Online system for identifying and addressing teen depression in primary care

用于识别和解决初级保健中青少年抑郁症的在线系统

• 批准号: 10433890
• 负责人: Barbara Jo Howard
• 金额: $ 48.95万
• 依托单位: TOTAL CHILD HEALTH, INC.
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10433890
• 关键词: 17 year old; Abnormal coordination; Address; Adolescent; Affect; Agreement; Algorithms; Appointment; Area; Artificial Intelligence; Caring; Child; Child Psychiatry; Childhood; Clinical; Computers; Consensus; Data; Data Collection; Depression and Suicide; Depression screen; Development; Evidence based treatment; Family; Feedback; Feeling; Focus Groups; Goals; Guidelines; Health; Health Professional; Individual; Information Systems; Intervention; Intervention Trial; Interview; Knowledge; Measures; Mental Depression; Mental Health; Mental Health Services; Modality; Moods; Office Visits; Online Systems; Parents; Patients; Phase; Primary Health Care; Process; Psychiatrist; Public Health; Qi; Qualitative Research; Questionnaires; Randomized Controlled Trials; Recommendation; Resources; Risk; Specialist; Specialty Boards; Supervision; Support System; Surveys; System; Teenagers; Testing; Texas; Text; Time; Training; Visit; Youth; adolescent health; barrier to care; base; behavioral health; care coordination; care providers; chatbot; checkup examination; child depression; depressive symptoms; follow-up; functional disability; implementation strategy; innovation; motivational enhancement therapy; programs; recruit; satisfaction; screening; shared decision making; single episode major depressive disorder; skills; success; suicidal risk; tool; volunteer

This proposal presents innovations to addressing teen depression during routine check-up visits through further development of an online clinical process support system called CHADIS. The primary care provider remains in the center of the process with his/her prior relationship with the family and humanity enabled with computer assistance prior to the encounter as well as moment of care reminders and teleprompted specific hints aimed at enhancing a patient focused balanced discussion of individual strengths and barriers to the teens goals known as a motivational interview. This is made feasible through pre-visit data collection providing relevant details to highlight as well as data to support omitting some traditional guidance areas with lower priority for the individual teen. Any conclusions coming from PCP recommendations and shared decision making is reinforced by a computer-based, always available chatbot guided by artificial intelligence that serves as a bridge to other helping professionals, strengths building resources, as well as conversations based on proven mental health therapies based on earlier pilot data for reducing depressive symptoms. These innovations will be tested via a cluster randomized control trial, demonstrating whether use of the system results in higher rates of screening, reductions in depressive symptoms, and accessing of evidence-based treatment for teen depression. Use of the system is reinforced by engagement of primary doctors and child psychiatrists in a related quality improvement program with data from their participation providing needed feedback for recertification of professional status requirements of their respective specialty boards. Success of the system would mean a new primary care workflow-friendly tool which could help adolescents avoid the significant functional impairment and increased risks that accompany teen depression. If this new paradigm for adolescent health supervision proves useful for depression, adaptations for other teen challenges might also be promising.

这项提案提出了创新，以解决青少年抑郁症在例行检查访问 通过进一步开发名为CHADIS的在线临床流程支持系统。的 初级保健提供者仍然处于过程的中心，他/她以前与 家庭和人类在遭遇之前能够得到计算机的帮助， 护理时刻提醒和远程提示的特定提示，旨在增强患者的关注度， 平衡讨论个人的优势和障碍，以青少年的目标被称为一个 动机面试通过访视前数据收集， 强调相关细节以及支持省略某些传统指导领域的数据 而对青少年个人来说优先级较低。来自PCP的任何结论 建议和共同决策是加强了基于计算机的，总是 由人工智能引导的可用聊天机器人，作为与其他帮助的桥梁 专业人士，优势建设资源，以及基于经过验证的心理对话 基于早期试点数据的健康疗法，以减少抑郁症状。这些 创新将通过一项群集随机对照试验进行测试，证明是否使用 该系统提高了筛查率，减少了抑郁症状， 青少年抑郁症的循证治疗。该系统的使用得到加强， 让初级医生和儿童精神科医生参与相关的质量改进 计划与数据，从他们的参与提供所需的反馈，重新认证 各专业委员会的专业地位要求。系统的成功 将意味着一个新的初级保健工作流程友好的工具，可以帮助青少年避免 严重的功能障碍和伴随青少年抑郁症的风险增加。如果这 青少年健康监督的新范式证明对抑郁症有用，适应 其他青少年挑战也可能是有希望的。

项目成果

Suicidal Ideation in Adolescents: Understanding Results from Screening with the PHQ-9M and the PSC-17P.

• DOI: 10.1097/dbp.0000000000001063
• 发表时间: 2022-08-01
• 期刊: JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
• 影响因子: 2.4
• 作者: Holcomb, Juliana M.;Dutta, Anamika;Bergmann, Paul;Riobueno-Naylor, Alexa;Haile, Haregnesh;Benheim, Talia S.;Sturner, Raymond;Howard, Barbara;Jellinek, Michael;Murphy, J. Michael
• 通讯作者: Murphy, J. Michael