Technology Enabled Services for Coordinated Care of Depression in Healthcare Settings

摘要 技术支持的服务(TESS)，它使用基于Web的和移动应用程序为患者提供 来自护理协调员的支持，通过随机对照试验一直表明是 在治疗抑郁症方面很有效。然而，在医疗保健环境中实施TESS的尝试失败了， 主要是因为现实世界中的患者和提供者都没有使用我们在研究中开发和评估的工具。 该中心通过多层次战略解决这一从研究到实践的问题。在研究中 建议(RP)级别，我们将在三个独特的医疗环境中设计和评估抑郁症的TESS 通常要管理好抑郁情绪。每个RP将包括一个独特的设计创新。RP1将设计和评估 支持初级保健协作护理计划的TES。RP1的设计创新将集中在 集成移动电话传感技术，创建更简单、更吸引人的患者工具。RP2将设计 并评估产后抑郁症的专业产科护理环境的TES。设计创新 将重点介绍可简化、组织和自动化工作流程的面向护理经理的工具和流程。 RP3以老年服务为背景，将专注于待在家里的老年人，他们几乎没有治疗选择。 设计创新将是利用声控智能个人助理来支持居家 老年人，为家庭照顾者提供支持。在研究层面，我们将利用三个RPS来改进 我们的加速创建到可持续(ACTS)研究框架，旨在克服研究到可持续发展 练习差距有几个方面。ACTS集成了人机交互(HCI)方法，将 将最终用户的声音纳入技术、服务协议和实施的设计和评估 对RPS进行规划，从而确保最终产品是可用的、有用的和可实施的。堆芯 研究设计元素和测量在整个RPS中是一致的，这将使我们能够评估 所有RP的ACTS框架，以验证ACTS框架的核心研究原则。与 在我们外部科学顾问委员会的帮助下，将利用这一经验为以下方面制定研究指南 数字心理健康研究，并将获得的关于TES和组织特征的知识汇总到 代表研究人员和开发人员基本信息的分类。我们将在今年实现这一点 通过一个高度跨学科的团队进行工作，由两名PI领导，他们是数字心理领域的领先专家 健康和人机界面(莫尔和雷迪)，在医学、实施科学、心理学、 研究方法和统计方法。每个RPS由诊所或服务主管和一名研究人员共同领导， 从而确保临床服务需求和研究之间的深度协作。因此，这个中心，通过使用 以个人研究项目和方法为重点的多层次方法将产生第一个 TESS专为在现实世界的医疗保健环境中实施而设计，并将提供大量和持久的 对研究方法的贡献，将提高科学的质量。

Abstract Technology-enabled services (TESs), which use web-based and mobile applications for patients coupled with support from a care coordinator, have consistently been shown through randomized controlled trials to be effective at treating depression. However, attempts to implement TESs in healthcare settings have failed, primarily because neither real-world patients nor providers use the tools we develop and evaluate in research. This center addresses this research-to-practice problem through a multi-level strategy. At the research proposal (RP) level, we will design and evaluate TESs for depression in three unique medical settings that commonly manage depression. Each RP will include a unique design innovation. RP1 will design and evaluate a TES to support a primary care collaborative care program. The design innovation of RP1 will focus on integrating mobile phone sensing technologies to create simpler, more engaging patient tools. RP2 will design and evaluate a TES for a specialty obstetrics care setting for postpartum depression. The design innovation will focus on care manager-facing tools and processes that can simplify, organize, and automate workflows. RP3, set in a geriatric service, will focus on homebound older adults, for whom there are few treatment options. The design innovation will be to harness a voice-controlled intelligent personal assistant to support homebound older adults, with supports for family caregivers. At the research level, we will harness the three RPs to refine our Accelerated Create-to-Sustainment (ACTS) research framework, which aims to overcome the research-to- practice gap in several ways. ACTS integrates human computer interaction (HCI) methods to incorporate the voice of end users into the design and evaluation of the technologies, service protocol, and implementation plan for the RPs, thereby ensuring that the end product is usable, useful, and can be implemented. Core research design elements and measurements are consistent across the RPs, which will allow us to evaluate the ACTS framework across all RPs to validate the core research principles of the ACTS framework. With the help of our External Scientific Advisory Board, will use this experience to produce research guidelines for digital mental health research, and aggregate the knowledge gained about TES and organization features into a taxonomy that represents essential information for researchers and developers. We will achieve this this work through a highly interdisciplinary team, led by two PIs who are leading experts in experts in digital mental health and HCI (Mohr and Reddy), with additional expertise in medicine, implementation science, psychology, research methods, and statistics. Each of the RPs is co-led by the clinic or service chief and a researcher, thereby ensuring a deep collaboration between clinical service needs and research. Thus, this Center, by using a multilevel approach focusing on both the individual research projects and methodology, will produce the first TESs designed for implementation in real world healthcare settings, and will provide substantial and enduring contributions to research methodology that will improve the quality of science.