Scaling a smarter and more efficient intervention: Evaluating the feasibility of disseminating a novel mobile app platform to treat depression

扩大更智能、更有效的干预措施：评估传播新型移动应用程序平台治疗抑郁症的可行性

• 批准号: 9323599
• 负责人: JOAQUIN A ANGUERA
• 金额: $ 24.47万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9323599
• 关键词: Behavioral; Case Mixes; Characteristics; Clinical; Clinical Data; Clinical Trials; Communities; Competence; Consent; Data; Data Analytics; Data Collection; Ensure; Equilibrium; Evaluation; Event; Evidence based treatment; Goals; Health Personnel; Hour; Human; Improve Access; Individual; Intervention; Machine Learning; Measures; Mental Competency; Mental Depression; Mental Health; Mental Health Services; Modeling; Mood Disorders; Moods; National Institute of Mental Health; Natural Language Processing; Outcome; Participant; Patients; Performance; Pilot Projects; Population; Process; Provider; Public Health; Quality of Care; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research Priority; Services; System; Testing; Time; Training; arm; base; blind; care seeking; cost effective; dashboard; depressive symptoms; disability; evidence based guidelines; experience; functional outcomes; handheld mobile device; improved; improved outcome; innovation; iterative design; mHealth; mobile application; mobile computing; motivational intervention; novel; post intervention; research and development; response; satisfaction; targeted treatment; technological innovation; therapy development; tool

ABSTRACT The goal of this project is to conduct a pilot study to test the utility of a Natural Language Processing (NLP) clinical messaging tool to improve the reach and the quality (fidelity and competency) of coaches providing behavioral activation (BA) strategies through a mobile mental health app called Personalized Real-time Intervention for Motivational Enhancement (PRIME). Despite decades of research and development for the treatment of mood disorders, depression has risen from the 5th leading cause of disability to the leading cause in the US. Critical barriers for progress in the field are 1) Poor access to high quality care for consumers; 2) Limited mental health workforce; and 3) Few providers are trained in the delivery of evidence-based treatments. In response to this public health problem, our team is proposing to use a mobile platform to improve access to an evidence based treatment; increase the reach of mental health coaches while supporting the delivery of higher quality of care. We will improve the reach of clinicians by using a NLP-powered messaging tool, which will ensure fidelity to the BA model and clinicians will have access to real-time clinical information about their patients to guide more targeted treatment (competence). By improving the efficiency and competence of mental health coaches in the context of mobile mental health services, we expect patients to make greater gains in depression, mood-related disability, and in achieving personal goals. In order to evaluate the feasibility, tolerability, and overall impact of the enhancements to PRIME, we will spend Year 1 engaging stakeholders in a human centered iterative design process and spend Years 2-3 conducting a pilot randomized controlled trial in which we will randomize 120 individuals with depression to either receive 8- weeks of 1) PRIME 1.0 (current version) OR 2) PRIME 2.0 (version with the NLP-powered clinician dashboard). Using BRIGHTEN, our mobile clinical trial platform, we will recruit participants, consent, screen, evaluate and deliver the intervention entirely remotely. The pilot data from this study will be used to prepare for a R01 study to definitively determine whether PRIME may be used to efficiently and effectively improve outcomes for a significantly larger number of individuals with depression.

摘要 该项目的目标是进行一项试点研究，以测试自然语言处理（NLP）的实用性。 临床消息传递工具，以提高教练的覆盖范围和质量（忠诚度和能力）， 行为激活（BA）策略，通过一个名为个性化实时的移动的心理健康应用程序 动机增强干预（PRIME）。尽管经过几十年的研究和开发， 治疗情绪障碍，抑郁症已从第五大致残原因上升为第一大致残原因 在美国.该领域取得进展的关键障碍是：1）消费者难以获得高质量的护理; 2） 有限的精神卫生工作人员;和3）很少有提供者在提供循证医学方面接受过培训。 治疗。为了应对这一公共卫生问题，我们的团队建议使用移动的平台， 改善获得循证治疗的机会;增加心理健康教练的覆盖面，同时支持 提供更高质量的护理。我们将通过使用NLP供电的 消息传递工具，这将确保对BA模型的保真度，临床医生将能够访问实时临床 患者的信息，以指导更有针对性的治疗（能力）。通过提高效率 和能力的心理健康教练在移动的心理健康服务的背景下，我们希望病人 在抑郁症、情绪相关的残疾和实现个人目标方面取得更大的进步。为了 我们将在第一年评估PRIME增强功能的可行性、耐受性和总体影响 让利益相关者参与以人为本的迭代设计过程，并花2-3年的时间进行试点 一项随机对照试验，我们将120名抑郁症患者随机分为两组， 1）PRIME 1.0（当前版本）或2）PRIME 2.0（具有NLP动力临床医生的版本）的周数 仪表板）。使用BRIGHTEN，我们的移动的临床试验平台，我们将招募参与者，同意，筛选， 完全远程评估和提供干预措施。本研究的试点数据将用于准备 R 01研究，以明确确定PRIME是否可用于有效改善 结果对于一个显着更大数量的个人与抑郁症。