Targeted Intervention to Increase MH Treatment Among Depressed Black Adolescents

描述（由申请人提供）：患有抑郁症的黑人青少年代表了一个不太可能接受心理健康治疗的群体，主要是由于非经济原因，包括负面的家庭影响，对服务和提供者的负面看法，以及与经历抑郁症状相关的自我耻辱。干预措施，增加抑郁症的连接，黑人青少年心理健康服务是重要的，因为未经治疗的抑郁症是其他严重问题的前兆，为这个人口，包括辍学，青少年怀孕，自杀。虽然以前的策略已被用来提高服务参与成年人，有一个缺乏的策略或干预措施，专门针对抑郁症，黑人青少年在他们的中学年龄。本R21应用程序的总体目标是检查建立联系干预（MCI）的可行性和可接受性。MCI是一种理论驱动的1-（可能是2-）会话干预，旨在改善抑郁症黑人青少年的参与度，感知相关性和治疗满意度。作为其可行性和可接受性的初步研究，我们将实施MCI作为一个辅助的人际心理治疗抑郁的青少年（IPT-A），在学校提供的循证干预。 为了解决MCI的持续发展和完善，这个R21应用程序的目标是：（1）检查MCI在学校心理健康服务中抑郁的黑人青少年中的可行性（例如，招募挑战，记录MCI是否可以在1个或2个会话中交付，对MCI协议的忠诚度）;（2）对MCI参与者进行深入访谈（青少年和照顾者），以引出以下观点：（a）MCI的内容;（B）影响MCI参与的任何社会规范;（c）与MCI参与相关的寻求帮助自我效能的任何改善;（3）在10名青少年初步试点的基础上修订MCI手册;（4）检验MCI的可接受性（通过满意度评级）通过更大的试点开放试验修订MCI;（5）进行初步分析，探索MCI相关的结构，包括感知障碍，治疗态度，参与IPT-A的青少年中的改变意愿，以及护理人员参与MCI会话、抑郁严重程度水平和参加IPT-A会话的次数是否对关键MCI结构随时间的变化产生积极或消极影响。拟议研究的结果将提供：（1）初步支持一个潜在的参与战略，以提高抑郁症的黑人青少年在学校心理健康服务的心理健康治疗利用率;和（2）有价值的试点数据，为未来，更大的MCI试验。

DESCRIPTION (provided by applicant): Black adolescents with depression represent a group less likely to receive mental health treatment, primarily due to non-financial reasons including negative family influences, negative perceptions of services and providers, and self-stigma associated with experiencing depressive symptoms. Interventions that increase the connection of depressed, Black adolescents to mental health services are important because untreated depression is a precursor to other serious problems for this population, including school dropout, teen pregnancy, and suicidality. While previous strategies have been used to improve service engagement for adults, there is a dearth of strategies or interventions that specifically target depressed, Black adolescents in their middle school-age years. The overall goal of this R21 application is to examine the feasibility and acceptability of the Making Connections Intervention (MCI). The MCI is a theoretically driven 1- (possibly 2-) session intervention designed to improve engagement, perceived relevance, and treatment satisfaction among depressed Black adolescents. As an initial examination of its feasibility and acceptability, we wil implement the MCI as an adjunct to the Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), an evidence-based intervention delivered in schools. To address the continued development and refinement of the MCI, the goals of this R21 application are: (1) to examine the feasibility of the MCI among depressed Black adolescents in school mental health services (e.g., recruiting challenges, documenting whether the MCI can be delivered in 1 or 2 sessions, fidelity to the MCI protocol); (2) to conduct in-depth interviews with MCI participants (adolescents and caregivers) to elicit perspectives on: (a) the MCI's content; (b) any social norms that influence MCI participation; (c) any improvements in help-seeking self-efficacy associated with MCI participation; and (d) expectancies about participating in the MCI; (3) to revise the MCI manual based on the initial pilot with 10 adolescents; (4) to examine the acceptability (via satisfaction ratings) of the revised MCI via a larger pilot open trial; and (5) o conduct preliminary analyses to explore MCI-relevant constructs, including perceived barriers, treatment attitudes, and readiness to change among adolescents who participate in the IPT-A, and whether caregiver participation in the MCI session, level of depression severity, and attended number of IPT-A sessions positively or negatively influence change over time regarding the key MCI constructs. The outcome of the proposed studies will provide: (1) preliminary support for a potential engagement strategy to enhance the mental health treatment utilization of depressed Black adolescents in school mental health services; and (2) valuable pilot data for a future, larger trial of the MCI.