Supporting Mental Health in Underserved Youth: Engagement with Digital Mental Health Technologies in Pediatric Primary Care

支持服务不足的青少年的心理健康：在儿科初级保健中使用数字心理健康技术

• 批准号: 10688083
• 负责人: Colleen Stiles-Shields
• 金额: $ 16.65万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-13 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10688083
• 关键词: Acceleration; Address; American; Appointment; Caring; Chicago; Child; Childhood; Clinical; Collaborations; Communities; Crime; Data; Decision Making; Detection; Development; Development Plans; Diagnosis; Disease; Educational Materials; Educational workshop; Environment; Ethics; Ethnic Origin; Evaluation; Evidence based treatment; Face; Family; Feedback; Future; Goals; Health; Health Services Accessibility; Health Technology; Individual; Institution; Insurance Coverage; Intervention; Interview; Investments; Knowledge; Language; Link; Medical; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Mind; Mobile Health Application; Modeling; National Institute of Mental Health; Observational Study; Outcome; Parents; Patients; Pediatrics; Perception; Population; Preparation; Primary Care; Privacy; Process; Productivity; Public Health; Race; Randomized; Recommendation; Reporting; Research; Risk; Scientist; Service setting; Sexual and Gender Minorities; Side; Symptoms; System; Teenagers; Testing; Training; Transportation; Underserved Population; Well Child Visits; Youth; behavioral health; brief intervention; career; career development; child services; clinical care; computerized; design; digital mental health; dissemination science; ethnic minority; evidence base; feasibility trial; healing; health care service; health disparity; health inequalities; implementation framework; implementation outcomes; implementation science; improved; innovation; low socioeconomic status; mHealth; organizational readiness; pediatrician; primary care clinic; primary care setting; programs; psychoeducation; psychoeducational; racial minority; randomized trial; remediation; research and development; satisfaction; screening; service delivery; skills; social stigma; uptake; usability; user centered design

Project Summary/Abstract Mental health disorders are the most common disease of childhood. Yet, millions of teens do not receive mental health care. Most at risk are teens from underserved populations (e.g., low socioeconomic status; racial/ethnic and/or gender/sexual minority), who face a myriad of barriers to mental health screening and care. As such, traditional methods for reaching underserved teens with mental health disorders are not working, resulting in life-long health disparities and a significant public health impact. Consistent with the recommendations made in the NIMH National Advisory Mental Health Council Workgroup report, the goal of this K08 application is to use and adapt existing digital mental health technologies to advance the engagement, assessment, detection, treatment, and delivery of services for pediatric mental health. Specifically, the Accelerated Creation-to-Sustainment Model will guide the development and implementation of the Teen Assess, Check, and Heal (TeACH) System into a pediatric primary care clinic serving teens and families from the West Side of Chicago. In Aim 1, the PI and her mentorship team will collaborate with underserved teens (n=20) and their parents (n=20) to identify strategies to target top barriers to engagement as well as top ethical concerns and requirements for cultural relevance, usability, and usefulness of the TeACH System. In Aim 2, the plan for implementing the TeACH System will be refined through observations, interviews, and co-design workshops with pediatric primary care pediatricians and staff. In Aim 3, the TeACH System will be implemented into a primary care clinic and evaluated in a randomized trial for: 1) engagement and implementation outcomes; and 2) assessment of remediation of health disparities by analyzing differential outcomes (e.g., race, insurance status, individual perceptions of mental health) in a randomized trial. This innovative research will inform general digital mental health technology engagement adaptations needed for underserved teens and identify implementation practices to support the TeACH System in pediatric primary care settings. The PI and her mentorship team will also determine the feasibility and satisfaction of the TeACH System in preparation for the PI’s planned expansion of the System across multiple primary care clinics in a future R01 proposal. The proposed research and career development plans logically build from the PI’s foundational training in pediatrics/behavioral health, user-centered design, and mobile health (mHealth) evaluation to provide opportunities to gain knowledge and skills in: 1) pediatric health disparities; 2) dissemination and implementation science; and 3) ethics specific to deploying digital mental health technologies for underserved populations. Supported by an interdisciplinary team of experts and in institutional environment invested in supporting innovative initiatives to improve the mental and behavioral health of underserved populations, this K08 will launch the PI into a successful career as an independent clinical scientist.

