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: 10659146
• 负责人: Raina Merchant
• 金额: $ 106.08万
• 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 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10659146
• 关键词: Absenteeism; Acute; Address; Affect; Anxiety; Appointment; Black race; COVID-19; COVID-19 impact; COVID-19 pandemic; Caring; Categories; Certification; 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; 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; Patients; Pennsylvania; Perception; Personal Satisfaction; Pharmacists; Pharmacy facility; Phase; Physicians; Population; Process; Productivity; Provider; Psychiatrist; Public Health; Race; Radiology Specialty; Randomized, Controlled Trials; Recovery; Reporting; Research; Research Design; Resources; Schedule; Self Assessment; Self Direction; Self Perception; Self-Injurious Behavior; Series; Services; Stoicism; Structure; Surveys; Testing; Text Messaging; Thinking; Time; Trauma; Triage; Underrepresented Minority; Universities; Well in self; Woman; Women' s Health; Work; Writing; acute care; care seeking; crowdsourcing; design; digital; digital health; digital models; digital platform; direct patient care; effectiveness evaluation; evidence base; group intervention; health assessment; health care availability; health care delivery; high risk population; hospital care; improved; insight; male health; minority health; novel coronavirus; pandemic disease; patient oriented; peer coaching; peer support; personal protective equipment; physical therapist; primary outcome; professional atmosphere; psychologic; racial population; remote assessment; resilience; response; satisfaction; secondary outcome; social stigma; telehealth; treatment as usual; treatment effect; virtual visit; web platform

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.

新颖的冠状病毒（Covid-19）从根本上改变了医疗保健的分配，并显着影响 个人和社区的心理健康。对医疗保健心理健康的影响 在大流行的各个阶段，劳动力尤其紧张。这种影响是 预计所有人都将是慢性和普遍的，尤其是对不成比例的不成比例的 少数民族和女性人口。开发和测试可扩展数字方法的迫切需要 可以随着时间和之外的时间来识别，解决和支持医护人员的福祉（HCW） 大流行。 HCW很忙，并且与获得心理健康支持有关。我们寻求 利用数字平台来方便易于访问以福祉为中心的资源，并直接连接到 心理健康提供者通过实时支持使用阶梯式护理模型。在急性阶段 大流行，我们的团队在整个宾夕法尼亚州医学卫生系统中开发并实施了宾夕法尼亚钴。 Cobalt是一个基于Web和文本消息的平台，允许HCW完成上下文调查，并 基于循证的评估在自己的时间上进行远程评估。然后将个人定向到量身定制的幸福感 资源和适当的个人或小组心理保健。遍及宾夕法尼亚医学，在短短7个月内， Cobalt拥有18,300种唯一用户，并确定了111个HCW，报告了关于自我伤害和的想法 立即将这些人与心理健康提供者联系起来，以进行支持和评估。而钴 持续的参与度很高，并提高了卫生系统识别高风险个人的能力， 需要激励用户。个人必须“努力”照顾他们并克服多个障碍 从确定对心理健康支持的需求到任命和参加任命。 我们 寻求评估主动参与个人的“推动”护理模型（钴+）是否可以 改善个人心理健康，对访问的满意度以及减少影响劳动力的因素 生产力（例如缺勤）。具体目标将通过随机对照试验评估 与钴（通常的护理）相比，钴+对HCW抑郁/焦虑症（主要结果）的有效性。 次要结果将包括幸福感，对护理的满意度以及工作措施 生产率。种族和性别将探讨异质治疗效果。此外，我们将寻求 与 通过半结构化定性访谈，HCW中的钴。总体而言，该项目旨在解决 巨大差距并加强了HCW的访问并接收心理健康和以福祉为中心的资源以及 关心。我们的目的是，这将使人们能够积极主动的福祉文化和心理健康支持 大流行期间多个阶段的医疗保健劳动力。我们的方法评估现有数字 模型可以及时执行并迅速缩放以在其他卫生系统中使用。