Assessing the effectiveness of a digital platform to support the mental health of healthcare workers in the response and recovery phases of COVID-19

评估数字平台在 COVID-19 的应对和恢复阶段支持医护人员心理健康的有效性

• 批准号: 10309487
• 负责人: Raina Merchant
• 金额: $ 121.81万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10309487
• 关键词: Absenteeism; Acute; Address; Affect; Anxiety; Appointment; COVID-19; COVID-19 pandemic; Caring; Categories; Cessation of life; Chronic; Clinical; Cobalt; Communities; Decision Making; Discipline of Nursing; Economics; Effectiveness; Effectiveness of Interventions; Evaluation; Feedback; Female; First Aid; Gender; Guidelines; Health Insurance Portability and Accountability Act; Health Personnel; Health Resources; Health Services Accessibility; Health system; Healthcare; Heterogeneity; Hospitals; Hour; Human Resources; Individual; Intake; Internet; Intervention; Interview; Link; Measures; Medicine; Mental Depression; Mental Health; Mental Health Services; Methods; Minority; Mission; Modeling; Motivation; National Institute of Mental Health; Nurses; Occupational Therapist; Online Systems; Patients; Pennsylvania; Perception; Personal Satisfaction; Pharmacists; Pharmacy facility; Phase; Physicians; Population; Process; Productivity; Provider; Psyche structure; Psychiatrist; Public Health; Race; Radiology Specialty; Randomized Controlled Trials; Recovery; Reporting; Research; Research Design; Resources; Schedule; Self Assessment; Self Perception; Self-Direction; Self-Injurious Behavior; Series; Services; Stoicism; Structure; Subgroup; Surveys; Testing; Text Messaging; Thinking; Time; Trauma; Triage; Underrepresented Minority; Universities; Woman; Work; Writing; acute care; base; care seeking; crowdsourcing; design; digital; digital health; digital models; direct patient care; effectiveness evaluation; evidence base; group intervention; health assessment; health care availability; health care delivery; high risk; improved; insight; men; novel coronavirus; pandemic disease; patient oriented; peer coaching; peer support; personal protective equipment; physical therapist; primary outcome; professional atmosphere; psychologic; resilience; response; satisfaction; secondary outcome; social stigma; telehealth; treatment as usual; treatment effect; virtual visit

The novel coronavirus (COVID-19) has radically changed the delivery of healthcare and significantly impacted the mental health of individuals and communities. The effect upon the mental health of the healthcare workforce has been particularly strained throughout the various phases of the pandemic. This impact is predicted to be chronic and pervasive for all and particularly for disproportionately affected underrepresented minority and female populations. There is a critical need to develop and test scalable digital approaches which can identify, address and support the well-being of healthcare workers (HCW) over time and beyond the pandemic. HCWs are busy and there is stigma associated with accessing mental health support. We seek to leverage digital platforms to facilitate ease of access to well-being focused resources and direct connection to mental health providers through real time support using a stepped model of care. During the acute phase of the pandemic, our team developed and implemented Penn Cobalt across the Penn Medicine health system. Cobalt is a web and text-message based platform which allows HCWs to complete contextual surveys and evidence-based assessments remotely on their own time. Individuals are then directed to tailored well-being resources and appropriate individual or group mental healthcare. Across Penn Medicine, and in just 7 months, Cobalt has had 18,300 unique users and has identified 111 HCWs reporting thoughts of self-harm and immediately connected those individuals with a mental health provider for support and evaluation. While Cobalt has had sustained high engagement and increased the health system's ability to identify high-risk individuals, it requires a motivated user. Individuals must “pull” care toward them and overcome multiple barriers ranging from identifying the need for mental health support, to making an appointment, and attending the appointment. We seek to evaluate whether a “pushed” model of care (Cobalt+), which proactively engages individuals, can improve individual mental health, satisfaction with access, and decrease factors which affect workforce productivity (e.g. absenteeism). The specific aims will evaluate, through a randomized controlled trial, the effectiveness of Cobalt+ on HCW depression/anxiety (primary outcome) compared with Cobalt (usual care). Secondary outcomes will include well-being, satisfaction with access to care, and measures of work productivity. Heterogeneous treatment effects will be explored for race and gender. Additionally, we will seek to better understand perceptions of access to mental health care and the effectiveness of Cobalt compared with Cobalt among HCWs through semi-structured qualitative interviews. Overall, this project seeks to address a significant gap and enhance HCW access and receipt of mental health and well-being focused resources and care. Our intent is that this will enable a proactive culture of well-being and mental health support for the healthcare workforce during the multiple phases of the pandemic. Our approach evaluates existing digital models which can be executed in a timely fashion and rapidly scaled for use across other health systems.

新型冠状病毒 (COVID-19) 从根本上改变了医疗保健的提供方式，并对 个人和社区的心理健康 医疗保健对心理健康的影响。 在大流行的各个阶段，劳动力都特别紧张。 预计对所有人，特别是对受影响程度不成比例的代表性不足的人来说，这将是慢性和普遍的 迫切需要开发和测试可扩展的数字方法。 能够随着时间的推移和超出规定范围来识别、解决和支持医护人员 (HCW) 的福祉 疫情期间，医护人员很忙碌，而获得心理健康支持会带来耻辱。 利用数字平台方便地获取以福祉为中心的资源并直接连接 心理健康服务提供者在急性期使用阶梯式护理模式提供实时支持。 在大流行期间，我们的团队在 Penn Medicine 卫生系统中开发并实施了 Penn Cobalt。 Cobalt 是一个基于网络和短信的平台，允许医护人员完成背景调查和 然后根据个人的时间进行远程基于证据的评估，以实现量身定制的福祉。 整个 Penn Medicine 的资源和适当的个人或团体心理保健，在短短 7 个月内， Cobalt 拥有 18,300 名独立用户，并识别出 111 名医护人员报告了自残和 立即将这些人与心理健康提供者联系起来，以获取支持和评估。 持续的高参与度并提高了卫生系统识别高风险个体的能力， 需要积极主动的用户必须“拉动”他们的注意力并克服各种障碍。 从确定心理健康支持的需要，到预约和参加预约。 我们 寻求评估主动参与个人的“推动”护理模式（Cobalt+）是否可以 改善个人心理健康、获得满意度并减少影响劳动力的因素 具体目标将通过随机对照试验评估生产力（例如缺勤）。 与钴（常规护理）相比，钴+对医护人员抑郁/焦虑（主要结果）的有效性。 次要结果将包括福祉、对获得护理的满意度以及工作衡量标准 此外，我们将探讨种族和性别的异质治疗效果。 与其他药物相比，可以更好地了解人们对获得精神卫生保健的看法以及钴的有效性 总体而言，该项目旨在通过半结构化定性访谈解决医护人员中的钴问题。 显着差距，并增强医护人员获得和接受以心理健康和福祉为重点的资源， 我们的目的是，这将为人们提供积极的福祉和心理健康支持文化。 我们的方法评估了大流行的多个阶段的医疗保健人员。 这些模型可以及时执行并快速扩展以供其他卫生系统使用。