A protocol for applying health equity-informed implementation science models and frameworks to adapt a sleep intervention for adolescents at risk for suicidal thoughts and behaviors.
A protocol for applying health equity-informed implementation science models and frameworks to adapt a sleep intervention for adolescents at risk for suicidal thoughts and behaviors.
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DOI：
10.3389/fpubh.2022.971754
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发表时间：
2022
影响因子：
5.2
通讯作者：
Goldstein, Tina R. R.
中科院分区：
文献类型：
--
作者：
Williamson, Ariel A. A.;Soehner, Adriane M. M.;Boyd, Rhonda C. C.;Buysse, Daniel J. J.;Harvey, Allison G. G.;Jonassaint, Charles R. R.;Franzen, Peter L. L.;Goldstein, Tina R. R.
预防青少年自杀想法和行为（STB）的有效和公平策略是一项紧迫的公共卫生优先事项。青少年睡眠障碍与STB密切相关，但很少在预防性干预措施中或在STB风险不成比例增加的黑人和/或西班牙裔/拉丁裔青年中得到解决。本文描述了健康公平知情的实施科学模型和框架的应用，以适应和评估基于证据的跨诊断睡眠和昼夜节律（TSC）干预与抑郁症和STB风险的少数民族背景的青少年的初级保健实施。本多阶段研究方案使用评估、决策、适应、生产、专题专家-整合、培训、测试（ADAPT-ITT）模型，以适应和评价TSC在患有抑郁症、有STB风险以及主要为黑人和/或西班牙裔/拉丁裔背景的青少年中的初级保健实施。我们整合了实施研究的综合框架（CFIR）在初步定性调查的青少年，照顾者和临床医生的TSC的看法。随后的ADAPT-ITT阶段包括基于定性调查的系统和迭代测试适应性，持续的关键知情人输入，然后在试点随机试验中评估适应性TSC的可行性，可接受性和有效性。基于青少年抑郁症和睡眠健康差异的研究，我们预计将需要TSC适应，以加强对抑郁症，STB风险，主要是黑人和/或西班牙裔/拉丁裔背景的青少年的干预内容。我们还预计，将需要调整，使TSC提供方法与初级保健实施保持一致。考虑到最终用户和背景，调整循证干预措施，有助于确保干预战略和提供方法为健康状况不同的人群所接受，并对他们可行。虽然TSC已显示出对睡眠障碍青少年的有效性，但我们预计有必要进行额外的多阶段研究，以优化TSC对患有抑郁症和STB风险的黑人和/或西班牙裔/拉丁裔青少年的初级保健服务。
Effective and equitable strategies to prevent youth suicidal thoughts and behaviors (STB) are an urgent public health priority. Adolescent sleep disturbances are robustly linked to STB but are rarely addressed in preventive interventions or among Black and/or Hispanic/Latinx youth for whom STB risk is increasing disproportionately. This paper describes an application of health equity-informed implementation science models and frameworks to adapt and evaluate the evidence-based Transdiagnostic Sleep and Circadian (TSC) intervention for primary care implementation with adolescents of minoritized backgrounds with depression and STB risk. This multiphase study protocol uses the Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, Testing (ADAPT-ITT) model to adapt and evaluate TSC for primary care implementation with adolescents who are depressed, at risk for STB, and of primarily Black and/or Hispanic/Latinx backgrounds. We integrate the Consolidated Framework for Implementation Research (CFIR) in an initial qualitative inquiry of adolescent, caregiver, and clinician perceptions of TSC. Subsequent ADAPT-ITT phases include systematically and iteratively testing adaptations based on the qualitative inquiry, with ongoing key informant input, and then evaluating the adapted TSC for feasibility, acceptability, and efficacy in a pilot randomized trial. Based on youth depression and sleep health disparities research, we expect that TSC adaptations will be needed to enhance intervention content for adolescents with depression, STB risk, and primarily Black and/or Hispanic/Latinx backgrounds. We also anticipate adaptations will be needed to align TSC delivery methods with primary care implementation. Adapting evidence-based interventions with end-users and contexts in mind can help ensure that intervention strategies and delivery methods are acceptable to, and feasible with, health disparate populations. Although TSC has shown effectiveness for adolescents with sleep disturbances, we expect that additional multiphase research is necessary to optimize TSC for primary care delivery with Black and/or Hispanic/Latinx adolescents with depression and STB risk.
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