Development and Testing of imHere4U: A Digital Suicide Prevention Intervention for Cyberbullied Adolescents

自杀是青少年死亡的第二大原因，而被网络欺凌的青少年死亡人数是 像那些没有受到网络欺凌的人一样，可能表现出自杀的想法和行为。网络欺凌(CB)是 与自杀念头密切相关，这一现象波动很快，这表明有必要 在CB病例附近进行干预，以降低自杀风险。公共卫生需要减少自杀 网络欺凌青少年的风险，特别是未得到充分服务的青少年(即少数族裔青年 背景)，他们面临较高的CB和自杀念头和行为。然而，目前的干预措施是 在满足未得到充分服务的年轻人的需求和在高潮时刻进行干预的能力有限 脆弱性。这项以病人为本的辅导式职业发展奖(K23)旨在提供 申请人是一名行为健康科学家和临床社会工作者，具备弥合差距所需的技能 在CB干预和自杀预防之间使用利益相关者知情和经验驱动的数字 针对青少年的干预措施。为了实现这一长期目标，多学科培训计划将提供 具有以下专长的申请者：(1)在线临床试验的设计、实施和分析；(2)理论、研究、 以及青少年公民行为评估和干预的方法；以及(3)加强服务不足的方法 青少年对以人为中心设计(HCD)和简明动机的数字干预的利用 干预措施。申请者将在一个强大的多学科环境中接受指导，并完成 青少年自杀预防、CB研究、HCD和在线临床试验领域的专家。正式 培训和课程工作将促进临床试验设计和实施方面的培训(伦理和社交媒体- 基于招聘)和分析(机器学习的中介和协调分析和评估[ML] 临床试验模型)、CB研究和提高参与度的方法(HCD和激励性 采访)。一个补充性的研究计划将集中在imHere4U的开发和测试上，这是一款刚刚推出的 针对网络欺凌青少年的自杀预防干预。基于提示可接受性的试点数据 在网络欺凌的青少年、父母和专业人士中，我们提出了三个目标。目标1： 网络欺凌青少年(N=20；&gt；35%未得到充分服务)将参与迭代设计，以优化数字 满足他们需求的产品。目标2：最近受到网络欺凌的青少年(N=80；&gt；35%未得到充分服务)将参与 在线RCT测试imHere4U加上在线互动问卷与单独的问卷调查。目标3： 我们将研究使用ML算法向青少年提供关于他们支持的反馈的可行性 和欺凌网络互动。这项试验将测试imHere4U，Essential的可行性和初步疗效 用于随后的R01应用程序的数据，以在更大的样本和传播中测试imHere4U的有效性 结果。这项调查的结果有望导致有效的干预措施，填补关键的 通过干预CB发生的时间和地点来预防青少年自杀风险，从而在服务提供方面存在差距。

Suicide is the second leading cause of death among adolescents, and youth who are cyberbullied are twice as likely to exhibit suicidal thoughts and behaviors as those who are not cyberbullied. Cyberbullying (CB) is strongly associated with suicidal ideation, a phenomenon known to fluctuate rapidly, which suggests need to intervene proximally to instances of CB to reduce suicide risk. There is public health need to reduce suicide risk among cyberbullied adolescents, especially underserved adolescents (i.e., youth from minority backgrounds) who face higher rates of CB and suicidal thoughts and behavior. Yet, current interventions are limited in their capacity to meet the needs of underserved youth and to intervene in moments of high vulnerability. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to provide the applicant, a behavioral health scientist and clinical social worker, with the skills necessary to bridge the gap between CB intervention and suicide prevention with stakeholder-informed and empirically driven digital interventions for adolescents. To accomplish this long-term goal, a multidisciplinary training plan will provide the applicant with expertise in: (1) design, conduct, and analysis of online clinical trials; (2) theory, research, and methods of adolescent CB assessment and intervention; and (3) methods of enhancing underserved adolescents’ utilization of digital interventions using human centered design (HCD) and brief motivational interventions. The applicant will receive mentoring in a strong multidisciplinary environment with accomplished experts in the fields of adolescent suicide prevention, CB research, HCD, and online clinical trials. Formal training and coursework will advance training in clinical trial design and conduct (ethics and social media- based recruitment), and analysis (mediation and moderation analysis and evaluation of machine learning [ML] models for clinical trials), CB research, and methods for enhancing engagement (HCD and motivational interviewing). A complementary research plan will focus on development and testing of imHere4U, a just-in- time, suicide prevention intervention for cyberbullied adolescents. Based on pilot data suggesting acceptability of imHere4U among cyberbullied youth, parents, and professionals, we propose three aims. Aim 1: Cyberbullied adolescents (N=20; >35% underserved) will participate in iterative design to optimize a digital product for their needs. Aim 2: Recently cyberbullied adolescents (N=80; >35% underserved) will participate in an online RCT testing imHere4U plus Questionnaires of online interactions vs. Questionnaires alone. Aim 3: We will examine the feasibility of using a ML algorithm to deliver feedback to adolescents on their supportive and bullying online interactions. This trial will test the feasibility and preliminary efficacy of imHere4U, essential data for a subsequent R01 application to test imHere4U’s efficacy within a larger sample and dissemination outcomes. Results from this investigation are expected to lead to an efficacious intervention that fills a critical gap in service delivery by intervening when and where CB occurs to prevent adolescent suicide risk.