Technology Enabled Services for Coordinated Care of Depression in Healthcare Settings

医疗机构中抑郁症协调护理的技术支持服务

• 批准号: 10202400
• 负责人: DAVID CURTIS MOHR
• 金额: $ 149.1万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10202400
• 关键词: Address; Car Phone; Caregivers; Caring; Case Manager; Chicago; Classification; Clinic; Clinical; Clinical Sciences; Clinical Services; Collaborations; Communication; Coupled; Decision Making; Discipline of obstetrics; Elderly; Elements; Ensure; Evaluation; Family Caregiver; Family Practice; Foundations; Geriatrics; Guidelines; Health Services Research; Healthcare; Individual; Investigational Therapies; Knowledge; Measurement; Medical; Medicine; Mental Depression; Mental Health; Methods; Mission; Modeling; Morbidity - disease rate; Online Systems; Outcome; Output; Patients; Perinatal; Persons; Phase; Physicians; Population; Postpartum Depression; Primary Health Care; Problem Solving; Process; Protocols documentation; Provider; Psychology; Quality of life; Randomized Controlled Trials; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Proposals; Role; Science; Scientist; Services; System; Taxonomy; Technology; Update; Voice; Work; base; care coordination; care systems; collaborative care; computer human interaction; cost; design; digital mental health; experience; family support; health care settings; implementation design; implementation science; improved; information organization; innovation; intelligent personal assistant; medical specialties; mobile application; mortality; obstetric care; patient engagement; patient population; programs; research to practice; sensor technology; service organization; statistics; sustainability framework; tool; treatment optimization; treatment research

Abstract Technology-enabled services (TESs), which use web-based and mobile applications for patients coupled with support from a care coordinator, have consistently been shown through randomized controlled trials to be effective at treating depression. However, attempts to implement TESs in healthcare settings have failed, primarily because neither real-world patients nor providers use the tools we develop and evaluate in research. This center addresses this research-to-practice problem through a multi-level strategy. At the research proposal (RP) level, we will design and evaluate TESs for depression in three unique medical settings that commonly manage depression. Each RP will include a unique design innovation. RP1 will design and evaluate a TES to support a primary care collaborative care program. The design innovation of RP1 will focus on integrating mobile phone sensing technologies to create simpler, more engaging patient tools. RP2 will design and evaluate a TES for a specialty obstetrics care setting for postpartum depression. The design innovation will focus on care manager-facing tools and processes that can simplify, organize, and automate workflows. RP3, set in a geriatric service, will focus on homebound older adults, for whom there are few treatment options. The design innovation will be to harness a voice-controlled intelligent personal assistant to support homebound older adults, with supports for family caregivers. At the research level, we will harness the three RPs to refine our Accelerated Create-to-Sustainment (ACTS) research framework, which aims to overcome the research-to- practice gap in several ways. ACTS integrates human computer interaction (HCI) methods to incorporate the voice of end users into the design and evaluation of the technologies, service protocol, and implementation plan for the RPs, thereby ensuring that the end product is usable, useful, and can be implemented. Core research design elements and measurements are consistent across the RPs, which will allow us to evaluate the ACTS framework across all RPs to validate the core research principles of the ACTS framework. With the help of our External Scientific Advisory Board, will use this experience to produce research guidelines for digital mental health research, and aggregate the knowledge gained about TES and organization features into a taxonomy that represents essential information for researchers and developers. We will achieve this this work through a highly interdisciplinary team, led by two PIs who are leading experts in experts in digital mental health and HCI (Mohr and Reddy), with additional expertise in medicine, implementation science, psychology, research methods, and statistics. Each of the RPs is co-led by the clinic or service chief and a researcher, thereby ensuring a deep collaboration between clinical service needs and research. Thus, this Center, by using a multilevel approach focusing on both the individual research projects and methodology, will produce the first TESs designed for implementation in real world healthcare settings, and will provide substantial and enduring contributions to research methodology that will improve the quality of science.

摘要