Effectiveness of interpretation training to reduce anxiety: Evaluating technology-based delivery models and methods to reduce attrition

口译培训减少焦虑的有效性：评估基于技术的交付模式和方法以减少人员流失

• 批准号: 9926536
• 负责人: BETHANY A TEACHMAN
• 金额: $ 14.22万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9926536
• 关键词: Address; Adherence; Age; Alcohol consumption; Anxiety; Anxiety Disorders; Award; Car Phone; Cognitive; Communities; Computers; Control Groups; Data; Data Collection; Devices; Diagnosis; Dropout; Drops; Effectiveness; Evidence based treatment; Future; Healthcare; Human; Infrastructure; Intervention; Laboratories; Mediating; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Modeling; Modification; Moods; National Institute of Mental Health; Online Systems; Outcome; Participant; Pathology; Performance; Population; Positioning Attribute; Privatization; Protocols documentation; Quality of life; Randomized; Reading; Research; Resources; Risk; Sampling; Self Efficacy; Sequential Multiple Assignment Randomized Trial; Severities; Site; Social Work; Symptoms; Technology; Telephone; Testing; Thinking; Training; Work; adaptive intervention; anxiety symptoms; anxious; associated symptom; base; burden of illness; compare effectiveness; cost effective; distraction; effectiveness testing; effectiveness trial; experience; follow-up; high risk; improved; meetings; mortality; participant retention; preference; programs; psychoeducation; recruit; service delivery; service utilization; web page; web site

Project Summary/Abstract Approximately 25-30% of the U.S. population will experience anxiety pathology severe enough to qualify for an anxiety disorder diagnosis during their lifetime. Critically, the majority will not receive treatment, creating a serious need to consider alternative approaches to delivering mental health services that can meet needs on a larger scale. Cognitive Bias Modification (CBM) interventions for anxiety hold considerable promise as a way to meet these needs. These programs alter biased ways of thinking, such as selective assignment of threat interpretations, which are known to cause and maintain anxiety. CBM for interpretation bias (CBM-I) has established efficacy when administered via computer in the laboratory, and there is clear evidence for target engagement (i.e., change in interpretations, the identified mechanism). Now, effectiveness needs to be tested in the community, using sufficiently large samples to evaluate key moderators of its effects, including delivery method (computer vs. mobile phone) and the addition of minimal human contact (for those at risk of attrition). Addressing attrition is critical given high rates of drop out for web-based interventions. The PI's lab is ideally positioned to test moderators of CBM-I. Specifically, via the PI's MindTrails web site (established with the lab's prior NIMH R34MH106770 award), the lab already has the infrastructure to deliver CBM to the public and recruit large anxious samples. Moreover, the PI and Co-I have established infrastructure to do mobile sensing of mood and CBM-I delivery via mobile phones. Thus, the project can respond to NIMH's request for “Effectiveness trials that can contribute to advancing the personalization of mental health care.” The current proposal aims to compare effectiveness and target engagement of CBM-I delivered via computer vs. mobile phone, and test if adding minimal human contact for participants at risk of dropout improves retention and outcomes. Study 1 will provide a pilot feasibility and user experience test of the CBM-I program on mobile phones. Study 2 will examine the lab's current online, computer-based CBM-I data to help determine empirical indicators of attrition. Study 3 will provide the primary test of moderators of effectiveness. Namely, in Study 3, N=840 high anxious participants will be randomized to one of 3 conditions: 1) CBM-I training delivered by computer (at existing MindTrails site); 2) CBM-I training delivered by mobile phone; 3) Control group- Psychoeducation only. CBM-I conditions include 5 weekly training sessions. Based on theoretically- and empirically-derived predictors of attrition, participants identified as high-risk for dropout in conditions 1 and 2 will then be randomly assigned to add minimal human contact (using the TeleCoach protocol) or no change. Using this adaptive intervention, known as Sequential, Multiple Assignment, Randomized Trial (SMART), the project can test both the effects of CBM-I delivery method and the added value of human contact to improve retention for participants at high-risk for dropping out. !

项目摘要/摘要 大约25-30％的美国人群将经历足够严重的动画病理病理，以获得资格 焦虑症一生中的诊断。至关重要的是，大多数人不会接受治疗，创造 迫切需要考虑提供可以满足需求的心理健康服务的替代方法 较大规模。焦虑的认知偏见修改（CBM）干预措施会考虑有望 满足这些需求。这些程序改变了有偏见的思维方式，例如选择性分配威胁 解释，已知会导致和维护动画。 CBM解释偏差（CBM-I）具有 实验室中通过计算机管理时确定的有效性，并且有明确的目标证据 参与（即，解释，确定的机制改变）。现在，需要测试有效性 在社区中，使用足够大的样本来评估其效果的关键主持人，包括交付 方法（计算机与手机）和增加人类接触（对于那些流失风险的人）。 考虑到基于Web的干预措施的高辍学率，解决损耗至关重要。 PI的实验室是理想情况下 定位用于测试CBM-I的主持人。具体而言，通过Pi的Mindtrails网站（使用实验室建立 该实验室已经具有将CBM交付给公众和 招募大型焦虑样本。此外，PI和Co-I已经建立了基础架构来进行移动感官 通过手机交付的情绪和CBM-I。那就可以回应NIMH的要求 “有助于推进心理保健个性化的有效试验。”电流 提案旨在比较通过计算机与移动的CBM-I的有效性和目标参与 打电话，并测试是否增加有辍学风险的参与者的人类接触是否会改善保留率和 结果。研究1将对CBM-I计划的飞行员可行性和用户体验测试 电话。研究2将检查实验室当前基于计算机的CBM-I数据，以帮助确定 损耗的经验指标。研究3将提供有效性主持人的主要测试。即，在 研究3，n = 840个高焦虑的参与者将被随机分为3个条件之一：1）CBM-I训练已交付 通过计算机（现有Mindtrails网站）； 2）手机提供的CBM-I培训； 3）对照组 - 只有心理教育。 CBM-I条件包括5个每周的培训课程。基于理论和 经验衍生的流失预测指标，参与者在条件1和2中被确定为辍学的高风险 然后将随机分配以添加最小的人类联系（使用远程协议）或无更改。 使用这种自适应干预措施，称为顺序，多个分配，随机试验（SMART）， 项目可以测试CBM-I输送方法的影响和人接触的附加值以改善 在高风险的参与者辍学的参与者中保留。