Optimizing Technology Interventions for Help-Seeking for Depression and Suicidality in Sexual and Gender Minority Youth

A.摘要 只有三分之一的青少年获得抑郁症治疗，许多人无法与诊所男性互动- TAL卫生资源。性和性别少数民族青年(SGMY)患严重心理健康的风险更大 精神障碍和自杀，但更不可能获得心理健康服务，即使可以获得服务。 普遍存在的因素--耻辱、对治疗的负面看法、缺乏心理健康知识--都是导致 不寻求服务。主流心理健康干预未能解决SGMY的独特因素，即- HIBIT求助：双重耻辱(围绕心理健康的耻辱以及内在化的同性恋恐惧症和变态 恐惧症)，担心暴露SGM身份，家庭支持程度低，无法获得SGM肯定的精神 健康专业人士。尽管很难接触到SGMY，但有抑郁风险的SGMY在网上相当活跃。还没有 SGMY缺乏特定的循证在线干预措施，社区干预措施也没有加强 心理健康求助。需要有针对性的在线干预措施，以解决防止 寻求帮助，但他们自己是有用的和吸引人的。目前的提议将使用用户告知的效率 考虑SGMY异质性和特定需求的技术干预设计方法。我们会 使用行为干预技术模型设计和研究几个干预原则(IP)，或 包括干预目标和行为策略在内的理论概念，以了解哪些机制 在迭代设计和潜在的模式时，行动是有希望的。我们将使用人机交互- 开发(HCI)框架、发现、设计/构建和测试，以开发和研究多个IP。具体来说，我们将 (1A)在SGMY进行基于互联网的定性研究，以探索当前在线工具、观点的使用情况 关于干预目标(例如，负面态度，如污名、社会支持、知识)和知识产权偏好 组件和交付方式，(1b)使用人机界面技术开发初始原型并寻求迭代 用户反馈和(2)使用阶乘试验评估4个最终的低保真原型以了解每个IP 原型个体与组合在求助意向上的可行性、可用性、接受性和变化性 不同(种族、民族、年龄、性别认同、性取向)的SGMY的在线样本。这将通知您 高保真干预的开发，其中可能包括针对特定SGMY亚组分的不同组件 将在更大的临床试验中进行评估。私人侦探拉多维奇博士是一名青少年内科研究员 医学，并使用利益相关者知情的方法和人机界面技术进行了多年的研究 告知干预发展情况。通过与SGM健康、利益相关者参与、甚至- 设计、定性分析、人机界面设计以及BIT开发和测试，我们有一个令人兴奋的机会 为患有抑郁症和自杀倾向的SGM青少年弥合差距，以激励他们并装备他们 他们获得治疗所需的工具。本提案响应NOT-MH-18-031号文件 迭代测试和NOT-MD-19-001-测试减少污名干预措施。

A. Abstract Only one-third of adolescents access treatment for depression, and many fail to interact with clinic-based men- tal health resources. Sexual and gender minority youth (SGMY) are at greater risk for severe mental health disorders and suicidality but even less likely to access mental health services, even when access is available. Widespread factors – stigma, negative beliefs about treatment, lack of mental health knowledge - contribute to not seeking services. Mainstream mental health interventions fail to address unique factors to SGMY that in- hibit help-seeking: double stigma (stigma around mental health as well as internalized homophobia and tran- sphobia), concern about revealing SGM status, low family support, lack of access to SGM affirming mental health professionals. Despite being hard-to-reach, SGMY at risk for depression are quite active online. Yet SGMY-specific evidence-based online interventions are lacking and community interventions do not enhance mental health help-seeking. Targeted online interventions are needed to address unique factors which prevent help-seeking but are themselves usable and engaging. The current proposal will use a user-informed efficient approach to technology intervention design considering the heterogeneity and specific needs of SGMY. We will use the Behavioral Intervention Technology Model to design and study several intervention principles (IPs), or theoretical concepts including intervention aims and behavioral strategies, to understand which mechanisms of action hold promise while being iterating design and potential modalities. We will use human computer interac- tion (HCI) framework, Discover, Design/Build, and Test to develop and study several IPs. Specifically we will (1a) conduct an internet-based qualitative study in SGMY to explore current use of online tools, perspectives on intervention targets (e.g. negative attitudes like stigma, social support, knowledge), and preferences for IP components and delivery modalities, (1b) use HCI techniques to develop initial prototypes and seek iterative user feedback and (2) evaluate 4 finalized low-fidelity prototypes using a factorial trial to understand each IP prototype’s individual and combined feasibility, usability, acceptability, and change in help-seeking intention in an online sample of diverse (racially, ethnically, age, gender identity, sexual orientation) SGMY. This will inform the development of a high-fidelity intervention which may include different components for specific SGMY sub- groups to be evaluated in a larger clinical trial. The PI, Dr. Radovic, is a physician researcher in adolescent medicine and has conducted years of research using stakeholder-informed methods and HCI techniques to inform intervention development. By working with experts in SGM health, stakeholder engagement, interven- tion design, qualitative analysis, HCI design, and BIT development and testing, we have an exciting opportunity to bridge the gap for SGM adolescents with depression and suicidality to motivate them to and equip them with the tools they need to access treatment. This proposal is responsive to NOT-MH-18-031 by conducting nimble iterative testing and NOT-MD-19-001 - testing stigma reduction interventions.