A Mightier healthcare system: Introducing a game-based pediatric mental health intervention into payor-sponsored care to evaluate financial and clinical outcomes

更强大的医疗保健系统：将基于游戏的儿科心理健康干预引入付款人赞助的护理中，以评估财务和临床结果

• 批准号: 10081053
• 负责人: Jason Kahn
• 金额: $ 73.69万
• 依托单位: NEUROMOTION, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10081053
• 关键词: Address; Adolescent; Age; Ambulatory Care; Back; Biofeedback; Boat; Boston; California; Caring; Child; Child health care; Childhood; Chronic; Clinic; Clinical; Clinical Data; Control Groups; Data; Diagnosis; Economic Burden; Face; Family; Financial Hardship; Growth; Health; Health Insurance; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Heart Rate; Home environment; Hospital Departments; Insurance Carriers; Intervention; Investments; Measures; Mediating; Mental Health; Mind; Mission; Modeling; National Institute of Mental Health; Outcome; Outpatients; Parents; Participant; Patients; Pediatric Hospitals; Phase; Physiological; Play; Population; Provider; Psychiatry; Public Health; Randomized; Reporting; Research; Signal Transduction; Small Business Innovation Research Grant; Stress; Symptoms; System; Technology; Texas; Time; United States; Video Games; Visit; Wait Time; Weight maintenance regimen; Work; applied behavior analysis; autistic children; barrier to care; base; behavioral health; care seeking; clinical efficacy; cost; design; digital; emotion dysregulation; emotion regulation; evidence base; executive function; follow-up; health care service utilization; health care settings; heart rate monitor; intervention cost; meetings; neural network; reduce symptoms; skills; social stigma; stem; traditional care; treatment as usual

PROJECT SUMMARY Access to effective pediatric mental health treatment is a major public health concern in the United States as paucity of pediatric providers leading to long wait times, financial burden, and stigma pose significant barriers to treatment. Digital mental health promises to remedy many chronic problems we face in providing timely and accessible mental health interventions to children. With that in mind, we created Mightier, an app-based heart rate biofeedback videogame platform designed to teach and facilitate practice of emotional regulation skills. Since launching in 2016, Mightier has reached 17,000 families, with a monthly growth rate of approximately 10%, and month to month retention of 90%. The technology behind Mightier is backed by three trials showing clinical efficacy and since commercial launch 75% of families who have engaged with the product report improvement. However, our core mission remains increasing access to care, and the direct-to-consumer distribution of digital health also faces access challenges. We propose that access to effective digital mental health interventions can be increased by meeting families where they already know to seek care: the traditional healthcare system. We have partnered with a nationwide behavioral health insurance provider to pilot the integration of Mightier with traditional healthcare clinics. The proposed research will pilot the integration of Mightier into the two behavioral health clinics identified by our payor partner. To simulate real-world integration, healthcare providers will be responsible for referring children with chronic emotional dysregulation to Mightier. Once identified by their providers, children will be randomized into Mightier or control groups for 6 months of use. Through this work we will demonstrate the value of Mightier to various stakeholders via decreased long-term healthcare utilization (aim 1), confirm that Mightier use results in decreased symptoms of emotional dysregulation, irritability, and parent stress (aim 2). Ultimately this work will pave the way forward for large scale integration of digital healthcare and more traditional healthcare avenues while simultaneously increasing Mightier’s ability to reach children in need.

项目概要 获得有效的儿科心理健康治疗是美国的一个主要公共卫生问题，因为 儿科服务提供者的缺乏导致等待时间长、经济负担和耻辱，构成了重大障碍 数字心理健康有望解决我们在提供及时和治疗方面面临的许多长期问题。 考虑到这一点，我们创建了 Mightier，一款基于应用程序的心脏。 评价生物反馈视频游戏平台，旨在教授和促进情绪调节技能的练习。 自2016年推出以来，Mightier已覆盖17,000个家庭，每月增长率约为 10%，每月保留率为 90% Mightier 背后的技术得到了三项试验的支持。 临床疗效以及自商业推出以来 75% 使用过该产品的家庭报告 然而，我们的核心使命仍然是增加获得护理的机会以及直接面向消费者的机会。 数字健康的分发也面临着获取挑战。我们建议获取有效的数字心理。 可以通过与已经知道要寻求护理的家庭会面来增加健康干预措施：传统的 我们与一家全国性的行为健康保险提供商合作试点该系统。 Mightier 与传统医疗诊所的整合。 拟议的研究将试点将 Mightier 整合到由 为了模拟现实世界的整合，医疗保健提供者将负责转介。 患有慢性情绪失调的儿童一旦被其提供者识别出来，他们将被 随机分为 Mightier 组或对照组，使用 6 个月。 通过减少长期医疗保健利用率（目标 1），Mightier 对各个利益相关者的价值，确认 更频繁地使用可以减少情绪失调、烦躁和父母压力的症状（目标 2）。 最终，这项工作将为数字医疗保健等的大规模整合铺平道路 传统的医疗保健途径，同时增强 Mightier 接触有需要的儿童的能力。