms; Telephone Interviews; Testing; Time; Training Programs; Treatment Efficacy; Underserved Population; Update; Youth; aged; base; biological adaptation to stress; coping; cost; design; ethnic minority population; evidence base; follow-up; health care service utilization; help-seeking behavior; indexing; man; parent-child communication; parental monitoring; physical conditioning; population based; psychosocial; public health relevance; racial and ethnic; resilience; satisfaction; self help; skills

DESCRIPTION (provided by applicant): A single disaster, terrorist attack, or other large-scale incident can adversely affect thousands of youth and families. Immediate consequences may include unmet basic needs and high economic burden to families. Disasters also can dramatically affect family routines, marital stress, parent-child interactions, and, more broadly, family roles and relationships. Whereas most youth are resilient (i.e., do not develop serious mental or physical health problems) in the aftermath of disasters, various problems of public health significance are prevalent, such as PTSD, depression, and substance abuse. This underscores the need for effective, widely accessible, and cost-efficient interventions that foster resilience or rapid recovery secondary to the health effects of disasters. To date, few evidence-based early interventions have been developed. Children and adolescents are underrepresented in disaster research, and disaster- affected families have insufficient access to evidence-based resources. Few early interventions have undergone rigorous scientific evaluation; fewer have targeted youth. Further, many efficacious self-help and Web-based interventions exist for the general population, but none exist for disaster-affected youth and families. Recently, our research team developed and explored the feasibility of a Web-delivered, education-based intervention for adults designed to reduce risk for prevalent mental health and health-risk consequences of disasters. Results of our pilot study with 325 New York City-area adults two years after the September 11th terrorist attacks supported the feasibility and potential utility of Web-based educational approaches post- disaster. The primary aims of the proposed project are to (a) develop a Web-based intervention for disaster-affected adolescents and parents targeting health-related correlates of disasters (i.e., development phase), (b) conduct a randomized controlled population-based study to examine feasibility and preliminary efficacy of the intervention with 3,000 disaster-affected adolescents and their parents (i.e., RCT phase), (c) refine the intervention based on feasibility and efficacy data, and (d) prepare for larger-scale research in the acute post-disaster phase. Our strategy to target a wide range of symptom presentations, as well as both subthreshold and diagnostic levels, is consistent with public health recommendations based on findings indicating benefits in terms of reduced health costs and positive outcomes associated with evidence- informed early interventions. PUBLIC HEALTH RELEVANCE: Disasters occur often in the U.S. and can negatively affect thousands of families simultaneously. The mental health consequences of disasters are significant, but few resources are available for youth and families to help them learn about healthy coping strategies and services that might be available to them in their communities. The goal of this project is to develop and evaluate an online, self-help resource for adolescents and parents who are affected by disasters. The self-help resource will be educational, highly interactive and engaging, and will be designed to reduce risk for the development of mental health problems after a disaster, such as posttraumatic stress reactions, depression, and alcohol and drug-use problems.

描述（由申请人提供）：一次灾难、恐怖袭击或其他大规模事件就可能对成千上万的青少年和家庭产生不利影响。直接后果可能包括基本需求得不到满足以及家庭的沉重经济负担。灾难还会极大地影响家庭日常生活、婚姻压力、亲子互动，以及更广泛的家庭角色和关系。尽管大多数青少年在灾难发生后具有复原力（即不会出现严重的心理或身体健康问题），但各种具有公共卫生意义的问题仍然普遍存在，例如创伤后应激障碍（PTSD）、抑郁症和药物滥用。这强调需要采取有效、广泛可及且具有成本效益的干预措施，以促进灾害对健康影响继发的复原力或快速恢复。迄今为止，几乎没有开发出基于证据的早期干预措施。儿童和青少年在灾害研究中的代表性不足，受灾家庭无法充分获得循证资源。很少有早期干预措施经过严格的科学评估；以青少年为目标的人较少。此外，对于普通大众来说，存在许多有效的自助和基于网络的干预措施，但对于受灾青少年和家庭来说却没有。最近，我们的研究团队开发并探索了一种针对成年人的基于网络的、基于教育的干预措施的可行性，旨在降低普遍心理健康的风险和灾害造成的健康风险后果。 9 月 11 日恐怖袭击两年后，我们对 325 名纽约市地区的成年人进行了试点研究，结果支持了灾后基于网络的教育方法的可行性和潜在效用。拟议项目的主要目标是 (a) 针对受灾害影响的青少年和家长制定基于网络的干预措施，针对灾害的健康相关因素（即发展阶段），(b) 开展一项基于人群的随机对照研究对 3,000 名受灾青少年及其家长检验干预措施的可行性和初步效果（即 RCT 阶段），(c) 根据可行性和效果数据完善干预措施，以及 (d) 为灾后紧急阶段的更大规模研究。我们针对广泛的症状表现以及阈下和诊断水平的策略与公共卫生建议一致，这些建议基于表明与循证早期干预相关的降低健康成本和积极结果方面的益处的研究结果。 公共卫生相关性：灾难在美国经常发生，可能同时对数千个家庭产生负面影响。灾害对心理健康造成的影响是巨大的，但青年和家庭几乎没有资源来帮助他们了解社区中可能提供的健康应对策略和服务。该项目的目标是为受灾害影响的青少年和家长开发和评估在线自助资源。该自助资源将具有教育性、高度互动性和吸引力，旨在降低灾难后出现心理健康问题的风险，例如创伤后应激反应、抑郁症、酗酒和吸毒问题。

项目成果

A Randomized Trial of Attention Training for Generalized Social Phobia: Does Attention Training Change Social Behavior?

• DOI: 10.1016/j.beth.2013.04.010
• 发表时间: 2013-12-01
• 期刊: BEHAVIOR THERAPY
• 影响因子: 3.7
• 作者: Bunnell, Brian E.;Beidel, Deborah C.;Mesa, Franklin
• 通讯作者: Mesa, Franklin

Development and preliminary evaluation of a behavioural HIV-prevention programme for teenage girls of Latino descent in the USA.

• DOI: 10.1080/13691058.2014.891049
• 发表时间: 2014
• 期刊: Culture, health & sexuality
• 作者: Davidson TM;Lopez CM;Saulson R;Borkman AL;Soltis K;Ruggiero KJ;de Arellano M;Wingood GM;Diclemente RJ;Danielson CK
• 通讯作者: Danielson CK

Access and completion of a Web-based treatment in a population-based sample of tornado-affected adolescents.

在受龙卷风影响的青少年群体样本中获得并完成基于网络的治疗。

• DOI: 10.1037/ser0000017
• 发表时间: 2015
• 期刊: Psychological services
• 影响因子: 2.3
• 作者: Price,Matthew;Yuen,EricaK;Davidson,TatianaM;Hubel,Grace;Ruggiero,KennethJ
• 通讯作者: Ruggiero,KennethJ