Mobile Health to Monitor Risk for COVID-19 and Improve Mental Health during the Pandemic

移动医疗可监测 COVID-19 风险并改善大流行期间的心理健康

• 批准号: 10599378
• 负责人: Michael S. Businelle
• 金额: $ 74.27万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-05 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10599378
• 关键词: Address; Adoption; Affect; American Indians; Anxiety; Black race; Businesses; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 risk; COVID-19 stress; Cellular Phone; Cessation of life; Child Care; Chronic; Clinical; Communities; Contracts; Control Groups; Coupled; Data; Diagnostic; Disease Progression; Ecological momentary assessment; Effectiveness; Elements; Essential worker; Ethnic Population; Etiology; Evaluation; Fright; Health; Health behavior; Healthcare; Hospitalization; Household; Individual; Individual Differences; Infection; Intervention; Interview; Job loss; Latino; Latinx; Long-Term Care for Elderly; Maintenance; Measures; Mediating; Mediator; Meditation; Mental Depression; Mental Health; Monitor; Occupations; Outcome; Outcome Study; Pain; Participant; Performance at work; Physical activity; Population; Predisposition; Psyche structure; Public Health; Randomized; Recommendation; Research; Risk; SARS-CoV-2 exposure; Safety; Schedule; Sleep; Social Distance; Social Interaction; Social support; Socioeconomic Status; Stress; Symptoms; Telephone; Testing; Therapeutic; Time; Unemployment; Virus; Vulnerable Populations; Work; access disparities; anxiety sensitivity; anxiety symptoms; behavioral health; cost; depressive symptoms; design; digital; digital intervention; effectiveness evaluation; efficacy evaluation; ethnic minority population; evidence base; experience; follow-up; functional disability; group intervention; health care availability; health disparity; health economics; improved; intervention effect; low socioeconomic status; mHealth; mindfulness; mindfulness intervention; mobile application; novel coronavirus; pandemic disease; perceived discrimination; precision medicine; psychoeducation; psychoeducational; racial discrimination; racial minority population; racial population; school closure; skills; social health determinants; standard of care; stress reduction

ABSTRACT Clear health disparities have emerged in rates of COVID-19 exposure, hospitalization, and death among Black, Latinx, and American Indian (BLAI) individuals, relative to Non-Latino White (NLW) individuals, and BLAI populations are disproportionately affected by lower behavioral health access and heightened negative mental health outcomes as a result of the pandemic. The current project directly aligns with the objectives of PAR-20- 243 as it addresses health disparities in access to behavioral health care during COVID-19 among BLAI via an adaptation of the established, initially validated, low-cost, mobile application (‘app’) that will target ongoing mental health concerns among BLAI with elevated anxiety and/or depressive symptoms. Utilizing a precision medicine approach, the Easing Anxiety Sensitivity for Everyone (EASE) app targets anxiety sensitivity, a transdiagnostic individual difference factor implicated in the etiology, maintenance, and progression of anxiety and depressive symptoms. EASE includes COVID-19 symptom monitoring, exposure management skills, and psychoeducation on COVID-19-related stress and the impact of stress on susceptibility to infection and disease progression. Participants (N = 800; 200 Black, 200 Latinx, 200 American Indian, and 200 NLW) will be randomized to either EASE or to an active standard-of-care control digital intervention (Headspace app) for anxiety and depression. The present study will include a baseline assessment, a 3-month intervention period, a 3-month continued assessment period (with access to intervention materials), and 3- and 6-month post- baseline assessments that includes a qualitative interview via phone or online platform (e.g., Zoom) at the 6- month follow-up. Participants will complete two scheduled daily ecological momentary assessments (EMAs) during the intervention and continued assessment periods that will guide a just-in-time approach to immediate, personalized behavioral health care. Assessments will be completed remotely. Aim 1. To compare the effect of EASE with COVID-19 specific elements (n = 400) to an established empirically validated standard-of-care digital intervention with COVID-19 specific elements (n = 400). To evaluate the efficacy of the experimental intervention across each race/ethnic group. Aim 2. To identify the therapeutic mechanisms of EASE, including theoretically driven mediators (i.e., anxiety sensitivity, subsequent changes in COVID-19 related stress and fear) and moderators (i.e., perceived racial discrimination, social support, and socioeconomic status). Overall, the current proposal has the potential to significantly impact public health and safety by decreasing anxiety and depression symptoms among vulnerable populations determined to be most at risk of exacerbated, long-lasting negative health sequelae.

抽象的 明确的健康分布已经出现在199.9的率，黑人的暴露，住院和死亡的率， 拉丁裔和美洲印第安人（blai）个人，相对于非拉丁裔白人（NLW）个体和blai 人口受到较低的行为健康获取的影响不成比例的，心理负面的负面影响 大流行的结果。当前的项目直接与Par-20-的目标保持一致 243因为它解决了Blai在Covid-19期间获得行为医疗保健方面的健康分配， 适应已建立的，最初验证的低成本，移动应用程序（'app'），该应用程序将针对正在进行的 焦虑和/或抑郁症状升高的BLAI的心理健康问题。利用精度 医学方法，对每个人的缓解焦虑敏感性（轻松）应用程序针对动画焦虑敏感性，一个 动画的病因，维护和进展中实施的转诊个体差异因素 和抑郁症状。轻松包括19症状监测，暴露管理技能和 对共vid-19与19的压力的心理教育以及压力对感染易感性和 疾病进展。参与者（n = 800; 200个黑色，200个拉丁裔，200个美洲印第安人和200 NLW）将是 随机将其随机或为积极的护理标准控制数字干预措施（Headspace App） 焦虑和沮丧。本研究将包括基线评估，一个3个月的干预期，一个 3个月的持续评估期（使用干预材料）以及3个月和6个月后 基线评估包括通过电话或在线平台（例如Zoom）进行定性采访 一个月随访。参与者将完成两项计划的每日生态瞬时评估（EMAS） 在干预和持续评估期间，将指导即时的即时方法 个性化行为保健。评估将远程完成。目标1。比较 使用共同元素（n = 400）易于实现经验验证的现有标准 具有COVID-19特定元素的数字干预（n = 400）。评估实验的效率 每个种族/族裔群体的干预。目标2。确定轻松的治疗机制，包括 理论上驱动的介体（即动画敏感性，随后的COVID-19相关压力的变化和 恐惧）和主持人（即感知的种族歧视，社会支持和社会经济地位）。全面的， 当前的提案有可能通过减少动画和 弱势群体中的抑郁症状被确定最有恶化，持久的风险 负性后遗症。