项目概要/摘要 心理健康障碍是儿童期最常见的疾病，然而，数以百万计的青少年却没有接受治疗。 面临最大风险的是来自服务不足人群的青少年（例如，社会经济地位低下； 种族/民族和/或性别/性少数），他们在心理健康筛查和护理方面面临无数障碍。 因此，针对患有精神健康障碍的服务不足青少年的传统方法不起作用， 导致终生健康差异和重大公共卫生影响。 NIMH 国家咨询心理健康委员会工作组报告中提出的建议，目标 这个 K08 应用程序是使用和调整现有的数字心理健康技术来促进参与， 具体来说，是针对儿科心理健康的评估、检测、治疗和服务。 加速创造到维持模型将指导青少年项目的开发和实施 将评估、检查和治疗 (TeACH) 系统纳入儿科初级保健诊所，为来自以下地区的青少年和家庭提供服务 在目标 1 中，PI 和她的指导团队将与芝加哥西区的服务不足的青少年合作。 （n=20）及其父母（n=20）确定针对参与的主要障碍以及最高道德的策略 在目标 2 中，对 TeACH 系统的文化相关性、可用性和实用性的关注和要求。 将通过观察、访谈和共同设计完善 TeACH 系统的实施计划 在目标 3 中，将与儿科初级保健儿科医生和工作人员一起举办研讨会。 应用于初级保健诊所并通过随机试验进行评估：1）参与度和 实施结果；2) 通过分析差异来评估健康差异的补救措施 随机试验中的结果（例如种族、保险状况、个人对心理健康的看法）。 创新研究将为一般数字心理健康技术参与调整提供信息 服务不足的青少年并确定实践实施以支持儿科小学的 TeACH 系统 PI 及其指导团队还将确定 TeACH 的可行性和满意度。 该系统正在为 PI 计划将该系统扩展到多个初级保健诊所做准备 未来的 R01 提案提出的研究和职业发展计划在逻辑上是根据 PI 的建议构建的。 儿科/行为健康、以用户为中心的设计和移动医疗 (mHealth) 方面的基础培训 评估提供获得以下方面知识和技能的机会：1) 儿科健康差异；2) 传播和实施科学；3) 部署数字心理健康的具体伦理学 由跨学科专家团队和机构提供支持。 环境投资支持创新举措，以改善心理和行为健康 对于服务不足的人群，这款 K08 将使 PI 作为独立临床医生走向成功的职业生涯 科学家。

项目成果

Benefit-finding among young adults with spina bifida.

• DOI: 10.1177/1359105321990804
• 发表时间: 2022-04
• 期刊: JOURNAL OF HEALTH PSYCHOLOGY
• 影响因子: 3.2
• 作者: Kritikos, Tessa K.;Stiles-Shields, Colleen;Shapiro, Jenna B.;Holmbeck, Grayson N.
• 通讯作者: Holmbeck, Grayson N.

Patient-Reported Experiences With Median Arcuate Ligament Syndrome: Resilience and Resources Required.

• DOI: 10.1037/cpp0000355
• 发表时间: 2022-03
• 期刊: CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY
• 影响因子: 1.1
• 作者: Stiles-Shields, Colleen;Osos, Sylwia;Sunnquist, Madison L;Mak, Grace Zee;Skelly, Christopher L;Drossos, Tina
• 通讯作者: Drossos, Tina

Community Teens' COVID-19 Experience: Implications for Engagement Moving Forward.

社区青少年的 COVID-19 经历：对今后参与的影响。

• DOI: 10.1007/s10880-023-09975-z
• 发表时间: 2024
• 期刊: Journal of clinical psychology in medical settings
• 影响因子: 2.2
• 作者: Stiles-Shields,Colleen;Reyes,KarenM;Lennan,Nia;Zhang,Jim;Archer,Joseph;Julion,WrenethaA;Shalowitz,MadeleineU
• 通讯作者: Shalowitz,MadeleineU

Median arcuate ligament syndrome: a cost analysis to determine the economic burden of a rarely diagnosed disease.

• DOI: 10.3389/fpsyg.2023.1166744
• 发表时间: 2023
• 期刊: FRONTIERS IN PSYCHOLOGY
• 影响因子: 3.8
• 作者: Skelly, Christopher L.;Stiles-Shields, Colleen;Goldenthal, Hayley;Bohr, Nicole;Feldman, Estee;Mak, Grace Zee;Drossos, Tina
• 通讯作者: Drossos, Tina

Targeting Coping to Improve Surgical Outcomes in Pediatric Patients With Median Arcuate Ligament Syndrome: Feasibility Study.

• DOI: 10.3389/fpsyg.2021.695435
• 发表时间: 2021
• 期刊: Frontiers in psychology
• 影响因子: 3.8
• 作者: Stiles-Shields C;Osos S;Heilbrun A;Feldman ECH;Mak GZ;Skelly CL;Drossos T
• 通讯作者: Drossos T