Text-Message-Based Depression Prevention for High-Risk Youth in the ED

针对急诊科高危青少年的基于短信的抑郁症预防

• 批准号: 8821665
• 负责人: Megan Larin Ranney
• 金额: $ 18.27万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8821665
• 关键词: 17 year old; Accident and Emergency department; Address; Adherence; Adolescent; Aggressive behavior; Alcohols; Anxiety; Attention; Beck depression inventory; Behavioral; Caring; Client satisfaction; Clinical Trials; Cognitive; Cognitive Therapy; Communities; Complement; Conflict (Psychology); Data Analyses; Depressed mood; Development; Emergency Department Physician; Emergency Department patient; Emergency department visit; Emotional; Enrollment; Evaluation; Fellowship; Focus Groups; Funding; Future; Gender; Goals; Grant; Guidelines; Healthcare; Healthy People 2020; Intervention; Interview; K-Series Research Career Programs; Lead; Learning; Link; Location; Measures; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Morbidity - disease rate; National Institute of Mental Health; Nutritional; Participant; Patient risk; Persons; Physicians; Population; Population Heterogeneity; Post-Traumatic Stress Disorders; Prevention; Preventive; Preventive Intervention; Process; Protocols documentation; Public Health; Qualitative Research; Questionnaires; Randomized; Recording of previous events; Regulation; Relative (related person); Reporting; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Services; Source; Staging; Structure; System; Target Populations; Techniques; Technology; Teenagers; Testing; Text; Time; Training; Training Activity; Translating; United States National Institutes of Health; Violence; Work; Youth; base; career development; depression prevention; depressive symptoms; design; dual diagnosis; effective intervention; efficacy testing; eligible participant; fighting; high risk; high risk sexual behavior; improved; innovation; innovative technologies; mortality; motivational enhancement therapy; patient oriented; peer; peer victimization; peer violence; pilot trial; practical application; prevent; primary outcome; programs; public health relevance; secondary outcome; skills; therapy development; treatment as usual; trend; usability; violence prevention

DESCRIPTION (provided by applicant): This integrated research and training plan will prepare Dr. Ranney, a fellowship-trained, practicing emergency physician, to become an independently funded physician-researcher with expertise in emergency department (ED)-based mental health interventions. Dr. Ranney's long-term research goal is to become an expert in developing effective, easily-disseminated, technology-augmented mental health interventions for high-risk ED patients. Her short-term goals, for this K23 Mentored Patient Oriented Career Development Award, are to (1) gain expertise in the development and evaluation of technology-augmented ED depression interventions, and (2) to test the hypothesis that a brief in-ED + longitudinal text-message ("ED+text") indicated depression prevention intervention is acceptable and feasible for high-risk youth. Depressive symptoms and peer violence are common, significant, and strongly correlated causes of morbidity, mortality, and ED visits among adolescents. The ED is often the primary source of care for high-risk youth with depressive symptoms and history of peer violence. The ED is well established as a location for mental health intervention, yet few resources are available to high-risk youth. Most adolescent ED patients use text-messaging. Text-message behavioral change has been shown effective. In this project, Dr. Ranney and mentors will develop and pilot a single-session in-ED + 8 week longitudinal text-message program ("ED+text") to reduce depressive symptoms, for adolescent ED patients with depressive symptoms and a history of peer violence. Under the guidance of a strong mentorship team of NIH-funded researchers, Dr. Ranney will achieve five specific training goals: (1) Gain advanced training in ED-based mental health research, focusing on the link between depression and violence; (2) Develop expertise in use of technology, particularly text-messaging, to enhance intervention delivery and evaluation; (3) Become a skilled user of qualitative research methodology to inform intervention development; (4) Learn how to design and conduct a clinical trial of an ED-based depression prevention intervention; (5) Develop skills in longitudinal data analysis for clinical trials. Dr. Ranney's training activities will be complemented by an innovative research plan allowing practical application of her new skills. Using a staged approach, Dr. Ranney will, first, conduct focus groups to develop our innovative "ED+text" intervention content; next, refine the intervention through an iterative process of open trials; finally, test the acceptability and feasibility of the intervention through a randomized piot study (n=100). This work is a crucial step toward preventing depression and co-occurring disorders among a high-risk population that does not typically seek out services. It addresses a current lack of easily-accessible preventive interventions, addressing NIMH Strategic Objectives 3 (treatment development for diverse populations) and 4 (strengthening public health impact), as well as critical Adolescent and Mental Health objectives of Healthy People 2020.

描述（由申请人提供）：这项综合研究和培训计划将使 Ranney 博士（一位接受过专科培训的执业急诊医师）做好准备，成为一名独立资助的医师研究员，拥有基于急诊科 (ED) 的心理健康干预方面的专业知识。 Ranney 博士的长期研究目标是成为为高危 ED 患者开发有效、易于传播、技术增强的心理健康干预措施的专家。她获得 K23 以患者为导向的指导职业发展奖的短期目标是 (1) 获得开发和评估技术增强 ED 抑郁症干预措施的专业知识，以及 (2) 检验以下假设： + 纵向短信（“ED+文字”）表明抑郁症预防干预对于高危青少年来说是可接受且可行的。 抑郁症状和同伴暴力是青少年发病、死亡和急诊就诊的常见、重要且密切相关的原因。急诊室通常是有抑郁症状和同伴暴力史的高危青少年的主要护理来源。急诊室是公认的心理健康干预场所，但可供高危青少年使用的资源却很少。大多数青少年 ED 患者使用短信。短信行为改变已被证明是有效的。在这个项目中，Ranney 博士和导师将开发并试行一个单次 ED + 8 周纵向短信计划（“ED+text”），以减少抑郁症状，针对有抑郁症状和病史的青少年 ED 患者同伴暴力。 在由 NIH 资助的研究人员组成的强大导师团队的指导下，Ranney 博士将实现五个具体培训目标：（1）获得基于 ED 的心理健康研究的高级培训，重点关注抑郁与暴力之间的联系； (2) 发展技术使用方面的专业知识，特别是短信，以加强干预措施的实施和评估； (3) 成为定性研究方法的熟练使用者，为干预措施的制定提供信息； (4) 了解如何设计和开展基于 ED 的抑郁症预防干预措施的临床试验； (5)培养临床试验纵向数据分析技能。 Ranney 博士的培训活动将得到一项创新研究计划的补充，使她的新技能能够得到实际应用。 Ranney博士将采用分阶段的方式，首先通过焦点小组来开发我们创新的“ED+文本”干预内容；接下来，通过公开试验的迭代过程完善干预措施；最后，通过随机试点研究（n=100）测试干预措施的可接受性和可行性。 这项工作是在通常不寻求服务的高危人群中预防抑郁症和并发疾病的关键一步。它解决了目前缺乏易于获得的预防干预措施的问题，解决了 NIMH 战略目标 3（针对不同人群的治疗开发）和 4（加强公共卫生影响），以及 2020 年健康人群的关键青少年和心理健康目标。