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

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 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.