Developing a Digital Intervention for Adolescent Nonsuicidal Self-injury

制定针对青少年非自杀性自残的数字干预措施

• 批准号: 10740718
• 负责人: Kaylee Payne Kruzan
• 金额: $ 17.62万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740718
• 关键词: 14 year old; 17 year old; Address; Adolescence; Adolescent; Advocacy; Affect; Anxiety; Assessment tool; Attenuated; Attitude; Award; Behavior; Behavioral; Cognitive; Collaborations; Conduct Clinical Trials; Data; Development; Disclosure; Dissemination and Implementation; Distress; Early Intervention; Emotional; Ensure; Ethnic Origin; Evidence based practice; Frequencies; Future; Gender; Goals; Hospitalization; Informal Social Control; Intervention; Interview; Leadership; Link; Mental Depression; Mental Health; Methodology; Methods; Modeling; Motivation; Participant; Pathway interactions; Persons; Population; Positioning Attribute; Prevalence; Process; Quality of life; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Activity; Research Personnel; Research Project Grants; Resources; Risk; Self Assessment; Severities; Stigmatization; Suicide; Suicide attempt; Testing; Time; Tissues; Training; adolescent health; advocacy organizations; barrier to care; behavior change; career; cost; demographics; design; digital; digital delivery; digital intervention; digital mental health; early onset; effectiveness-implementation RCT; effectiveness/implementation hybrid; effectiveness/implementation trial; efficacy testing; evidence base; experience; follow-up; health literacy; help-seeking behavior; high risk; high-risk adolescents; implementation design; implementation evaluation; improved; iterative design; literacy; meetings; non-suicidal self injury; pilot trial; preference; prevent; primary outcome; programs; psychiatric comorbidity; psychoeducation; psychoeducational; psychologic; recruit; secondary outcome; skills; skills training; social stigma; suicidal; suicidal morbidity; suicidal risk; therapy design; treatment effect; usability; user centered design; web site

PROJECT SUMMARY/ABSTRACT Nonsuicidal self-injury (NSSI) affects an estimated 17% of adolescents worldwide. Earlier onset in adolescence is linked to more severe trajectories of NSSI, suicide plans, and poorer quality of life. Though early intervention for NSSI is critical, most adolescents with NSSI do not seek professional help, and many do not self-disclose their behaviors to anyone in person, limiting access to support and preventing pathways to treatment. While several psychological interventions have been effective in reducing adolescent NSSI, structural barriers (e.g., time, cost), attitudinal barriers (e.g., stigma, mental health literacy), and the prevalence of non-disclosure constrain their accessibility and reach. Digital mental health interventions (DMHIs) present an opportunity to reach this high-risk and non-treatment-engaged population and increase their access to evidence-based psychological strategies. Indeed, adolescents report receptivity to digital interventions and engage in NSSI help-seeking online at high rates. However, to date there are no publicly available DMHIs designed to support this adolescent population. In collaboration with Mental Health America (MHA), the nation's largest mental health advocacy organization, the proposed K01 application will address this gap by designing and evaluating a DMHI attuned to the unique needs and preferences of adolescents (14-17 years) who engage in NSSI. This project will leverage a moment of online information-seeking through MHA's website, to deliver a low-intensity DMHI focused on acquisition and practice of evidence-based skills to improve self-regulation and deliver help-seeking information, to ultimately reduce NSSI frequency and encourage future treatment engagement. Partnering with MHA to deliver the DMHI provides a clear dissemination pathway and access to a diverse group of adolescents who are not in treatment. To design the DMHI, I will employ user-centered design activities, which involve key stakeholders in the research and design process to ensure adolescents' needs and preferences are reflected in the final DMHI. I will also engage MHA stakeholders in the development of a strategic implementation and dissemination plan through their website. I will then pilot a randomized controlled trial (RCT) of the DMHI with 80 adolescents (14-17 years of age) randomized on a 1:1 basis to receive the DMHI (n=40) or an active psychoeducational control (n=40) for the duration of 8 weeks. This K01 will be a critical first step in positioning me to achieve my career goal and become a leading independent researcher in digital mental health. My four training aims are designed to support this overarching goal by extending my expertise in: 1) UCD and summative methods including usability testing for DMHIs and support further development of expertise in 2) the conduct of clinical trials, 3) scalable implementation methodologies, and 4) treatment models for adolescent NSSI. Accomplishment of these training goals and the proposed research project will provide the skills necessary for the development of an R01 of a fully powered hybrid implementation-effectiveness trial testing the efficacy of the DMHI.

项目摘要/摘要 非杀伤性自我伤害（NSSI）影响了全球17％的青少年。早期发作 青春期与NSSI，自杀计划和生活质量较差的更严重的轨迹有关。尽管 NSSI的早期干预至关重要，大多数具有NSSI的青少年不寻求专业帮助，许多人都这样做 不要自我限制自己的行为，以限制获得支持的机会并防止通往的途径 治疗。虽然几种心理干预措施有效地减少了青少年NSSI，但 结构性障碍（例如，时间，成本），态度障碍（例如污名，心理健康素养）和流行率 不披露的限制了其可访问性和触及范围。数字心理健康干预措施（DMHIS）提出了 有机会达到这个高风险和非治疗参与的人口，并增加他们的进入 循证心理策略。实际上，青少年报告了数字干预措施的接受能力 以高比率在线参与NSSI寻求帮助。但是，迄今为止还没有公开可用的DMHI 旨在支持这个青春期人群。与心理健康（MHA）合作， 国家最大的心理健康倡导组织，拟议的K01申请将解决这一差距 设计和评估DMHI满足青少年的独特需求和偏好（14-17岁） 从事NSSI的人。该项目将利用MHA的在线信息寻求的时刻 网站，提供低强度DMHI，专注于获取和实践基于证据的技能 改善自我调节并提供寻求帮助的信息，最终降低NSSI频率和 鼓励未来的治疗参与。与MHA合作交付DMHI可清楚 传播途径并进入未接受治疗的各种青少年。设计 DMHI，我将采用以用户为中心的设计活动，涉及研究和设计的主要利益相关者 确保青少年需求和偏好的过程反映在最终的DMHI中。我也会参与MHA 利益相关者通过其网站制定战略实施和传播计划。我 然后将驾驶DMHI的随机对照试验（RCT），有80名青少年（14-17岁） 以1：1为基础接收DMHI（n = 40）或主动心理教育对照（n = 40） 持续时间为8周。这个K01将是确定我实现职业目标的关键第一步 成为数字心理健康领域的主要独立研究员。我的四个训练目标是 通过扩展我的专业知识来支持这一总体目标：1）UCD和总结方法，包括可用性 测试DMHIS并支持进一步发展专业知识2）临床试验的进行，3）可扩展 实施方法和4）青少年NSSI的治疗模型。完成这些 培训目标和拟议的研究项目将提供开发必要的技能 全功率混合实施效应试验的R01测试了DMHI的功效。