User-centered Design and Evaluation of a Virtual Human Patient to Improve Safety Planning Skills

以用户为中心的虚拟人类患者设计和评估，以提高安全规划技能

• 批准号: 10218526
• 负责人: Aaron Martin Norr
• 金额: $ 19.9万
• 依托单位: SEATTLE INST FOR BIOMEDICAL/CLINICAL RES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10218526
• 关键词: Accident and Emergency department; Adoption; Age; Area; Behavioral; COVID-19 pandemic; Clinical; Clinical Skills; Code; Computer software; Computers; Continuing Education; Control Groups; Data; Development; Distance Learning; Evaluation; Feedback; Feeling suicidal; Focus Groups; Gender; Goals; Gold; Health Personnel; Healthcare Systems; Human; Individual; Infrastructure; Institutes; Internet; Intervention; Interview; Joints; Knowledge; Learning; Manuals; Measures; Medical; Medical center; Mental Health; Methods; National Institute of Mental Health; Outpatients; Patient Self-Report; Patient-Focused Outcomes; Patients; Persons; Phase; Physical Examination; Pilot Projects; Population; Populations at Risk; Prevention; Provider; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Research; Resources; Risk; Running; Safety; Sampling; Self Efficacy; Site; Standardization; Structure; Suicide; Suicide prevention; Technology; Testing; Training; Training Programs; United States Department of Veterans Affairs; Veterans; Visit; Work; base; blind; clinical practice; cost; cost effective; design; educational atmosphere; effective intervention; efficacy evaluation; experience; formative assessment; hands-on learning; heuristics; improved; informant; innovation; learning strategy; military service; novel; provider behavior; randomized trial; rehearsal; research data dissemination; safety practice; satisfaction; service member; simulation; skills; sound; statistics; suicidal; suicidal behavior; suicidal risk; suicide rate; technology development; tool; usability; user centered design; virtual; virtual human

PROJECT SUMMARY Despite unprecedented suicide prevention efforts undertaken in the last decade, suicide rates among veterans and military service members remain elevated relative to the pre-9/11 era, highlighting the need for improved development and implementation of scientifically supported interventions for this at-risk population. This project will develop an online, interactive Virtual Standardized Patient (VSP) to train providers within the Department of Veterans Affairs (VA) to administer the brief suicide Safety Planning Intervention (SPI). Research has demonstrated the SPI to be an acceptable, feasible, and effective intervention for veterans at elevated risk of suicide. However, training to conduct the SPI has been limited and no currently available training provides the opportunity for behavioral rehearsal and interactive practice in an online format available at the convenience of the provider. The current proposal will develop a VSP using best practices in user-centered design to create a standardized training tool to assist providers in developing clinical skills to more effectively implement the SPI. The project will include a two-phase study. Phase I will include a formative evaluation to inform the design of the VSP with SPI specific content and will involve iterative revisions based on user- centered design feedback from VA healthcare providers (N = 10). Once the final version of the VSP is completed, it will be evaluated in a mixed methods pilot study with 30 VA healthcare providers to examine changes in provider SPI clinical skills, knowledge, confidence, and self-efficacy (phase II). This evaluation of the VSP will encourage future research and dissemination of this novel training tool, if effective. The resulting VSP will be cost-effective and highly scalable, and will require only a desktop computer with Internet access to run. The VSP will be developed to target training for a wide range of providers, not just those in mental health. Similarly, the technology will be developed such that it could be disseminated to providers who work with veteran and non-veteran patients outside of the VA. This training tool will be useful for providers initially learning the SPI, as well as those who wish to refresh their skills. Our proposal brings together two teams (VA Puget Sound and the USC Institute for Creative Technologies) with a history of high impact mental health technology development. These teams have unique, and complementary, expertise in order to successfully execute this proposal. Results have the potential to make a substantial impact on the VA healthcare system and its at-risk patients. Next steps will include a fully powered randomized controlled trial to examine the efficacy of the developed VSP on provider behaviors (clinical skills) and patient outcomes, followed by dissemination of the VSP to other VA and non-VA sites, if efficacious.

项目总结 尽管在过去十年中采取了前所未有的自杀预防努力，但退伍军人和 与9/11之前的时代相比，兵役人员的数量仍然较高，突显了改善发展的必要性 并为这一高危人群实施科学支持的干预措施。该项目将开发一种 在线、交互式虚拟标准化患者(VSP)培训退伍军人事务部(VA)内的提供者以 实施简短的自杀安全计划干预(SPI)。研究表明，SPI是一种可以接受的、 对自杀风险较高的退伍军人进行可行和有效的干预。然而，进行SPI的培训有 有限，目前没有可用的培训提供了行为排练和互动的机会 在提供商方便的情况下以在线形式进行练习。目前的提案将开发一个VSP，使用 以用户为中心的设计方面的最佳实践，以创建标准化培训工具来帮助提供商开发临床 更有效地实施SPI的技能。该项目将包括两个阶段的研究。第一阶段将包括形成性 评估，为VSP的设计提供SPI特定内容的信息，并将涉及基于用户- 来自退伍军人管理局医疗保健提供者的集中设计反馈(N=10)。一旦VSP的最终版本完成，它将 在与30家退伍军人医疗保健提供商进行的混合方法试点研究中进行评估，以检查提供商SPI临床的变化 技能、知识、自信和自我效能感(第二阶段)。对VSP的这种评估将鼓励未来的研究和 传播这一新型培训工具，如果有效的话。由此产生的VSP将具有成本效益和高度可扩展性，并将 只需要一台可以访问互联网的台式计算机即可运行。VSP将发展为广泛的目标培训 一系列的提供者，不仅仅是那些精神健康的人。同样，这项技术的开发将使其能够 传播给为退伍军人管理局以外的退伍军人和非退伍军人患者工作的提供者。这个培训工具将是 对于最初学习SPI的提供商以及那些希望更新他们的技能的人来说很有用。我们的建议带来了 两个团队(VA Puget Sound和南加州大学创意技术研究所)在历史上具有很高的影响力 心理健康技术的发展。这些团队拥有独特和互补的专业知识，以便 成功执行此建议。结果有可能对退伍军人管理局的医疗保健系统产生重大影响 以及它的高危患者。下一步将包括一项完全有效的随机对照试验，以检查 制定关于提供者行为(临床技能)和患者结果的VSP，然后将VSP传播到 其他VA和非VA部位，如果有效。