User-centered design of a mobile health intervention to promote help-seeking and reduce duration of untreated illness among young adults with early psychosis

项目摘要/摘要 在精神病早期提供协调的专科护理(CSC)可以减少长期的 与精神分裂症谱系障碍相关的慢性化和功能障碍。然而，很少有年轻人患有 早期精神病(EP)参与了这些项目。患有EP的年轻人特别容易患上 对精神治疗的耻辱和消极信念，因此常常担心向 个人关怀。尽管患有EP的年轻人不愿寻求服务，但他们经常与心理健康有关 通过在线和移动技术提供资源。已经开发了几种数字健康干预措施，如 为这一人群提供面对面服务的附加服务，并已证明可行性、可接受性和 初步疗效。然而，为患有EP的年轻人设计的数字健康工具寥寥无几 与面对面护理无关的人。在缺乏此类工具的情况下，个人通常会求助于社交媒体或 往往将污名化的信仰具体化或阻止寻求帮助的论坛。移动卫生干预措施出现 特别适合于这一群体，因为移动设备是 大多数年轻人，并可以提供个性化的、实时的、实时的支持，向用户介绍 CSC中涉及的心理社会干预。然而，目前还不清楚是否以及距离有多远 可以利用提供的mHealth来提高对患有EP的年轻人的治疗参与度。 拟议的研究项目建议开发和测试旨在 通过心理教育、减少污名的内容、压力管理练习、 以及通过音频、视频和自动激励文本提供的本地相关治疗信息 互动，并通过生态瞬时评估(EMA)进行个性化。这个项目将需要一个用户- 以治疗为中心的设计方法，包括(1) 情景调查，以了解与移动健康和面对面相关的障碍、兴趣和偏好 治疗，(2)开发、改进和可用性测试，以及(3)试点随机对照试验 评估与主动控制mHealth干预的可行性、可接受性和初步疗效的比较 只提供压力管理。 这项研究项目将提供候选人整体培训计划的核心部分。这个K23 职业发展奖提供培训，以支持独立研究计划的发展 减少护理患有EP的年轻人的障碍的干预措施。这包括三个培训领域，包括 (1)移动健康目标提高精神健康护理参与度；(2)以用户为中心的设计；以及(3) 先进的数字健康试验纵向模型和量化方法。这些目标将通过 专家指导，授课培训，课程作业，以及研究项目的圆满完成。

PROJECT SUMMARY / ABSTRACT Coordinated specialty care (CSC) provided in the early course of psychosis can reduce the long-term chronicity and dysfunction associated with schizophrenia-spectrum disorders. However, few young adults with early psychosis (EP) are engaged with these programs. Young adults with EP are particularly susceptible to stigma and negative beliefs about psychiatric treatment, and thus are often apprehensive to present to in- person care. Despite their reluctance to seek services, young adults with EP often engage with mental health resources through online and mobile technologies. Several digital health interventions have been developed as adjuncts to in-person services for this population and have demonstrated feasibility, acceptability and preliminary efficacy. However, there are few available digital health tools designed for young adults with EP who are not connected to in-person care. In the absence of such tools, individuals often turn to social media or forums that often reify stigmatizing beliefs or discourage help seeking. Mobile health interventions appear particularly well suited to this population given the fact that mobile devices are the primary media source for most young adults and can provide individualized, real-time, real-place support to introduce users to psychosocial interventions involved in CSC. It remains unclear at present, however, whether and how remotely delivered mHealth can be leveraged to increase engagement in treatment for young adults with EP. The proposed research project proposes to develop and test an mHealth intervention designed to impact help-seeking beliefs through psychoeducation, stigma-reducing content, stress management exercises, and locally relevant treatment information delivered through audio, video, and automated motivational text interactions, and personalized through ecological momentary assessment (EMA). This project will take a user- centered design approach with individuals who are both engaged and unengaged in treatment, including (1) a contextual inquiry to understand barriers, interests and preferences related to mHealth and in-person treatment, (2) development, refinement and usability testing, and (3) a pilot randomized controlled trial assessing feasibility, acceptability and preliminary efficacy compared to an active control mHealth intervention providing only stress management. This research project will provide a central piece of the candidate's overall training plan. This K23 career development award provides training to support an independent research program developing interventions that reduce barriers to care for young adults with EP. This includes three training areas, including (1) mobile health targeting increasing mental health care engagement, (2) user-centered design, and (3) advanced longitudinal models and quantitative methods for digital health trials. These goals will be met through expert mentorship, didactic training, coursework, and the successful completion of the research project.