Assessing the effectiveness of a digital platform to support the mental health of healthcare workers in the response and recovery phases of COVID-19

评估数字平台在 COVID-19 的应对和恢复阶段支持医护人员心理健康的有效性

• 批准号: 10451636
• 负责人: Raina Merchant
• 金额: $ 114.14万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451636
• 关键词: Absenteeism; Acute; Address; Affect; Anxiety; Appointment; Black race; COVID-19; COVID-19 impact; COVID-19 pandemic; Caring; Categories; Cessation of life; Chronic; Clinical; Cobalt; Communities; Decision Making; Discipline of Nursing; Economics; Effectiveness; Effectiveness of Interventions; Evaluation; Feedback; First Aid; Gender; Guidelines; Health Insurance Portability and Accountability Act; Health Personnel; Health Resources; Health Services Accessibility; Health system; Healthcare; Heterogeneity; Hospitals; Hour; Human Resources; Individual; Intake; Internet; Intervention; Interview; Link; Measures; Medicine; Mental Depression; Mental Health; Mental Health Services; Methods; Minority; Minority Women; Mission; Modeling; Motivation; National Institute of Mental Health; Nurses; Occupational Therapist; Online Systems; Patients; Pennsylvania; Perception; Personal Satisfaction; Pharmacists; Pharmacy facility; Phase; Physicians; Population; Process; Productivity; Provider; Psychiatrist; Public Health; Race; Radiology Specialty; Randomized Controlled Trials; Recovery; Reporting; Research; Research Design; Resources; Schedule; Self Assessment; Self Perception; Self-Direction; Self-Injurious Behavior; Series; Services; Stoicism; Structure; Subgroup; Surveys; Testing; Text Messaging; Thinking; Time; Trauma; Triage; Underrepresented Minority; Universities; Well in self; Woman; Work; Writing; acute care; base; care seeking; crowdsourcing; design; digital; digital health; digital models; direct patient care; effectiveness evaluation; evidence base; group intervention; health assessment; health care availability; health care delivery; high risk; improved; insight; men; novel coronavirus; pandemic disease; patient oriented; peer coaching; peer support; personal protective equipment; physical therapist; primary outcome; professional atmosphere; psychologic; remote assessment; resilience; response; satisfaction; secondary outcome; social stigma; telehealth; treatment as usual; treatment effect; virtual visit

The novel coronavirus (COVID-19) has radically changed the delivery of healthcare and significantly impacted the mental health of individuals and communities. The effect upon the mental health of the healthcare workforce has been particularly strained throughout the various phases of the pandemic. This impact is predicted to be chronic and pervasive for all and particularly for disproportionately affected underrepresented minority and female populations. There is a critical need to develop and test scalable digital approaches which can identify, address and support the well-being of healthcare workers (HCW) over time and beyond the pandemic. HCWs are busy and there is stigma associated with accessing mental health support. We seek to leverage digital platforms to facilitate ease of access to well-being focused resources and direct connection to mental health providers through real time support using a stepped model of care. During the acute phase of the pandemic, our team developed and implemented Penn Cobalt across the Penn Medicine health system. Cobalt is a web and text-message based platform which allows HCWs to complete contextual surveys and evidence-based assessments remotely on their own time. Individuals are then directed to tailored well-being resources and appropriate individual or group mental healthcare. Across Penn Medicine, and in just 7 months, Cobalt has had 18,300 unique users and has identified 111 HCWs reporting thoughts of self-harm and immediately connected those individuals with a mental health provider for support and evaluation. While Cobalt has had sustained high engagement and increased the health system's ability to identify high-risk individuals, it requires a motivated user. Individuals must “pull” care toward them and overcome multiple barriers ranging from identifying the need for mental health support, to making an appointment, and attending the appointment. We seek to evaluate whether a “pushed” model of care (Cobalt+), which proactively engages individuals, can improve individual mental health, satisfaction with access, and decrease factors which affect workforce productivity (e.g. absenteeism). The specific aims will evaluate, through a randomized controlled trial, the effectiveness of Cobalt+ on HCW depression/anxiety (primary outcome) compared with Cobalt (usual care). Secondary outcomes will include well-being, satisfaction with access to care, and measures of work productivity. Heterogeneous treatment effects will be explored for race and gender. Additionally, we will seek to better understand perceptions of access to mental health care and the effectiveness of Cobalt compared with Cobalt among HCWs through semi-structured qualitative interviews. Overall, this project seeks to address a significant gap and enhance HCW access and receipt of mental health and well-being focused resources and care. Our intent is that this will enable a proactive culture of well-being and mental health support for the healthcare workforce during the multiple phases of the pandemic. Our approach evaluates existing digital models which can be executed in a timely fashion and rapidly scaled for use across other health systems.

新型冠状病毒（COVID-19）从根本上改变了医疗保健的提供，并产生了重大影响