Evaluation of an Asynchronous Remote Communities Approach to Behavioral Activation for Depressed Adolescents

对抑郁青少年行为激活的异步远程社区方法的评估

• 批准号: 10657790
• 负责人: Jessica Lynne Jenness
• 金额: $ 23.83万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10657790
• 关键词: Address; Adolescent; Behavior; Behavioral; Behavioral Sciences; COVID-19 pandemic; Caring; Chronic; Clinic; Clinical Treatment; Clinical Trials; Communities; Data; Data Collection; Data Security; Development; Diagnosis; Ecological momentary assessment; Effectiveness; Elements; Engineering; Ethnic Origin; Evaluation; Feedback; Funding; Future; Goals; Health Insurance Portability and Accountability Act; Health Services Accessibility; Improve Access; Intervention; Mediating; Mental Depression; Mental Health; Mental Health Services; Methods; Modeling; Monitor; Moods; Motivation; National Institute of Mental Health; Outcome; Outpatients; Participant; Patient-Focused Outcomes; Patients; Pilot Projects; Population; Privatization; Psyche structure; Psychiatry; Race; Randomized, Controlled Trials; Reporting; Research; Research Personnel; Resource-limited setting; Service delivery model; Site; Social Interaction; Socioeconomic Status; Strategic Planning; Symptoms; Technology; Teenagers; Testing; Time; Universities; Washington; Work; adolescent health; adolescent patient; arm; behavior change; behavioral outcome; chatbot; child depression; data visualization; depressive symptoms; design; digital; digital delivery; digital tool; disability; effectiveness trial; evidence base; feasibility testing; functional disability; human centered design; improved; improved outcome; information gathering; innovation; light weight; mobile computing; novel; peer; pilot test; preventive intervention; prototype; psychosocial; remote communities; service intervention; skills; social; social media; synchronous therapy; technology platform; tool; usability

PROJECT SUMMARY Approximately 3.1 million adolescents are diagnosed with depression each year with over 60% not receiving or engaging in mental health care. In an effort to address the significant challenges in access to and engagement with evidence-based psychosocial interventions (EBPIs) for adolescent depression, investigators in the University of Washington’s Departments of Psychiatry and Behavioral Sciences (MPI Jenness) and Human Centered Design and Engineering (MPI Kientz) partnered to conduct pilot work addressing these challenges through the use of Asynchronous Remote Communities (ARC) supported behavioral activation (BA+ARC). ARCs are technology-mediated groups that use private online platforms (e.g., Slack, Microsoft Teams) to deliver weekly tasks to participants and includes features such as asynchronous therapist and chatbot coaching, ecological momentary assessment (EMA) of mood, activity, and skill-use tracking, and peer communities that aim to improve support and motivation to engage in therapy and behavior change. Pilot work included successful design and development of a preliminary BA+ARC prototype (ActivaTeen) that was found to be acceptable, usable, and engaging to clinician and patient target users. The present proposal responds to PAR-21-131 “Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions” and aims to advance this pilot work by conducting a mixed-methods study that 1) builds and conducts usability testing on a functional, usable, and robust BA+ARC platform that will satisfy the needs of mental health clinicians and adolescent patients identified through our pilot study (e.g., data security, HIPAA compliance, clinician workflow integration), and 2) tests the feasibility, usability, and change in proposed target mechanisms and outcomes of BA+ARC compared to BA treatment only (BA-Only) within a moderately-sized randomized control trial conducted within our partner site’s outpatient psychiatry clinic. We hypothesize 1) BA+ARC target users will report increased acceptability, feasibility, usability, and less burden than users of BA-Only; 2) BA+ARC adolescents will demonstrate improvements on hypothesized treatment mechanisms including therapist alliance, timeliness of intervention, social belongingness, and greater engagement in care compared to BA-Only adolescents; 3) Adolescents treated by BA+ARC versus BA+Only will have improved outcomes in depression symptoms and diagnoses and functional impairments. This research addresses the broader NIMH Strategic Plan Goal 4.3: Develop innovative service delivery models to dramatically improve the outcomes of mental health services received in diverse communities and populations by investigating a novel, technology-mediated service model that has the potential to improve access to and effectiveness of EBPIs for adolescent depression.

项目摘要 每年约有310万青少年被诊断出患有抑郁症，超过60％未接受或 从事心理保健。为了应对进入和参与的重大挑战 与青少年抑郁症的基于证据的社会心理干预措施（EBPI），研究人员 华盛顿大学精神病学和行为科学系（MPI Jenness）和人类 集中的设计与工程（MPI Kientz）合作开展飞行员工作，以应对这些挑战 通过使用异步远程社区（ARC）支持行为激活（BA+ARC）。弧 是使用私人在线平台（例如Slack，Microsoft团队）提供每周的技术介导的团体 参与者的任务，包括异步治疗师和聊天机器人教练等功能 暂时评估情绪，活动和技能追踪以及旨在的同伴社区的评估（EMA） 改善从事治疗和行为改变的支持和动机。飞行员工作包括成功设计 并开发初步的BA+ARC原型（Activateen），该原型被认为是可以接受的，可用的 参与临床和患者目标使用者。目前对PAR-21-131的提案回应“飞行员 治疗，预防和服务干预措施的有效试验”，旨在促进该飞行员 通过进行混合方法研究的工作，即1）对功能，可用， 和强大的BA+ARC平台，将满足心理健康临床医生和青少年患者的需求 通过我们的试点研究（例如数据安全，HIPAA合规性，临床工作流程集成）和2）和2 测试BA+ARC的拟议目标机制和结果的可行性，可用性和变化 在我们的伴侣内进行的中等大小的随机对照试验中仅（仅BA）治疗（仅BA） 网站的门诊精神病学诊所。我们假设1）BA+ARC目标用户将报告可接受性， 可行性，可用性和燃烧少于仅BA的用户； 2）BA+ARC青少年将演示 改善了假设的治疗机制，包括治疗师联盟，干预的及时性， 与仅BA的青少年相比，社会归属感和更多的护理参与； 3）青少年 通过BA+ARC与BA+治疗仅将改善抑郁症状和诊断的结果， 功能障碍。这项研究解决了更广泛的NIMH战略计划目标4.3：开发 创新的服务交付模型可极大地改善心理健康服务的结果 通过研究一项新型技术介导的服务，在潜水员社区和人群中获得 具有提高EBPIS对青少年抑郁症的访问和有效性的潜力的模型。