User-centered design of a mobile health intervention to promote help-seeking and reduce duration of untreated illness among young adults with early psychosis

以用户为中心的移动健康干预设计，以促进早期精神病年轻人寻求帮助并减少未经治疗的疾病持续时间

• 批准号: 10620810
• 负责人: Benjamin Edwards Buck
• 金额: $ 19.02万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10620810
• 关键词: Address; Area; Attitude; Award; Belief; Caring; Cellular Phone; Chronic; Cognitive Therapy; Communities; Computers; Coordinated Specialty Care; Data; Dedications; Detection; Development; Devices; Distal; Early Intervention; Ecological momentary assessment; Exercise; Exposure to; Family; Functional disorder; Funding; Goals; Grant; Health; Health Resources; Health Technology; Individual; Internet; Intervention; Interview; K-Series Research Career Programs; Lead; Mental Depression; Mental Health; Mental Health Services; Mentorship; Methods; Modeling; Motivation; National Institute of Mental Health; Outcome; Participant; Persons; Pharmaceutical Preparations; Phase; Population; Predisposition; Prevention; Psychiatric therapeutic procedure; Psychoses; Quality of life; Randomized, Controlled Trials; Recovery; Relapse; Reporting; Research; Research Project Grants; Sampling; Schizophrenia; Service delivery model; Services; Source; Stigmatization; Stress; Symptoms; Techniques; Technology; Testing; Text; Time; Training; Treatment Efficacy; Underserved Population; United States; United States Substance Abuse and Mental Health Services Administration; Work; Youth; active control; barrier to care; comparative efficacy; design; digital health; digital tool; duration of untreated psychosis; early psychosis; efficacious intervention; functional outcomes; handheld mobile device; health literacy; help-seeking behavior; improved; innovation; interest; mHealth; mobile computing; peer; preference; premature; prevent; primary outcome; programs; prototype; psychoeducation; psychoeducational; psychosocial; psychotic symptoms; readmission rates; reduce symptoms; remote delivery; response; schizophrenia spectrum disorder; service delivery; service intervention; social media; social stigma; stress management; therapy design; tool; usability; user centered design; young adult

PROJECT SUMMARY / ABSTRACT Coordinated specialty care (CSC) provided in the early course of psychosis can reduce the long-term chronicity and dysfunction associated with schizophrenia-spectrum disorders. However, few young adults with early psychosis (EP) are engaged with these programs. Young adults with EP are particularly susceptible to stigma and negative beliefs about psychiatric treatment, and thus are often apprehensive to present to in- person care. Despite their reluctance to seek services, young adults with EP often engage with mental health resources through online and mobile technologies. Several digital health interventions have been developed as adjuncts to in-person services for this population and have demonstrated feasibility, acceptability and preliminary efficacy. However, there are few available digital health tools designed for young adults with EP who are not connected to in-person care. In the absence of such tools, individuals often turn to social media or forums that often reify stigmatizing beliefs or discourage help seeking. Mobile health interventions appear particularly well suited to this population given the fact that mobile devices are the primary media source for most young adults and can provide individualized, real-time, real-place support to introduce users to psychosocial interventions involved in CSC. It remains unclear at present, however, whether and how remotely delivered mHealth can be leveraged to increase engagement in treatment for young adults with EP. The proposed research project proposes to develop and test an mHealth intervention designed to impact help-seeking beliefs through psychoeducation, stigma-reducing content, stress management exercises, and locally relevant treatment information delivered through audio, video, and automated motivational text interactions, and personalized through ecological momentary assessment (EMA). This project will take a user- centered design approach with individuals who are both engaged and unengaged in treatment, including (1) a contextual inquiry to understand barriers, interests and preferences related to mHealth and in-person treatment, (2) development, refinement and usability testing, and (3) a pilot randomized controlled trial assessing feasibility, acceptability and preliminary efficacy compared to an active control mHealth intervention providing only stress management. This research project will provide a central piece of the candidate's overall training plan. This K23 career development award provides training to support an independent research program developing interventions that reduce barriers to care for young adults with EP. This includes three training areas, including (1) mobile health targeting increasing mental health care engagement, (2) user-centered design, and (3) advanced longitudinal models and quantitative methods for digital health trials. These goals will be met through expert mentorship, didactic training, coursework, and the successful completion of the research project.

项目概要/摘要 在精神病早期提供的协调专业护理 (CSC) 可以减少长期症状 与精神分裂症谱系疾病相关的慢性和功能障碍。然而，很少有年轻人拥有 早期精神病（EP）参与了这些项目。患有 EP 的年轻人特别容易受到 对精神科治疗的耻辱和消极信念，因此常常担心向内 人关怀。尽管患有 EP 的年轻人不愿寻求服务，但他们经常关注心理健康问题 通过在线和移动技术获取资源。已经开发了几种数字健康干预措施 为这一人群提供面对面服务的辅助手段，并已证明其可行性、可接受性和 初步疗效。然而，专为患有 EP 的年轻人设计的可用数字健康工具很少 与面对面护理无关的人。在缺乏此类工具的情况下，个人通常会转向社交媒体或 经常具体化污名化信仰或阻止寻求帮助的论坛。移动健康干预措施出现 鉴于移动设备是主要媒体来源，因此特别适合这一人群 大多数年轻人，可以提供个性化、实时、真实的支持，向用户介绍 CSC 涉及的心理社会干预。然而，目前尚不清楚是否以及如何远程 可以利用提供的移动医疗来增加患有 EP 的年轻人的治疗参与度。 拟议的研究项目建议开发和测试移动医疗干预措施，旨在 通过心理教育、减少耻辱的内容、压力管理练习来影响寻求帮助的信念， 以及通过音频、视频和自动激励文本提供的本地相关治疗信息 互动，并通过生态瞬时评估（EMA）进行个性化。该项目将需要用户 以参与和未参与治疗的个人为中心的设计方法，包括（1） 情境调查，以了解与移动医疗和面对面相关的障碍、兴趣和偏好 治疗，(2) 开发、完善和可用性测试，以及 (3) 试点随机对照试验 与主动控制移动医疗干预措施相比，评估可行性、可接受性和初步疗效 仅提供压力管理。 该研究项目将提供候选人总体培训计划的核心部分。这个K23 职业发展奖提供培训以支持独立研究项目的发展 减少护理患有 EP 的年轻人的障碍的干预措施。这包括三个培训领域，包括 (1) 移动医疗旨在提高心理健康护理参与度，(2) 以用户为中心的设计，以及 (3) 用于数字健康试验的先进纵向模型和定量方法。这些目标将通过 专家指导、教学培训、课程作业以及研究项目的成功完成。