Bounce Back Now: A Low-Cost Intervention to Facilitate Post-Disaster Recovery

立即反弹：促进灾后恢复的低成本干预措施

• 批准号: 9294864
• 负责人: SANDRO MD, MPH, DRPH GALEA
• 金额: $ 78.24万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-20 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9294864
• 关键词: Accident and Emergency department; Acute; Address; Adjustment Disorders; Affect; American; Back; Caring; Cellular Phone; Cessation of life; China; Chronic; Clinical; Clinical effectiveness; Communities; Computers; Counseling; Country; Data Collection; Depressed mood; Devices; Disasters; Disease Outbreaks; Distress; Economics; Effectiveness; Emotional; Employment; Ensure; Family; Funding; Future; Health Personnel; Healthcare; Human Resources; India; Individual; Indonesia; Injury; International; Internet; Intervention; Mental Depression; Mental Health; Minority; Monitor; Online Systems; Outcome; Ownership; Participant; Patient observation; Phase; Philippines; Post-Traumatic Stress Disorders; Predictive Factor; Procedures; Property; Provider; Randomized; Readiness; Recovery; Recruitment Activity; Red Cross; Reporting; Research; Resources; Risk Factors; Schedule; Services; Shelter facility; Societies; Stress; Survivors; Symptoms; Tablets; Technology; Testing; Time; Tornadoes; Training; Transportation; Triage; United States Substance Abuse and Mental Health Services Administration; Update; Use Effectiveness; Work; avoidance behavior; base; behavioral health; brief intervention; cost; cost effectiveness; cost efficient; depressive symptoms; design; disaster survivor; evidence base; follow up assessment; handheld mobile device; health care service utilization; high risk; improved; innovation; laptop; loved ones; mood symptom; novel; post-traumatic stress; public health relevance; reduce symptoms; resilience; response; self help; service utilization; severe mental illness; social; social stigma; stressor; treatment as usual; user-friendly

 DESCRIPTION (provided by applicant): Disasters confront individuals with a wide range of stressors, including threat of death or injury, loss of loved ones, limited access to basic needs, and financial strain due to property damage or disruptions in employment. Many survivors are resilient or recover rapidly, but a significant minority develops behavioral health problems such as posttraumatic stress disorder and depression. Some efficacious treatments exist for these mental health problems, but many disaster survivors encounter barriers to receipt of services (e.g., stigma, time commitment, cost, scheduling, transportation). The availability of brief, effective, free, and highly accessible interventions to facilitate personal and community resilience and rapid and sustained recovery is potentially of tremendous value to disaster-affected communities and disaster response agencies. We propose to evaluate Bounce Back Now (BBN), a novel, scalable, and highly sustainable technology-based intervention. BBN will be accessible via any device that is connected to the internet, such as a computer, smartphone, or tablet; it will be optimized for mobile devices to ensure that it is highly accessible and user friendly. The intervention consists of three major components: (1) a symptom/activity tracking component designed to facilitate self-monitoring in the acute post-disaster phase; (2) a brief self-help intervention component that aims to accelerate mental health recovery relative to PTSD and mood symptoms; and (3) a provider assistance component that will connect survivors to a national Disaster Distress Helpline. Our research has supported the feasibility of the first two components of BBN, and the initial efficacy of the brief intervention component of BBN. The Disaster Distress Helpline is a national service administered by the Substance Abuse and Mental Health Services Administration that provides crisis counseling and local referrals to mental health providers. We will recruit 5,000 disaster survivors to test the intervention: 2,500 will be randomly assigned to the BBN condition, the other 2,500 to an enhanced usual care comparison condition. We will also examine the cost effectiveness of the BBN intervention relative to enhanced usual care. A secondary research aim centers on the exploration of triage- level risk factors that are associated with mental health recovery, use of BBN, and service utilization. The American Red Cross and the Office of the Assistant Secretary for Preparedness and Response have partnered with us on this application and will assist us with participant recruitment and collection of data relating to triage- level risk factors. We will conduct this research using an innovative phased-funding approach that will ensure that we are prepared to initiate research in the immediate aftermath of a triggering disaster incident. This study will significantly improve the evidence base around technology-based disaster mental health interventions.

 描述（由申请人提供）：灾难给个人带来了各种各样的压力，包括死亡或受伤的威胁、失去亲人、获得基本需求的机会有限，以及由于财产损失或就业中断而造成的财务紧张。恢复能力强或恢复很快，但有相当一部分人会出现行为健康问题，例如创伤后应激障碍和抑郁症，对于这些心理健康问题存在一些有效的治疗方法，但许多灾难幸存者在接受服务方面遇到障碍（例如，耻辱、时间投入、提供简短、有效、免费和易于获得的干预措施来促进个人和社区的恢复能力以及快速和持续的恢复，对受灾社区和救灾机构具有潜在的巨大价值。 Bounce Back Now (BBN) 是一种新颖、可扩展且高度可持续的基于技术的干预措施，可通过任何连接到互联网的设备（例如计算机、智能手机或平板电脑）进行访问，并将针对移动设备进行优化；设备，以确保其高度可访问性和用户该干预措施由三个主要部分组成：(1) 旨在促进灾后紧急阶段自我监测的症状/活动跟踪部分；(2) 旨在加速心理健康恢复的简短自助干预部分。与创伤后应激障碍（PTSD）和情绪症状相关；（3）将幸存者与国家灾难救助热线联系起来的提供者援助部分，我们的研究支持了 BBN 前两个部分的可行性，以及简短干预部分的初步功效。 BBN 灾难求救热线。是由药物滥用和心理健康服务管理局管理的一项国家服务，提供危机咨询和当地心理健康服务提供者的转介。我们将招募 5,000 名灾难幸存者来测试干预措施：其中 2,500 人将被随机分配到 BBN 条件，另外 2,500 人将被分配到 BBN 条件。我们还将研究 BBN 干预相对于强化常规护理的成本效益。第二个研究目标集中于探索与心理健康相关的分诊级别风险因素。美国红十字会和负责准备和响应的助理部长办公室已与我们合作开发此应用程序，并将协助我们招募参与者并收集与分类级别风险因素相关的数据。我们将采用创新的分阶段资助方法进行这项研究，以确保我们准备好在引发灾难事件后立即启动研究。这项研究将显着改善基于技术的灾难心理健康干预措施的证据基础。