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; 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可能会对数千名青年和家庭产生不利影响。直接的后果可能包括未满足的基本需求和对家庭的巨大经济负担。灾难还可以极大地影响家庭习惯，婚姻压力，亲子互动以及更广泛的家庭角色和关系。在灾难发生后，大多数年轻人都是有韧性（即不要出现严重的心理或身体健康问题），但各种公共健康意义的问题都普遍存在，例如PTSD，抑郁症和药物滥用。这突显了有效，可及性和成本效益的干预措施的需求，这些干预措施促进了灾难对健康影响的恢复能力或快速恢复。迄今为止，很少有基于证据的早期干预措施。儿童和青少年在灾难研究中的人数不足，受灾难的家庭无法获得基于证据的资源。很少有早期干预措施经过严格的科学评估；对年轻人的目标很少。此外，许多有效的自助和基于网络的干预措施存在于普通人群中，但受灾的青年和家庭都不存在。最近，我们的研究小组开发并探讨了针对成年人进行基于网络的，基于教育的干预措施的可行性，旨在降低灾难的普遍心理健康和健康风险后果的风险。 9月11日恐怖袭击两年后，我们对325个纽约市地区成年人进行了试点研究的结果，支持了灾难后基于Web的教育方法的可行性和潜在效用。 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可行性和有效性数据，以及（d）为急性污染后阶段的大规模研究做准备。我们针对广泛的症状表现以及子阈值和诊断水平的战略与基于公共卫生建议的建议一致，这表明在降低健康成本和与证据知情的早期干预措施相关的积极结果方面表明了益处。 公共卫生相关性：灾难经常在美国发生，并可能同时影响数千个家庭。灾难的心理健康后果是重大的，但是青年和家庭几乎没有资源来帮助他们了解他们在社区中可能可以使用的健康应对策略和服务。该项目的目的是为受灾难影响的青少年和父母开发和评估一种在线，自助资源。自助资源将具有教育意义，高度互动和引人入胜，并将旨在减少灾难后心理健康问题发展的风险，例如创伤后压力反应，抑郁症，酒精和药物使用问题。