Bounce Back Now: A Low-Cost Intervention to Facilitate Post-Disaster Recovery

 描述（由申请人提供）：灾难使个人面临各种各样的压力，包括死亡或受伤的威胁，失去亲人，获得基本需求的机会有限，以及由于财产损失或就业中断而造成的财务压力。许多幸存者有弹性或迅速恢复，但也有少数人出现行为健康问题，如创伤后应激障碍和抑郁症。对于这些心理健康问题，存在一些有效的治疗方法，但许多灾难幸存者在接受服务时遇到障碍（例如，耻辱、时间承诺、成本、调度、运输）。提供简短、有效、免费和易于获得的干预措施，以促进个人和社区的复原力以及快速和持续的恢复，对受灾社区和救灾机构可能具有巨大的价值。我们建议评估Bounce Back Now（BBN），这是一种新颖的，可扩展的，高度可持续的技术干预。BBN将可通过任何连接到互联网的设备访问，如计算机、智能手机或平板电脑;它将针对移动的设备进行优化，以确保其高度可访问和用户友好。干预措施包括三个主要部分：（1）症状/活动跟踪部分，旨在促进灾后急性阶段的自我监测;（2）简短的自助干预部分，旨在加速与创伤后应激障碍和情绪症状有关的心理健康恢复;（3）提供者援助部分，将幸存者与国家灾难救助热线联系起来。我们的研究支持了BBN的前两个组成部分的可行性，以及BBN的简短干预组成部分的初步疗效。灾难求助热线是由物质滥用和精神卫生服务管理局管理的一项全国性服务，提供危机咨询和当地转介精神卫生服务提供者。我们将招募5,000名灾难幸存者来测试干预措施：2,500人将被随机分配到BBN条件下，其他2,500人将被分配到增强的常规护理比较条件下。我们还将研究BBN干预相对于加强常规护理的成本效益。第二个研究目标集中在探索与心理健康恢复、BBN使用和服务利用相关的分诊水平风险因素。美国红十字会和负责准备和反应的助理部长办公室已与我们就这一申请开展合作，并将协助我们招募参与者和收集与分诊级别风险因素有关的数据。我们将使用创新的分阶段资助方法进行这项研究，这将确保我们准备在触发灾难事件后立即启动研究。这项研究将显著改善基于技术的灾难心理健康干预措施的证据基础。

 DESCRIPTION (provided by applicant): Disasters confront individuals with a wide range of stressors, including threat of death or injury, loss of loved ones, limited access to basic needs, and financial strain due to property damage or disruptions in employment. Many survivors are resilient or recover rapidly, but a significant minority develops behavioral health problems such as posttraumatic stress disorder and depression. Some efficacious treatments exist for these mental health problems, but many disaster survivors encounter barriers to receipt of services (e.g., stigma, time commitment, cost, scheduling, transportation). The availability of brief, effective, free, and highly accessible interventions to facilitate personal and community resilience and rapid and sustained recovery is potentially of tremendous value to disaster-affected communities and disaster response agencies. We propose to evaluate Bounce Back Now (BBN), a novel, scalable, and highly sustainable technology-based intervention. BBN will be accessible via any device that is connected to the internet, such as a computer, smartphone, or tablet; it will be optimized for mobile devices to ensure that it is highly accessible and user friendly. The intervention consists of three major components: (1) a symptom/activity tracking component designed to facilitate self-monitoring in the acute post-disaster phase; (2) a brief self-help intervention component that aims to accelerate mental health recovery relative to PTSD and mood symptoms; and (3) a provider assistance component that will connect survivors to a national Disaster Distress Helpline. Our research has supported the feasibility of the first two components of BBN, and the initial efficacy of the brief intervention component of BBN. The Disaster Distress Helpline is a national service administered by the Substance Abuse and Mental Health Services Administration that provides crisis counseling and local referrals to mental health providers. We will recruit 5,000 disaster survivors to test the intervention: 2,500 will be randomly assigned to the BBN condition, the other 2,500 to an enhanced usual care comparison condition. We will also examine the cost effectiveness of the BBN intervention relative to enhanced usual care. A secondary research aim centers on the exploration of triage- level risk factors that are associated with mental health recovery, use of BBN, and service utilization. The American Red Cross and the Office of the Assistant Secretary for Preparedness and Response have partnered with us on this application and will assist us with participant recruitment and collection of data relating to triage- level risk factors. We will conduct this research using an innovative phased-funding approach that will ensure that we are prepared to initiate research in the immediate aftermath of a triggering disaster incident. This study will significantly improve the evidence base around technology-based disaster mental health interventions.