Feasibility Trial of a Mindfulness-basedmHealth Intervention to Mitigate the Effects of Chronic Workplace Stress among Juvenile Justice Officers

青少年司法官员(JJO)-对每年在美国被捕的100多万青少年负有责任-面对 超高的长期工作压力。这种压力与一系列不良后果有关。 情绪失调的基础是：抑郁、焦虑和工作倦怠。重要的是，JJO的员工 主要由黑人/非裔美国人和拉丁裔员工组成，这些群体面临着差异 在心理健康症状和倦怠方面与来自其他种族/民族背景的同龄人进行比较。干预措施 因此，解决JJO长期工作场所压力的影响将产生有意义的公共健康 在帮助纠正健康差距的同时受益。基于正念的干预(MBIS)改善情绪 调节和减少抑郁、焦虑和职业倦怠。JJO对mbi表现出强烈的兴趣，mbi可以是 通过移动医疗(MHealth)技术为员工量身定做并在工作日提供服务。这个项目 将根据经验支持的适应目标，调整MBI智能手机应用程序，以交付给JJO，以及 将进行可行性临床试验。它将建立在并行程序和通过先前的 NIH奖为被捕的青少年改编和测试MBI应用程序，提供独特、高效和经济实惠的 机会。这项研究将在芝加哥库克县进行，该县是美国第二大青少年司法系统， 在那里，研究团队已经进行了18年的NIH资助的研究。指导适应和实施 对于这款应用，团队将进行关键的线人访谈，这些访谈植根于理论上驱动的实施科学 框架。面试将在个人(JJO)和组织(领导力)两个层面进行。该队 我将与专业程序员合作，将面试结果转换为改编自 现有的源代码。对于可行性临床试验，JJO(n=50)将被单独随机分配到使用 改编MBI应用程序或同等强度的控制应用程序，持续30天。应用内分析将捕获客观使用情况 每个应用程序的功能。将采用自适应干预设计来吸引两个应用程序的非用户， 由此，指示未使用的分析数据将触发增强参与策略(例如，文本)的交付 鼓励使用的消息)。JJO的心理健康症状和职业倦怠将在基线上进行评估， 1个月和6个月，通过自我报告。JJOS还将完成为期一周的生态瞬时评估 (EMA)在基线和1个月时的客观背景和情感状态，以捕捉机制 工作场所的目标(即情绪失调)。在1个月后，JJO和领导层都将报告 通过深入的、混合的方法设计，可接受性和可行性。这项研究的完成将开发建筑 用于正式评估调整后的MBI应用程序的高影响、大规模试验的块。从理论上讲-- 推动实施的科学原则与mHealth技术相结合，将MBI应用程序定位为 跨不同的青少年司法系统可持续和可扩展，改善其健康轨迹 前线工作人员。

Juvenile justice officers (JJOs)—responsible for the over 1 million youth arrested each year in the U.S.—face exceptionally high chronic workplace stress. This stress is implicated in a constellation of adverse outcomes underpinned by emotion dysregulation: depression, anxiety, and workplace burnout. Importantly, JJO workforces are comprised heavily of Black/African American and Latinx employees, and these same groups face disparities in mental health symptoms and burnout compared with peers from other racial/ethnic backgrounds. Interventions that address the effects of chronic workplace stress among JJOs thus stand to yield meaningful public health benefit while helping redress health disparities. Mindfulness-based interventions (MBIs) improve emotion regulation and reduce depression, anxiety, and burnout. JJOs express strong interest in MBIs, which can be tailored and delivered to employees during their workdays via mobile health (mHealth) technology. This project will adapt an MBI smartphone app for delivery to JJOs based on empirically-supported adaptation targets, and will conduct a feasibility clinical trial. It will build on parallel procedures and technology developed through a prior NIH award to adapt and test an MBI app for arrested youth, offering a unique, efficient, and cost-effective opportunity. The study will take place in Chicago Cook County, the 2nd largest juvenile justice system in the U.S., where the study team has conducted NIH-funded research for 18 years. To guide adaptation and implementation of the app, the team will conduct key informant interviews rooted in a theoretically-driven implementation science framework. Interviews will be held on both the individual (JJO) and organizational (leadership) levels. The team will work with professional programmers to translate the interview findings into a secure app adapted from existing source code. For the feasibility clinical trial, JJOs (n=50) will be individually randomized to use the adapted MBI app or an equally intensive control app daily for 30 days. In-app analytics will capture objective use of each app feature. An adaptive intervention design will be employed to engage non-users of both apps, whereby analytics data indicating non-use will trigger delivery of an enhanced engagement strategy (e.g., text messages encouraging use). Mental health symptoms and burnout among JJOs will be assessed at baseline, 1, and 6 months via self-report. JJOs will also complete 1-week “bursts” of ecological momentary assessment (EMA) of their objective contexts and affective states at baseline and 1 month in order to capture the mechanistic target (i.e., emotion dysregulation) in the workplace. At 1 month, both JJOs and leadership will report on acceptability and feasibility via an in-depth, mixed-methods design. Completion of this study will develop building blocks for high-impact, large-scale trials that formally evaluate the adapted MBI app. The use of theoretically- driven implementation science principles coupled with mHealth technology will position the MBI app to be sustainable and scalable across diverse juvenile justice systems, improving the health trajectories of their frontline workers.