Harnessing Network Science to Personalize Scalable Interventions for Adolescent Depression

利用网络科学对青少年抑郁症进行个性化的可扩展干预措施

基本信息

批准号：
10786569
负责人：
Jessica Lee Schleider
金额：
$ 28.36万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-14 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10786569
关键词：
Adolescent Age Asian Americans Belief Benefits and Risks Black American Caregivers Caring Child Clinical Clinical Trials Consent Data Development Ethics Exclusion Family Feeling suicidal Funding Gatekeeping Gender Goals Health Services Accessibility Healthcare Hispanic Americans Improve Access Institutional Review Boards Intervention Interview Knowledge Laws Link Mental Depression Mental Health Mental Health Services Mental Tests Methods Native Americans Parental Consent Parents Persons Pharmaceutical Preparations Policies Population Positioning Attribute Procedures Process Public Health Race Research Research Personnel Research Support Running Safety Sampling Science Secure Severities Sex Orientation Sexual and Gender Minorities Shapes Socioeconomic Status Surveys Symptoms Teenagers Therapy trial United States National Institutes of Health Universities Work Youth aged child depression depressive symptoms ethnic minority evidence base experience gender minority insight parent grant physical conditioning prevent racial minority recruit research study response safety testing self help sexual minority social media treatment research waiver

项目摘要

Project Summary/Abstract Up to 80% of U.S. adolescents with depression will never access treatment. An often-overlooked contributor to this discrepancy is teens’ inability to access care independently. Historically, teens’ access to mental health treatment and research has required parental consent, yet many teens cite parents as a barrier to accessing mental health support. Positioning parents as gatekeepers to treatment may prevent all but the most privileged teens from accessing depression-related support. To date, some (but not all) U.S. states have enacted laws allowing youth aged ≥12 to consent, without a parent, to mental health care, and emerging research supports the safety and utility of these policies. For instance, across multiple NIH-funded trials, my research team has secured waivers of parent consent from our University IRB, allowing us to run trials of online single-session interventions (SSIs) in which teens with depression can self-refer into our studies (DP5OD028123-S1). Our results show that teens can safely engage in online SSIs, and that SSIs can reduce depression severity up to 3 months later. Waiving parental consent requirements also seemed to boost our sample’s diversity, allowing us to recruit population-congruent proportions of Black, Hispanic, Asian, and Native American adolescents in a recent nationwide trial (N=2,452). Most youth therapy trials include samples that are >90% white. Thus, national policies allowing teens to self-refer into certain kinds of mental health support may improve access to care for diverse adolescents. Despite this possibility, there are no formal policies for researchers, clinicians, or families for facilitating adolescents’ self-referral into mental health research or treatment. Characterizing teens’ perspectives is a necessary step toward creating youth-centered policies to guide circumstances under which teens should (and should not) be able to self-refer into mental health interventions and research. Therefore, the goal of this supplement project is to characterize adolescents’ views on teens’ self-referral into mental health research and treatment, integrating survey-based and interview data from adolescents with depression (N=30 from the Parent Grant sample, whose parents were involved in study consent, and N=15 drawn a social media-recruited sample, whose parents will not be involved in study consent). Specific aims are (1) to characterize what adolescents view as the benefits and risks of teens accessing mental health support without parent knowledge/consent; (2) to gauge whether adolescents’ views on this topic differ for supports that are offered in-person versus online; supports that do versus do not involve a therapist (i.e., self-help); and whether teens perceive their identities and symptoms as shaping their views on parental knowledge/consent in teen mental health research and treatment; and (3) to compare responses to (1) and (2) across teens whose parents were and were not involved in study consent procedures. This study will yield necessary insights toward policies on adolescents’ independent participation in mental health treatment and research, with sweeping implications for teens’ access to mental health care.

项目概要/摘要高达 80% 的美国抑郁症青少年永远无法获得治疗，这是一个经常被忽视的因素。这种差异是青少年无法独立获得护理，从历史上看，青少年无法获得心理健康。治疗和研究需要父母的同意，但许多青少年认为父母是他们获得治疗和研究的障碍将父母定位为治疗的看门人可能会阻止除最有特权的人之外的所有人。迄今为止，美国的一些（但不是全部）州已经颁布了法律。允许 12 岁以上的青少年在没有父母陪伴的情况下同意接受心理保健和新兴研究支持例如，在 NIH 资助的多项试验中，我的研究团队已经了解了这些政策的安全性和实用性。获得大学 IRB 的家长同意豁免，允许我们进行在线单次会议的试验干预措施 (SSI)，其中患有抑郁症的青少年可以自我参考我们的研究 (DP5OD028123-S1)。结果表明，青少年可以安全地参与在线 SSI，并且 SSI 可以将抑郁严重程度降低最多 3 接下来的几个月，放弃父母同意的要求似乎也提高了我们样本的多样性，使我们能够做到这一点。招募符合人口比例的黑人、西班牙裔、亚洲人和美洲原住民青少年最近的全国性试验（N = 2,452）包括> 90％的白人样本。允许青少年自我参考某些类型的心理健康支持的国家政策可能会改善获得服务的机会尽管有这种可能性，但还没有针对研究人员、追随者或其他人的正式政策。家庭促进青少年自我推荐参加心理健康研究或治疗。观点是制定以青年为中心的政策的必要步骤，以指导在何种情况下青少年应该（也不应该）能够自我参考心理健康干预和研究。该补充项目的目标是描述青少年对青少年自我推荐心理的看法健康研究和治疗，整合抑郁症青少年的调查和访谈数据（N = 30 来自家长资助样本，其父母参与了研究同意，N = 15 绘制了社会媒体招募的样本，其父母不会参与研究同意）。描述青少年认为青少年在不知情的情况下获得心理健康支持的好处和风险家长的了解/同意；(2) 衡量青少年对这一主题的看法是否与以下支持不同：面对面提供与在线提供的支持；是否需要治疗师参与（即自助）；青少年将自己的身份和症状视为塑造他们对青少年父母知识/同意的看法心理健康研究和治疗；(3) 比较以下青少年对（1）和（2）的反应：父母过去和现在都没有参与研究同意程序。这项研究将产生必要的见解。制定关于青少年独立参与心理健康治疗和研究的政策，对青少年获得心理保健的广泛影响。