Bounce Back Now: A Low-Cost Intervention to Facilitate Post-Disaster Recovery

立即反弹：促进灾后恢复的低成本干预措施

• 批准号: 9130271
• 负责人: SANDRO MD, MPH, DRPH GALEA
• 金额: $ 84.98万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-20 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9130271
• 关键词: Accident and Emergency department; Acute; Address; Adjustment Disorders; Affect; American; Back; Caring; Cellular Phone; Cessation of life; China; Chronic; Clinical; Clinical effectiveness; Communities; Computers; Counseling; Country; Data Collection; Depressed mood; Devices; Disasters; Disease Outbreaks; Distress; Economics; Effectiveness; Emotional; Employment; Ensure; Family; Funding; Future; Health; Health Personnel; Healthcare; Human Resources; India; Individual; Indonesia; Injury; International; Internet; Intervention; Mental Depression; Mental Health; Minority; Monitor; Online Systems; Outcome; Ownership; Participant; Patient observation; Phase; Philippines; Post-Traumatic Stress Disorders; Procedures; Property; Provider; Randomized; Readiness; Recovery; Recruitment Activity; Red Cross; Reporting; Research; Resources; Risk Factors; Schedule; Services; Shelter facility; Societies; Stress; Survivors; Symptoms; Tablets; Technology; Testing; Time; Tornadoes; Training; Transportation; Triage; United States Substance Abuse and Mental Health Services Administration; Update; Use Effectiveness; Work; avoidance behavior; base; behavioral health; brief intervention; cost; cost effectiveness; cost efficient; depressive symptoms; design; disaster survivor; evidence base; follow-up; handheld mobile device; health care service utilization; high risk; improved; innovation; laptop; loved ones; mood symptom; novel; post-traumatic stress; reduce symptoms; resilience; response; self help; service utilization; severe mental illness; social; social stigma; stress symptom; stressor; treatment as usual; user-friendly

 DESCRIPTION (provided by applicant): Disasters confront individuals with a wide range of stressors, including threat of death or injury, loss of loved ones, limited access to basic needs, and financial strain due to property damage or disruptions in employment. Many survivors are resilient or recover rapidly, but a significant minority develops behavioral health problems such as posttraumatic stress disorder and depression. Some efficacious treatments exist for these mental health problems, but many disaster survivors encounter barriers to receipt of services (e.g., stigma, time commitment, cost, scheduling, transportation). The availability of brief, effective, free, and highly accessible interventions to facilitate personal and community resilience and rapid and sustained recovery is potentially of tremendous value to disaster-affected communities and disaster response agencies. We propose to evaluate Bounce Back Now (BBN), a novel, scalable, and highly sustainable technology-based intervention. BBN will be accessible via any device that is connected to the internet, such as a computer, smartphone, or tablet; it will be optimized for mobile devices to ensure that it is highly accessible and user friendly. The intervention consists of three major components: (1) a symptom/activity tracking component designed to facilitate self-monitoring in the acute post-disaster phase; (2) a brief self-help intervention component that aims to accelerate mental health recovery relative to PTSD and mood symptoms; and (3) a provider assistance component that will connect survivors to a national Disaster Distress Helpline. Our research has supported the feasibility of the first two components of BBN, and the initial efficacy of the brief intervention component of BBN. The Disaster Distress Helpline is a national service administered by the Substance Abuse and Mental Health Services Administration that provides crisis counseling and local referrals to mental health providers. We will recruit 5,000 disaster survivors to test the intervention: 2,500 will be randomly assigned to the BBN condition, the other 2,500 to an enhanced usual care comparison condition. We will also examine the cost effectiveness of the BBN intervention relative to enhanced usual care. A secondary research aim centers on the exploration of triage- level risk factors that are associated with mental health recovery, use of BBN, and service utilization. The American Red Cross and the Office of the Assistant Secretary for Preparedness and Response have partnered with us on this application and will assist us with participant recruitment and collection of data relating to triage- level risk factors. We will conduct this research using an innovative phased-funding approach that will ensure that we are prepared to initiate research in the immediate aftermath of a triggering disaster incident. This study will significantly improve the evidence base around technology-based disaster mental health interventions.

 描述（由应用程序提供）：灾难面临着各种压力源的个人，包括死亡或伤害的威胁，失去亲人的损失，有限的获得基本需求以及由于财产损失或就业破坏而造成的财务压力。许多生存具有弹性或迅速恢复，但是少数族裔的发展行为健康问题，例如创伤后应激障碍和抑郁症。对于这些心理健康问题，存在一些有效的治疗方法，但是许多灾难存活遇到了接收服务的障碍（例如，污名，时间承诺，成本，时间表，运输）。短暂，有效，自由且高度易于获得的干预措施的可用性，以促进个人和社区的韧性以及快速，持续的康复可能对受灾影响的社区和灾难应对机构具有巨大的价值。我们建议立即评估反弹（BBN），这是一种新颖，可扩展且高度可持续的基于技术的干预措施。 BBN将通过连接到Internet的任何设备（例如计算机，智能手机或平板电脑）访问；它将针对移动设备进行优化，以确保其高度访问和用户友好。干预措施由三个主要组成部分组成：（1）一种症状/活动跟踪成分，旨在促进急性后降期阶段的自我监控； （2）一个简短的自助干预部分，旨在相对于PTSD和情绪症状加速心理健康； （3）将为国家灾难求助热线索引的提供者援助部分。我们的研究支持了BBN的前两个组成部分的可行性，以及BBN的简短干预部分的初始效率。灾难求助热线索引是由药物滥用和精神卫生服务管理局管理的国家服务，可为精神卫生提供者提供犯罪咨询和当地推荐。我们将招募5,000名灾难幸存者来测试干预措施：2,500将被随机分配到BBN条件下，其他2,500人将其用于增强的常规护理比较条件。我们还将研究BBN干预相对于增强常规护理的成本效益。二级研究的目的是探索与心理健康恢复，BBN和服务利用相关的分类水平危险因素。美国红十字会和助理秘书办公室的准备和响应办公室已与我们合作，并将帮助我们参与招募和收集与分类水平风险因素有关的数据。我们将使用一种创新的分阶段资助方法进行这项研究，该方法将确保我们准备在触发灾难后立即开始研究。事件。这项研究将大大改善基于技术的灾难心理健康干预措施的证据基础。