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.

项目概要/摘要 据估计，全球 17% 的青少年受到非自杀性自伤 (NSSI) 的影响。发病较早于 青春期与更严重的 NSSI 轨迹、自杀计划和较差的生活质量有关。尽管 NSSI 的早期干预至关重要，大多数患有 NSSI 的青少年不会寻求专业帮助，而且许多人会这样做 不要亲自向任何人透露自己的行为，从而限制了获得支持的机会并阻止了获得支持的途径 治疗。虽然一些心理干预措施可以有效减少青少年 NSSI， 结构性障碍（例如时间、成本）、态度障碍（例如耻辱、心理健康素养）和患病率 不披露限制了其可及性和影响范围。数字心理健康干预措施（DMHI）提出了 有机会接触到这些高风险和未接受治疗的人群，并增加他们获得治疗的机会 基于证据的心理策略。事实上，青少年报告了对数字干预措施的接受度 参与 NSSI 在线寻求帮助的比例很高。然而，迄今为止，还没有公开可用的 DMHI 旨在支持这一青少年群体。与美国心理健康组织 (MHA) 合作， 作为全国最大的心理健康倡导组织，拟议的 K01 应用程序将通过以下方式解决这一差距： 设计和评估适合青少年（14-17 岁）独特需求和偏好的 DMHI 从事 NSSI 的人。该项目将利用 MHA 的在线信息查找时刻 网站，提供低强度的 DMHI，重点关注循证技能的获取和实践 改善自我调节并提供寻求帮助的信息，最终减少 NSSI 频率和 鼓励未来的治疗参与。与 MHA 合作提供 DMHI 提供了明确的 传播途径和接触未接受治疗的不同青少年群体的机会。设计 DMHI，我将采用以用户为中心的设计活动，其中涉及研究和设计的主要利益相关者 确保青少年的需求和偏好反映在最终的 DMHI 中的过程。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 然后将在 80 名青少年（14-17 岁）中进行一项 DMHI 随机对照试验 (RCT) 按 1:1 的比例随机分配接受 DMHI (n=40) 或积极的心理教育控制 (n=40) 持续时间8周。 K01 将是我实现职业目标的关键第一步 成为数字心理健康领域领先的独立研究员。我的四个培训目标旨在 通过扩展我在以下方面的专业知识来支持这一总体目标：1）UCD 和总结性方法，包括可用性 测试 DMHI 并支持进一步发展 2) 临床试验的开展，3) 可扩展的专业知识 实施方法，4) 青少年 NSSI 的治疗模型。实现这些 培训目标和拟议的研究项目将提供发展所需的技能 全动力混合实施有效性试验的 R01，测试 DMHI 的功效。