Development and Evaluation of an Avatar Guided Mobile Health for Emerging Adults

针对新兴成年人的化身引导移动健康的开发和评估

• 批准号: 10843991
• 负责人: Lourah Marie Kelly
• 金额: $ 24.9万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10843991
• 关键词: Accident and Emergency department; Address; Adolescent; Adult; Age; Aggressive behavior; Alcohol consumption; Alcoholic Intoxication; Alcohols; Ambulatory Care; Appearance; Area; Attenuated; Award; Behavior monitoring; Caring; Clinical; Collaborations; Consultations; Consumer Participation; Data; Depressed mood; Development; Development Plans; Ecological momentary assessment; Education; Educational workshop; Emergency Care; Emergency department visit; Evaluation; Feedback; Feeling hopeless; Feeling suicidal; Foundations; Future; Goals; Health Benefit; Individual; Intervention; Interview; Link; Mental Health; Mentors; Methods; Mobile Health Application; Moods; Outpatients; Patients; Persons; Phase; Population; Postdoctoral Fellow; Protocols documentation; Provider; Public Health; Randomized; Randomized, Controlled Trials; Reading; Reporting; Research; Research Personnel; Risk; Risk Factors; Safety; Self-Injurious Behavior; Services; Severities; Signal Transduction; Suicide; Suicide attempt; Suicide prevention; System; Technology; Testing; Time; Training; Voice; Youth; acceptability and feasibility; active control; age group; alcohol comorbidity; alcohol intervention; alcohol misuse; alcohol services; alcohol use disorder; binge drinking; career; career development; chronic alcohol ingestion; comorbidity; design; diaries; drinking; efficacy trial; emerging adult; experience; feasibility research; feasibility testing; follow-up; group intervention; hands on research; high risk population; ideation; informant; iterative design; mHealth; medical specialties; multidisciplinary; novel; pilot trial; programs; reduced alcohol use; safety testing; skills; substance use; substance use treatment; suicidal; therapy development; trial comparing; unnecessary treatment; usability; young adult

ABSTRACT The proposed K99/R00 award aims to guide the applicant to research independence, specifically in mobile health (mHealth) interventions for emerging adults with alcohol misuse and comorbid conditions. Emerging adults have the highest rates of alcohol use disorders, suicidal ideation, and suicide attempts compared to any other age group. These problems are highly comorbid, with alcohol intoxication serving as a risk factor for suicidality. However, utilization of outpatient treatment services for alcohol or mental health is extremely low in this population, even following emergency department (ED) visits for either problem. Emerging adults are likely to be responsive to mHealth interventions, and mHealth is well-suited to the ED. mHealth can address an urgent public health need by bridging the gap between discharge and access to outpatient care and by supporting emerging adults who do not access outpatient care. This study seeks to design an evidence-informed interactive, avatar-guided mHealth intervention to provide ongoing education, skills practice, mood and behavior monitoring, and personalized feedback to reduce alcohol misuse and suicidality. This mHealth platform will be developed based on a review of commercial suicidality and alcohol mHealth apps, in-person integrated interventions, and an existing avatar-based mHealth platform, developed by co-mentor Easton. The study aims to: 1) seek feedback on the proposed mHealth intervention avatar, content, and features from a national youth advisory board, consumers (e.g., emerging adults with alcohol misuse and suicidality; n=25), clinical experts in emerging adult alcohol and suicidality treatment (n=10) and ED staff (n=10) creating an alpha version of the intervention; 2) test [usability] of the alpha version and [feasibility of research protocols] in an open pilot trial with (n=20) emerging adults, to inform a beta version, and 3) evaluate [acceptability and feasibility] in a randomized controlled [feasibility] trial comparing the beta version [of the avatar-guided mHealth intervention + standard ED care; n=30)] to an active control, a commercial suicide prevention app (MY3 [+ standard ED care; n=30). Secondary aims of the RCT are to test for safety and early signals of efficacy on a range of alcohol, suicidal ideation, and outpatient care variables at 6-, 12-, and 24-weeks post-randomization.] An exploratory aim is to examine within-person changes in same-day alcohol misuse and SI severity between intervention groups via daily diary and ecological momentary assessment. The training and career development plan includes courses, workshops, seminars, reading, and hands-on research in areas critical to the PI’s independence: mHealth intervention development within interdisciplinary teams, integrated alcohol and suicidality interventions for emerging adults, randomized controlled trials with fully-technology-based interventions, and lagged sequential analysis with ecological data. The R00 projects will provide pilot data to support future fully- powered R01 applications for [efficacy trials] of the avatar-guided mHealth intervention. The K99/R00 award will set the foundation of the PI’s independent research career, specializing in mHealth interventions for alcohol misuse.

抽象的 拟议的K99/R00奖旨在指导申请人独立研究，特别是在移动健康方面 （MHealth）针对新兴成年人滥用酒精和合并状况的干预措施。新兴的成年人有 与任何其他年龄段相比，酒精使用障碍，自杀念头和自杀企图的最高率。 这些问题是高度合并的，酒精毒性是自杀的危险因素。然而， 在该人群中，利用门诊治疗服务对酒精或心理健康的利用也极低，即使 在急诊科（ED）访问这两个问题。新兴的成年人可能会对 MHealth的干预措施和MHealth非常适合ED。 MHealth可以通过 弥合出院和获得门诊护理之间的差距，并通过支持不的成年人 访问门诊护理。这项研究旨在设计有证据的互动，头像引导的MHealth 干预以提供持续的教育，技能练习，情绪和行为监控，并个性化 反馈以减少滥用酒精和自杀。该MHealth平台将根据对 商业自杀和酒精MHealth应用程序，面对面的综合干预措施以及现有的基于头像 MHealth平台，由Co-Mentor Easton开发。该研究的目的是：1）寻求有关拟议的MHealth的反馈 全国青年顾问委员会，消费者的干预化身，内容和功能（例如，新兴的成年人 滥用酒精和自杀； n = 25），新兴的成人酒精和自杀治疗的临床专家 （n = 10）和ED员工（n = 10）创建干预的alpha版本； 2）Alpha版本的测试[可用性]和 [研究方案的可行性]在（n = 20）新兴成年人的开放试点试验中，以告知Beta版本，3） 在随机控制的[可行性]试验中评估[可接受性和可行性] 头像引导的MHealth干预 +标准护理； n = 30）]进行主动控制，商业自杀 预防应用程序（my3 [+标准护理； n = 30）。 RCT的次要目的是测试安全性和早期 在6岁，12岁和24周内的一系列酒精，自杀意念和门诊护理变量的效率信号 后送后。]探索性目的是检查当日酒精滥用和SI的人体内部变化 干预组之间的严重性通过日记和生态瞬时评估。培训和 职业发展计划包括在关键领域的课程，研讨会，半手，阅读和动手研究 对PI的独立性：跨学科团队内的MHealth干预开发，融合酒精和 针对新兴成年人的自杀性干预措施，随机对照试验，具有完全技术的干预措施， 并使用生态数据进行了滞后分析。 R00项目将提供试点数据，以完全支持未来 - AFATAR引导的MHealth干预措施的[功效试验]的供电R01申请。 K99/R00奖将设定 PI独立研究生涯的基础，专门研究滥用酒精的MHealth干预措施。