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Geospatial and Ecological momentary assessment Technology and Activity Engagement for at-risk youth

地理空间和生态临时评估高危青少年的技术和活动参与

基本信息

批准号：
10435008
负责人：
Charles Richard Jonassaint
金额：
$ 13.46万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-17 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10435008
关键词：
Accelerometer Address Administrator Adolescence Adolescent Affect African American Age Anhedonia Arasena-A Attitude Behavior Behavioral Behavioral trial Belief Black race Caregivers Cellular Phone Childhood Cognitive Therapy Communities Consolidated Framework for Implementation Research Data Ecological momentary assessment Effectiveness Enrollment Feedback Feeling suicidal Focus Groups Goals Health Health Disparities Research Home Individual Intervention Interview Investigation Mental Depression Mental Health Mental Health Services Mental disorders Methodology Methods Modeling Monitor Multimedia Outcome Population Heterogeneity Positive Reinforcements Primary Health Care Provider Psychotherapy Qualitative Methods Race Randomized Research Personnel Rewards Risk Risk Behaviors Risk Factors Sampling Severities Social isolation Suicide Suicide attempt Symptoms System Technology Technology Assessment Testing Therapeutic Time Youth aged base clinically significant cohort depressive symptoms digital experience health equity high risk human centered design implementation framework implementation science implementation strategy interest mobile computing mobile sensing pleasure prevent racial disparity racial diversity racial population randomized trial recruit secondary outcome smartphone Application study population suicidal adolescent suicidal behavior suicidal individual suicidal risk suicide rate tool treatment program trial comparing uptake usability

项目摘要

Adolescence is associated with high risk for suicidal thoughts and behaviors (STBs). In recent years, racial disparities in risk for STBs have become increasingly evident, with African American and other Black-identifying adolescents (herein, Black) experiencing higher rates of suicidal behavior than any other racial group of youth in the U.S. Thus, there is a need for culturally appropriate interventions that target risk factors for STBs among a growing population of racially diverse youth. Anhedonia, defined as the loss of interest or pleasure in enjoyable or valued activities, is a core feature of depression and an independent risk factor for STBs in youth. Behavioral Activation (BA) therapy is a cognitive behavioral intervention that directly targets anhedonia, by decreasing avoidance and isolation behaviors, using positive reinforcement to increase engagement in valued activities and the experience of reward. Growing evidence supports the effectiveness of BA for adolescents in the traditional face-to-face psychotherapy format, and BA has shown promise in the few preliminary investigations that included racially diverse youth. A key advantage of the BA model is that the focus on behavioral strategies is well suited for adaptation to digital platforms that incorporate mobile sensing and can generate objective data on activity. As the digital BA approach allows for real-time feedback to both users and providers on treatment goals and behavioral targets, it offers a significant advantage over traditional face-to-face intervention. To date, no studies have tested digital BA in a diverse study population that includes Black youth. The goal of this study, therefore, is to tailor and test a health coach supported, digital BA intervention to target anhedonia in a diverse sample of youth, using leading implementation science frameworks. The initial BA platform was developed by the investigators to collect mobile accelerometer and geospatial activity data using smartphone technology that is shared with a health coach or clinician to provide feedback and push BA intervention content via a smartphone app. We will first use the Consolidated Framework for Implementation Research (CFIR) to collect and analyze qualitative data from focus groups with racially diverse adolescents, caregivers, providers, and administrators on their perspectives of intervention needs and barriers and facilitators to BA intervention and implementation strategies. Next, using human-centered design methods, we will iteratively develop and adapt the BA intervention to the needs of racially diverse, at-risk adolescents. We will then conduct a pilot randomized trial comparing the digitally delivered BA intervention to passive, smartphone-based activity monitoring alone. A group of 75 adolescents (35% Black), ages 12-18, with moderate depression and elevated anhedonia symptoms will be recruited from the Signature R01. We will examine feasibility, acceptability, and impact on anhedonia (primary target); secondary outcomes include activity, depression, and STB risk. This project will inform a larger randomized trial of BA and has the potential to directly address a critical gap in mental health disparities research.

青少年与自杀念头和行为（STBs）的高风险有关。近年来，种族歧视