Mobile application for early detection and intervention to reduce psychological distress in informal family caregivers of community dwelling adults with chronic disorders in Thailand

用于早期检测和干预的移动应用程序，以减少泰国社区居民患有慢性疾病的非正式家庭护理人员的心理困扰

• 批准号: 10741239
• 负责人: Hongtu Chen
• 金额: $ 21.79万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10741239
• 关键词: Activities of Daily Living; Adult; Anxiety; Behavioral; Caregivers; Caring; Chronic Disease; Clinical; Communities; Computer software; Country; Development; Diagnosis; Distress; Early Diagnosis; Early Intervention; Effectiveness; Employment; Ensure; Evidence based intervention; Family Caregiver; Family member; Financial Hardship; Frequencies; Goals; Health; Health Technology; Income; Individual; Institutionalization; Intervention; Interview; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mobile Health Application; Outcome; Output; Participant; Patients; Persons; Phased Innovation Awards; Prevention; Privacy; Provider; Psychological Stress; Qualitative Research; Reporting; Research; Risk; Self Care; Self Efficacy; Technology; Testing; Thailand; Training; Western World; adverse outcome; burnout; care recipients; care seeking; caregiver interventions; caregiving; comparison control; coping mechanism; depressive symptoms; design; digital health; digital mental health; eHealth; effectiveness evaluation; evidence base; experience; experimental arm; fall risk; formative assessment; health care delivery; improved; innovation; literacy; low and middle-income countries; mHealth; mobile application; mobile computing; mortality; prevent; programs; psychological distress; randomized, clinical trials; routine care; social culture; social stigma; sociocultural determinant; stressor; success; usability; Activities of Daily Living; Adult; Anxiety; Behavioral; Caregivers; Caring; Chronic Disease; Clinical; Communities; Computer software; Country; Development; Diagnosis; Distress; Early Diagnosis; Early Intervention; Effectiveness; Employment; Ensure; Evidence based intervention; Family Caregiver; Family member; Financial Hardship; Frequencies; Goals; Health; Health Technology; Income; Individual; Institutionalization; Intervention; Interview; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mobile Health Application; Outcome; Output; Participant; Patients; Persons; Phased Innovation Awards; Prevention; Privacy; Provider; Psychological Stress; Qualitative Research; Reporting; Research; Risk; Self Care; Self Efficacy; Technology; Testing; Thailand; Training; Western World; adverse outcome; burnout; care recipients; care seeking; caregiver interventions; caregiving; comparison control; coping mechanism; depressive symptoms; design; digital health; digital mental health; eHealth; effectiveness evaluation; evidence base; experience; experimental arm; fall risk; formative assessment; health care delivery; improved; innovation; literacy; low and middle-income countries; mHealth; mobile application; mobile computing; mortality; prevent; programs; psychological distress; randomized, clinical trials; routine care; social culture; social stigma; sociocultural determinant; stressor; success; usability

Project Summary In lower-and-middle income countries (LMICs) like Thailand, family members providing care for adults with chronic disorders experience similar levels of mental health risks to that of their counterparts in higher income countries but have significantly more limited access to mental health care. Despite comparable rates of mental health illness, family caregivers in LMICs have significantly more limited access to mental health care—due to a number of factors, including the limited number of providers trained in mental health care delivery, as well as sociocultural factors, such as stigma and privacy concerns, that may prevent those in need from seeking care, and/or result in significant delays in obtaining diagnosis and treatment. Lack of treatment for caregiver mental health can lead to other adverse consequences for both caregivers and patients, including caregiver burnout, patient abuse, losing employment and elevated financial strain. Despite an accumulating body of evidence of the promise of mobile technology-based innovations for the treatment and prevention of mental health disorders in LMICs, as well the promise for improving mental health outcomes for family caregivers, there is limited research on the development, refinement, and implementation of evidence-based digital health technology into the routine care of family caregivers. The goal of the 5-year project is to develop and test a culturally informed Caregiver Mental Health Mobile Application (hereafter referred to as CAMMA) program that will deliver an evidence-based intervention to reduce mental health problems in family caregivers of adults with chronic disorders in Thailand. The R21 project will allow us to systematically adapt evidence-based self-care intervention contents developed originally in the Western world, and to make it compatible with the sociocultural and technological context in Thailand through qualitative and formative research. The R33 will allow us to test the usability and effectiveness of the mobile technology-enabled intervention in reducing negative mental health outcomes in Thai family caregivers. Specific Aims of the R21 include: 1) Conducting qualitative research on family caregivers of persons with chronic disorders, focusing on their experience with mental health problems, caregiving practice, coping mechanisms, and socio-technological barriers to technology acceptance and use; 2) Develop a mobile application for the delivery of the CAMMA intervention; 3) Conduct a formative evaluation of the CAMMA Intervention Components to ensure acceptability and usability of individual intervention components . Specific aims for the R33 include: 1) Assessing usability of the CAMMA intervention (including all intervention components); 2) Conducting a randomized clinical trial (RCT) to evaluate effectiveness of the CAMMA intervention in reducing psychological distress (depression, anxiety, psychological stress). We hypothesize that participants who receive the CAMMA intervention will show significantly higher reduction in depressive symptoms, anxiety, and psychological stress, compared to controls.

项目摘要 在泰国等低地区收入国家（LMIC）中，为成年人提供护理的家庭成员 慢性疾病的心理健康风险与其收入更高的同行的心理健康风险相似 国家，但获得精神卫生保健的机会大大有限。尽管心理率可比 健康疾病，LMIC的家庭护理人员获得精神卫生保健的机会大大有限 - 许多因素，包括在精神卫生保健提供方面培训的提供者数量有限，以及 社会文化因素（例如污名和隐私问题）可能会阻止有需要的人寻求护理， 和/或在获得诊断和治疗方面导致重大延迟。缺乏护理人员的精神治疗 健康会导致护理人员和患者的其他不利后果，包括护理人员的倦怠， 患者虐待，失业和财务压力升高。尽管有很多证据表明 基于移动技术的创新有望治疗和预防心理健康 LMIC的疾病，以及改善家庭护理人员心理健康成果的希望， 关于基于证据的数字健康的开发，改进和实施的研究有限 技术进入家庭护理人员的常规护理。 该5年项目的目标是开发和测试文化知情的护理人员心理健康手机 应用程序（以下称为CAMMA）计划，该计划将提供基于证据的干预措施 减少泰国慢性疾病成年人家庭护理人员的心理健康问题。 R21 项目将使我们能够系统地适应最初开发的基于证据的自我护理干预内容 在西方世界，使其与泰国的社会文化和技术环境兼容 通过定性和形成性研究。 R33将使我们能够测试 在减少泰国家庭护理人员的负面心理健康成果方面，基于移动技术的干预措施。 R21的具体目的包括：1）对患者的家庭照顾者进行定性研究 慢性疾病，专注于他们在心理健康问题，护理实践和应对方面的经验 机制以及技术接受和使用的社会技术障碍； 2）开发手机 申请CAMMA干预措施； 3） 对CAMMA进行形成性评估 干预组件以确保单个干预组件的可接受性和可用性 。 具体的 R33的目的包括：1）评估CAMMA干预的可用性（包括所有干预措施 成分）; 2）进行一项随机临床试验（RCT）以评估CAMMA的有效性 干预减少心理困扰（抑郁，焦虑，心理压力）。我们假设这一点 接受CAMMA干预的参与者将显示抑郁症的降低明显更高 与对照组相比，症状，动画和心理压力。