Harnessing Mobile Technology to Reduce Mental Health Disorders in College Populations

利用移动技术减少大学生的心理健康障碍

• 批准号: 10091553
• 负责人: Daniel Eisenberg
• 金额: $ 2.54万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-23 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10091553
• 关键词: 3-Dimensional; Address; Adopted; Adult; Age; Anxiety; Attitude; Behavioral; Behavioral Sciences; Clinical; Cognition; Cognitive Therapy; Counseling; Diet; Disease; Disease Progression; Eating Disorders; Economics; Effectiveness; Employee; Employment; Enrollment; Health; Health Services Accessibility; Health Technology; Healthcare; High School Student; Individual; Infrastructure; Intention; Internet; Intervention; Investments; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Modeling; Monitor; National Institute of Mental Health; Outcome; Pathology; Performance; Population; Prevalence; Prevention; Preventive Intervention; Public Health; Quality of life; Randomized; Relapse; Research; Research Personnel; Service delivery model; Services; Shapes; Students; Swelling; Symptoms; System; Testing; Therapeutic Intervention; Time; Universities; Weight; Work; base; care delivery; clinical anxiety; college; comorbidity; cost; cost effectiveness; economic outcome; effectiveness evaluation; evidence base; health care delivery; health economics; health service use; high risk; improved; improved outcome; mHealth; mobile computing; novel strategies; outcome forecast; outcome prediction; personalized intervention; personalized screening; population based; primary outcome; programs; response; restraint; screening; screening program; secondary outcome; service delivery; service engagement; service intervention; skills; social; treatment as usual; university student; uptake; young adult

PROJECT SUMMARY/ABSTRACT The prevalence of mental health problems among college populations has risen steadily in recent decades, with one-third of college students struggling with anxiety, depression, or an eating disorder. Yet, only 20-40% of college students with mental disorders receive treatment. Inadequacies in mental health care delivery result in prolonged illness, disease progression, poorer prognosis, and greater likelihood of relapse, highlighting the need for a new approach for detecting mental health problems and engaging college students in services. We have developed a transdiagnostic, low-cost mobile health targeted prevention and intervention platform that uses population-level screening for engaging college students in tailored services that address common mental health problems. This care delivery system represents an ideal model for service delivery given its use of our promising, evidence-based mobile programs, a transdiagnostic approach that addresses comorbid mental health issues, and personalized screening and intervention to increase service uptake, enhance engagement, and improve outcomes. Further, our service delivery model harnesses the expertise of our team of leaders in behavioral science, college student mental health, technology, and health economics, and bridges our team's work over the past 25 years in successfully implementing a population-based screening program in over 160 colleges and demonstrating the effectiveness of Internet-based programs for targeted prevention and intervention for anxiety, depression, and eating disorders in over 40 colleges. We propose to test the impact of this mobile mental health platform for service delivery in a large-scale trial across 20 colleges. Students who screen positive or at high-risk for clinical anxiety, depression, or eating disorders (excluding anorexia nervosa, for which more intensive medical monitoring is warranted), which account for a substantial proportion of the mental health burden on college campuses, and who are not currently engaged in mental health services (N=7,884; of 146,000 initially screened) will be randomly assigned to: 1) intervention via the mobile mental health platform; or 2) referral to usual care (i.e., campus health or counseling center). We will test whether the mobile mental health platform, compared to usual care, is associated with improved uptake (i.e., individuals beginning treatment) (Aim 1), reduced clinical cases and disorder-specific symptoms (Aims 2a, 2b), and improved quality of life and functioning (Aim 2c). We will also test putative targets/mechanisms, other mediators, predictors, and moderators of improved mental health outcomes (Aim 3) as well as stakeholder- relevant outcomes, including cost-effectiveness and academic performance (Aim 4). Our comprehensive mental health care platform can yield clinical benefit to students, appeal to university stakeholders, minimize barriers to implementation sustainability on campuses, and produce an economic return on investment compared to usual care. This population-level approach to service engagement has the potential to improve mental health outcomes for the 20+ million students enrolled in U.S. colleges and universities.

项目摘要/摘要 近几十年来，大学人群中心理健康问题的流行稳定增长， 有三分之一的大学生在焦虑，抑郁或饮食失调中挣扎。但是，只有20-40％ 精神障碍的大学生接受治疗。心理保健提供结果不足 在长期疾病中，疾病进展，预后较差和复发的可能性更大，强调了 需要一种新的方法来检测心理健康问题并吸引大学生参与服务。我们 已经开发了一个经过转诊，低成本移动健康针对的预防和干预平台 使用人口级筛查，吸引大学生参与量身定制的服务，以解决共同的精神 健康问题。考虑到我们的使用，此护理交付系统代表了服务提供的理想模型 有希望的，基于证据的移动程序，一种转诊方法，可解决合并症的精神 健康问题以及个性化筛查和干预措施以增加服务的吸收，增强参与度， 并改善结果。此外，我们的服务交付模型利用了我们的领导团队的专业知识 行为科学，大学生心理健康，技术和健康经济学，并桥接我们团队的 在过去的25年中，致力于成功实施160多个基于人群的筛查计划 大学并展示基于互联网的计划在有针对性的预防和 在40多所大学中，干预焦虑，抑郁和饮食失调。我们建议测试 这个移动心理健康平台在20所大学进行了大规模试验中，用于服务。学生 筛查临床焦虑，抑郁症或饮食失调的高风险筛查（不包括神经性厌食症， 为此保证了更密集的医疗监测），这占了很大一部分的 大学校园的心理健康负担，目前尚未从事心理健康服务 （n = 7,884；最初筛选的146,000个）将随机分配给：1）通过移动心理干预 健康平台；或2）转介给通常的护理（即校园健康或咨询中心）。我们将测试是否 与通常的护理相比，移动心理健康平台与改善的摄取有关（即个人 开始治疗）（AIM 1），临床病例减少和特异性症状（AIMS 2A，2B）和 改善生活质量和功能（AIM 2C）。我们还将测试假定的目标/机制，其他 改善心理健康结果（AIM 3）以及利益相关者的调解人，预测因素和主持人 - 相关结果，包括成本效益和学习成绩（AIM 4）。我们的全面 心理保健平台可以为学生带来临床利益，吸引大学利益相关者，最小化 实施校园可持续性的障碍，并产生经济投资回报 与通常的护理相比。这种人口级别的服务参与方法有可能改善 美国大学和大学入学的20多名学生的心理健康成果。