Digital Delivery of Evidence-Based Mental Health Content and Mentoring to Adolescents

以数字方式向青少年提供循证心理健康内容和指导

• 批准号: 10758731
• 负责人: Michael David Pullmann
• 金额: $ 55.84万
• 依托单位: APPA HEALTH INC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10758731
• 关键词: Accountability; Address; Adolescent; Adolescent and Young Adult; Advertising; Affect; Age Years; Anxiety; Behavioral; Caregivers; Caring; Cellular Phone; Clinical; Clinical effectiveness; Cognitive; Cognitive Therapy; Computers; Control Groups; Cost Analysis; Cost Effectiveness Analysis; Coupled; Data; Development; Drops; Early Intervention; Education; Educational process of instructing; Effectiveness; Elements; Employment; Ensure; Equity; Financial Hardship; Friends; Funding; Goals; Health; Health Personnel; Internet; Intervention; Knowledge; Learning; Light; Marketing; Meaning and purpose; Measurement; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methodology; Outcome; Participant; Personal Satisfaction; Persons; Phase; Pilot Projects; Prevention; Prevention strategy; Procedures; Quality of life; Randomized; Randomized, Controlled Trials; Reporting; Research; Resources; Risk; Sales; Sampling; Schools; Science; Services; Silicon; Small Business Innovation Research Grant; Structure; Supervision; Symptoms; Teenagers; Theory of Change; Therapeutic; TikTok; Training; Treatment Efficacy; United States; Universities; Use Effectiveness; Waiting Lists; Washington; Youth; aged; anxiety symptoms; arm; caregiver strain; child depression; commercialization; cost; cost effective; cost effectiveness; depressive symptoms; design; diadenosine pyrophosphate; digital; digital delivery; digital mental health; digital platform; digital tool; effectiveness research; effectiveness study; effectiveness trial; evidence base; experience; implementation strategy; improved; innovation; participant retention; peer coaching; peer support; physical conditioning; pilot test; pilot trial; premature; programs; psychoeducation; psychoeducational; psychosocial; randomized, clinical trials; recruit; self esteem; self help; severe mental illness; skills; social relationships; symptomatic improvement; tool; video delivery; young adult

PROJECT SUMMARY. This direct to Phase II SBIR proposal will study Appa Health, an adolescent-facing mental health smartphone and computer app. Appa combines (1) delivery of short-form digital evidence-based mental health content, emphasizing Cognitive Behavioral Therapy, via educational videos delivered by mental health experts who are internet influencers, with (2) trained and supervised near-peer mentors with relatable lived experiences who use supportive accountability to facilitate adolescents’ use of the evidence-based content. According to Appa’s theory of change, near-peer mentoring directly impacts adolescents’ mental health and well-being via relational and instrumental support, but also indirectly through the acquisition of evidence-based skills (e.g., cognitive restructuring, behavioral activation) taught via educational videos. We will examine the psychosocial mechanisms of the two primary elements of Appa, establish the effectiveness of Appa on adolescent depression and anxiety, other measures of functioning, and theoretical mechanisms, and examine the cost-effectiveness of the full Appa experience as well as a video-only condition that Appa is considering marketing. Aim 1 will collect initial data and improve study procedures via a small pilot study. Seventy-five adolescents aged 13-18 with elevated scores on measures of depression and/or anxiety will be randomly assigned to one of three conditions: (1) near-peer mentoring and digital tools (Full Appa), (2) digital content only (Appa Light), and (3) waitlist control. Results will be used to optimize methodology to achieve study goals with minimum burden and maximum retention. Aims 2 & 3 will examine Appa’s cost and effectiveness via a well-powered randomized clinical trial replicating the pilot trial using 400 adolescents. Variables will include clinical outcomes such as adolescent symptoms of depression, anxiety, and well-being, as well as treatment mechanisms and proximal outcomes. Because of the mental health workforce shortage, this study will have an impact on science by demonstrating the effectiveness of using laypersons (near-peer mentors) combined with expert digital content delivery and clinical supervision to support adolescents’ mental health. This study is innovative in the unique combination of near-peer mentoring with evidence-based content delivered via youth-targeted TikTok-style videos conducted by existing internet influencers. Questions on how to increase adolescent engagement with and use of evidence-based skills are important to intervention developers. The data from this study will directly impact Appa’s commercialization plan. Appa is scaling quickly, expanding from direct-to-consumer sales to partnerships with schools and self-funded employers, both of which are eager for documented clinical outcomes and identification of replicable mechanisms of change to ensure quality as Appa scales services. Cost-effectiveness analyses will drive development and design decisions (e.g., focusing resources on mentorship, content, or the mentorship-content integration), as well as commercialization decisions regarding target organizations and advertising.

项目摘要。直接对第二阶段SBIR提案将研究Appa Health，这是一个面向青少年的 心理健康智能手机和计算机应用。 APPA结合了（1）交付简短数字证据的交付 心理健康内容，强调认知行为疗法，通过精神上的教育视频 具有互联网影响者的健康专家，具有（2）受过培训和监督的近战指导者 使用支持问责制来促进青少年使用循证的生活经验 内容。根据Appa的变革理论，近点在精神上影响青少年的心理 通过关系和工具支持的健康和福祉，同时也间接地通过获取 通过教育视频教授的基于证据的技能（例如认知恢复，行为激活）。我们将 检查APPA两个主要要素的心理社会机制，确定有效性 青少年抑郁和焦虑，其他功能措施以及理论机制以及 检查完整的APPA体验的成本效益以及APPA的仅视频条件 考虑营销。 AIM 1将通过一项小型试点研究收集初始数据并改善研究程序。 七十五名青少年13-18岁，抑郁症和/或动画的得分较高 随机分配给三个条件之一：（1）近点的心理和数字工具（完整的APPA），（2）数字 仅内容（appa light）和（3）候补列表控制。结果将用于优化实现方法 研究目标最小燃烧和最大保留率。目标2和3将检查APPA的成本和 通过有力的随机临床试验通过400名青少年复制试验试验的有效性。 变量将包括临床结果，例如抑郁症，动画和福祉的青春期症状， 以及治疗机制和近端结果。由于精神卫生劳动力短缺， 这项研究将通过证明使用外行人的有效性（近点）对科学产生影响 导师）与专家数字内容交付和临床监督相结合，以支持青少年的心理 健康。这项研究在近调心理和基于证据的独特组合中具有创新性 通过现有互联网影响者进行的以青年为目标的Tiktok风格的视频提供的内容。问题 关于如何增加青少年参与和使用基于证据的技能对干预很重要 开发人员。这项研究的数据将直接影响APPA的商业化计划。 Appa正在扩展 很快，从直接到消费者的销售扩展到与学校和自筹资金雇主的合作伙伴关系 其中渴望有记录的临床结果以及确定可复制机制的变化机制 确保质量作为APPA量表服务。成本效益分析将推动开发和设计 决策（例如，将资源集中在精神训练，内容或辅助身份集成上），以及 有关目标组织和广告的商业化决策。