Development and testing of a caregiver-facing mobile health intervention to reduce duration of untreated psychosis

开发和测试面向护理人员的移动健康干预措施，以减少未经治疗的精神病的持续时间

• 批准号: 10626808
• 负责人: Benjamin Edwards Buck
• 金额: $ 23.33万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-08 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10626808
• 关键词: Affect; American; Area; Behavioral; Belief; Caregiver support; Caregivers; Caring; Cellular Phone; Clinical; Cognitive; Communication; Computers; Coordinated Specialty Care; Data; Detection; Development; Distress; Early Intervention; Early treatment; Effectiveness; Effectiveness of Interventions; Electronic Mail; Ensure; Face; Family; Family Caregiver; Family member; Feedback; Goals; Health Services Accessibility; Health Technology; Individual; Intervention; Interview; Knowledge; Local Government; Mental Health; Mental Health Services; Modeling; National Institute of Mental Health; Needs Assessment; Outcome; Parents; Patients; Persons; Persuasive Communication; Play; Population; Positioning Attribute; Predisposition; Prevention; Process; Provider; Psychoses; Psychotic Disorders; Questionnaires; Randomized, Controlled Trials; Recovery; Recurrence; Reporting; Research; Research Project Grants; Resources; Risk; Role; Sampling; Schizophrenia; Services; Social support; State Government; Stress; Symptoms; Testing; Text; Time; Uncertainty; United States; Work; acceptability and feasibility; burnout; caregiver interventions; caregiving; coping; depressive symptoms; design; digital; digital health; duration of untreated psychosis; early experience; early psychosis; effective intervention; effectiveness evaluation; experience; first episode psychosis; first episode schizophrenia; functional improvement; handheld mobile device; help-seeking behavior; improved; improved outcome; in vivo; insight; interest; mHealth; medical specialties; novel; online care; online resource; preference; programs; psychoeducation; psychoeducational; relapse patients; relapse risk; remote delivery; service delivery; skills; therapy design; tool; trial comparing; usability; user centered design; web platform; young adult

PROJECT SUMMARY / ABSTRACT Early intervention for young adults experiencing early psychosis significantly improves long-term functional trajectory. However, a long duration of untreated illness significantly reduces the impact of treatment. Caregivers often play a pivotal role in treatment-seeking, making first contact with providers, persuading the affected relative to make such contacts, or ensuring that the affected individual remains engaged in care. However, caregivers often lack accurate information about psychosis, treatments and recovery, or feel overwhelmed and unable to help or communicate with their affected relative. During this period, they are especially vulnerable to problematic or counterproductive appraisals of illness, for example, catastrophizing beliefs, or self- or patient-blaming attributions. The cognitive model of caregiving argues that negative family interactions can worsen symptoms and functioning while impeding help-seeking. Specialized family interventions improve outcomes for caregivers and affected young adults, but these interventions are provided to EP families in which the affected young adult has already presented to treatment. Thus, caregivers of untreated young adults with EP – arguably the individuals at greatest risk for poor outcomes – lack access to the services they need. Caregivers often turn to online resources for more information and social support. Early work examining web-based platforms has demonstrated that digital health technologies are feasible, acceptable, and have potential to improve caregivers’ psychosis-related knowledge and appraisals. Mobile health interventions are particularly well-suited to this task, as they can provide individualized, real-time, real- place support. It remains unclear at present, however, whether and how remotely delivered mHealth can be leveraged to increase engagement in treatment for young adults with EP. The proposed research project aims to develop and test an mHealth intervention designed to improve caregivers’ illness knowledge and caregiving skills through interactive cognitive-behavioral modules, and through these improvements, reduce distress, improve coping, improve family communication, increase caregiver treatment facilitation and reduce duration of untreated psychosis. This proposal will involve (1) needs assessment and user co-design sessions with EP caregivers to understand their needs, interests and preferences in a caregiver-facing mHealth intervention, (2) a one-week usability field trial of this new intervention to determine feasibility and functionality, and (3) a remote pilot randomized controlled trial comparing this new intervention to existing online caregiving support resources. Analyses will determine whether this approach is acceptable and feasible, as well as explore its effectiveness and impact on key components of the cognitive model of caregiving.

项目摘要 /摘要 早期患有早期精神病的年轻人的早期干预可显着改善长期 功能轨迹。但是，长期未经治疗的疾病会大大减少治疗的影响。 照顾者通常在寻求治疗方面发挥关键作用，与提供者首次接触，说服 受影响的是建立这种联系，或者确保受影响的人继续照顾。 但是，护理人员通常缺乏有关精神病，治疗和康复的准确信息，或感到 不知所措，无法帮助或与受影响的亲戚进行交流。在此期间，他们是 特别容易受到有问题或适得其反的疾病评估，例如灾难性 信念或自我指责的属性。负面家庭的照顾论点的认知模型 相互作用会使症状恶化，并在阻碍寻求帮助的同时发挥作用。专业家庭 干预措施改善了护理人员和受影响的年轻人的结果，但提供了这些干预措施 对于受影响的年轻人已经接受治疗的EP家族。那是照顾者 没有EP的未经治疗的年轻人 - 可以说是最大风险不佳的个人 - 无法获得 他们需要的服务。护理人员通常会转向在线资源以获得更多信息和社会支持。早期的 研究基于Web的平台的工作表明，数字健康技术是可行的， 可以接受的，并有可能改善护理人员与精神病相关的知识和评估。移动的 健康干预措施特别适合这项任务，因为它们可以提供个性化的实时，现实 - 放置支持。然而，目前尚不清楚，是否以及如何交付MHealth 利用以增加对EP年轻人的治疗。 拟议的研究项目旨在开发和测试旨在改善的MHealth干预措施 护理人员通过互动认知行为模块的疾病知识和护理技能，以及 通过这些改进，减少困扰，改善应对，改善家庭沟通，增加 护理人员治疗设施并减少未经治疗的精神病的持续时间。该建议将涉及（1）需求 评估和用户共同设计与EP护理人员，以了解他们的需求，兴趣和 面向护理人员的MHealth干预措施的偏好，（2）为期一周的可用性现场试验 干预以确定可行性和功能，以及（3）远程飞行员随机对照试验 将这种新干预与现有的在线护理支持资源进行比较。分析将确定 这种方法是否可以接受和可行，并探索其有效性和对关键的影响 护理认知模型的组成部分。

项目成果

User-Centered Development of Bolster, an mHealth Intervention for Early Psychosis Caregivers: Needs Assessment, Prototyping, and Field Trial.

• DOI: 10.2196/50522
• 发表时间: 2023-11-30
• 期刊: JMIR MENTAL HEALTH
• 影响因子: 5.2
• 作者: Buck, Benjamin;Wingerson, Mary;Whiting, Erica;Snyder, Jaime;Monroe-DeVita, Maria;Ben-Zeev, Dror
• 通讯作者: Ben-Zeev, Dror