Technology Enabled Services for Coordinated Care of Depression in Healthcare Settings

医疗机构中抑郁症协调护理的技术支持服务

• 批准号: 10462746
• 负责人: DAVID CURTIS MOHR
• 金额: $ 150.69万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 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 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10462746
• 关键词: Address; Car Phone; Caregivers; Caring; Case Manager; Chicago; Classification; Clinic; Clinical; Clinical Sciences; Clinical Services; Collaborations; Communication; Coupled; Decision Making; Discipline of obstetrics; Elderly; Elements; Ensure; Evaluation; Family Caregiver; Family Practice; Foundations; Geriatrics; Guidelines; Health Services Research; Healthcare; Individual; Investigational Therapies; Knowledge; Measurement; Medical; Medicine; Mental Depression; Mental Health Services; Methods; Mission; Modeling; Morbidity - disease rate; Online Systems; Outcome; Output; Patients; Perinatal; Persons; Phase; Physicians; Population; Postpartum Depression; Primary Health Care; Problem Solving; Process; Protocols documentation; Provider; Psychology; Quality of life; Randomized Controlled Trials; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Proposals; Role; Science; Scientist; Services; System; Taxonomy; Technology; Update; Voice; Work; base; care coordination; care systems; collaborative care; computer human interaction; cost; design; digital mental health; experience; family support; health care settings; implementation design; implementation science; improved; information organization; innovation; intelligent personal assistant; medical specialties; mobile application; mortality; obstetric care; patient engagement; patient population; programs; research to practice; sensor technology; service organization; statistics; sustainability framework; tool; treatment optimization; treatment research

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.

抽象的 技术支持服务 (TES)，使用基于网络和移动应用程序为患者提供服务 随机对照试验一致表明，来自护理协调员的支持是 对治疗抑郁症有效。然而，在医疗保健环境中实施 TES 的尝试失败了， 主要是因为现实世界的患者和提供者都不使用我们在研究中开发和评估的工具。 该中心通过多层次策略解决这一从研究到实践的问题。在研究中 提案（RP）级别，我们将在三种独特的医疗环境中设计和评估抑郁症的 TES， 通常治疗抑郁症。每个 RP 都将包含独特的设计创新。 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 集成手机传感技术来创建更简单、更具吸引力的患者工具。 RP2将设计 评估产后抑郁症专业产科护理机构的 TES。设计创新 将专注于面向护理经理的工具和流程，这些工具和流程可以简化、组织和自动化工作流程。 RP3 以老年病服务为背景，将重点关注居家老年人，因为他们的治疗选择很少。 设计创新将利用语音控制的智能个人助理来支持居家生活 老年人，并为家庭照顾者提供支持。在研究层面，我们将利用这三个RP来完善 我们的加速创造到维持（ACTS）研究框架，旨在克服研究到 通过多种方式练习间隙。 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中 制定 RP 计划，从而确保最终产品可用、有用且可以实施。核 研究设计元素和测量在各个 RP 中是一致的，这将使我们能够评估 跨所有 RP 的 ACTS 框架，以验证 ACTS 框架的核心研究原则。随着 在我们外部科学顾问委员会的帮助下，将利用这一经验来制定研究指南 数字心理健康研究，并将获得的有关 TES 和组织特征的知识汇总到 代表研究人员和开发人员重要信息的分类法。我们将实现这一目标 通过一个高度跨学科的团队进行工作，该团队由两位 PI 领导，他们是数字心理领域的顶尖专家 健康和人机交互（Mohr 和 Reddy），在医学、实施科学、心理学、 研究方法和统计。每个 RP 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合作。因此，本中心通过使用 注重单个研究项目和方法的多层次方法将产生第一个 TES 专为在现实世界的医疗保健环境中实施而设计，并将提供实质性和持久的 对研究方法的贡献将提高科学质量。