Electronic Bridge to Mental Health (eBridge) for College Students

大学生心理健康电子桥（eBridge）

• 批准号: 9462985
• 负责人: Cheryl A. King
• 金额: $ 8.58万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-11 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9462985
• 关键词: Address; Adherence; Adolescent and Young Adult; Adult; Age; Alcohol abuse; Alcohols; American; Caring; Cause of Death; Clinical; Clinical Research; Communication; Computers; Cost Measures; Counseling; Development; Direct Costs; Drug abuse; Effectiveness; Effectiveness of Interventions; Epidemiology; Feedback; Feeling suicidal; Foundations; Funding; Gender; Grant; Health Care Costs; Health Professional; Health Resources; Health Services; Health Services Research; Health behavior; Healthcare; Heavy Drinking; Individual; Internet; Intervention; Intervention Studies; Intervention Trial; Life; Link; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methodology; Modality; Modeling; National Institute of Mental Health; Online Systems; Outcome; Outcome Measure; Participant; Pharmaceutical Preparations; Phase; Population; Prevalence; Professional counselor; Psychotherapy; Randomized; Readiness; Recommendation; Recording of previous events; Reporting; Research; Resources; Risk; Risk Factors; Self Determination; Services; Standardization; Students; Suicide; Suicide attempt; Suicide prevention; Surveys; Testing; Time; Training; United States; Universities; adverse outcome; aged; base; college; cost; cost effectiveness; depressive symptoms; effectiveness measure; experience; follow-up; group intervention; health information technology; improved; instrument; motivational enhancement therapy; primary outcome; programs; public health relevance; randomized trial; screening; secondary outcome; service utilization; social stigma; substance misuse; suicidal adolescent; suicidal behavior; suicidal risk; therapy development; university student; web based interface; young adult

DESCRIPTION (provided by applicant): Suicidal behavior is a significant concern on college campuses, and suicide is the second leading cause of death in college student populations. Consistent with recommendations in the National Strategy for Suicide Prevention and spearheaded by organizations such as the American Foundation for Suicide Prevention, many universities have initiated voluntary web-based screening to identify students at elevated risk for suicide and in need of mental health services. This is a promising direction; however, research is needed to determine the efficacy of such an approach and how to most effectively link students with positive screens to professional services. With NIMH funding for an R34 intervention development grant, we developed, pilot tested and iteratively refined a theoretically-driven intervention, Students' eBridge to Mental Health (eBridge), which identifies students at elevated suicide risk and facilitates their linkage to mental health (MH) services. eBridge incorporates motivational interviewing (MI) principles and draws from health behavior promotion models that emphasize autonomy and self-determination. Following a web-based screen using standardized instruments to identify students at elevated risk (positive screens on any two or more of: lifetime suicide attempt, current suicidal ideation, alcohol abuse, depression), eBridge offers students the options of receiving personalized feedback (provided online in a conversational MI-adherent format) and corresponding online with professionals trained in MI and knowledgeable about local resources. In our R34 pilot randomized trial, students in the control condition received personalized feedback only, which was provided automatically and in graphic format. At 2-month follow-up, students assigned to eBridge reported (a) significantly higher levels of readiness to seek MH services; (b) significantly lower levels of stigma related to MH services; and (c) a higher likelihood of linking to MH services. In this application, we propose to conduct a large-scale, well-powered randomized controlled intervention trial across multiple universities to address the following specific aims: (1) determine the impact of eBridge on linkage to MH services, MH outcomes (suicidal thoughts and behaviors, depression, alcohol/substance misuse), and academic outcomes (grade point average, retention) at 6-month follow-up; and (2) examine possible moderators (gender, baseline levels of functioning, baseline recognition of problem) and mediators (engagement in online counseling, linkage to MH services) of eBridge effectiveness. Secondary aims include determining the costs associated with, and cost effectiveness of, the intervention. If the intervention is shown to be effective in his large-scale trial, it could be disseminated broadly to address suicide risk and associated mental health conditions and adverse consequences among college adults nationwide.

描述（由申请人提供）：自杀行为是大学校园的一个重要问题，自杀是大学生群体的第二大死因。根据《国家预防自杀战略》中的建议，并由美国预防自杀基金会等组织牵头，许多大学已启动自愿网络筛查，以识别自杀风险较高的学生。 自杀并需要心理健康服务。这是一个很有前途的方向；然而，需要进行研究来确定这种方法的有效性，以及如何最有效地将积极筛选的学生与专业服务联系起来。在 NIMH 的 R34 干预开发补助金资助下，我们开发、试点测试并迭代完善了一种理论驱动的干预措施，即学生心理健康电子桥梁 (eBridge)，该干预措施可识别自杀风险较高的学生，并促进他们与心理健康 (MH) 服务的联系。 eBridge 融入了动机访谈 (MI) 原则，并借鉴了强调自主性和自决性的健康行为促进模型。使用标准化工具进行基于网络的筛查来识别高风险学生（对以下任意两项或多项进行阳性筛查：一生自杀未遂、当前自杀意念、酗酒、抑郁），eBridge 为学生提供接收个性化反馈（以符合 MI 的对话格式在线提供）的选项，并与接受过 MI 培训且了解当地资源的专业人员进行在线通信。在我们的 R34 试点随机试验中，处于控制条件的学生仅收到个性化反馈，该反馈是自动以图形格式提供的。在 2 个月的随访中，分配到 eBridge 的学生报告说 (a) 寻求 MH 服务的准备程度显着提高； (b) 与以下方面相关的耻辱程度显着降低 MH 服务； (c) 链接到 MH 服务的可能性更高。在本申请中，我们建议在多所大学进行大规模、有力的随机对照干预试验，以实现以下具体目标：(1) 确定 eBridge 对 MH 服务、MH 结果（自杀想法和行为、抑郁、酒精/药物滥用）和 6 个月随访时的学术成果（平均绩点、保留率）的影响； (2) 检查 eBridge 有效性的可能调节因素（性别、功能基线水平、问题识别基线）和中介因素（参与在线咨询、与 MH 服务的联系）。次要目标包括确定与干预相关的成本和成本效益。如果这种干预措施在他的大规模试验中被证明是有效的，那么它可以广泛传播，以解决全国大学生的自杀风险和相关的心理健康状况以及不良后果。