Refinement and Testing of Implementation Strategies to Promote Psychotherapy Attendance for Depression among Latinx Teens

改进和测试实施策略以促进拉丁裔青少年接受抑郁症心理治疗

• 批准号: 10665546
• 负责人: Allison McCord Stafford
• 金额: $ 15.35万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-14 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665546
• 关键词: Address; Adolescent; Adoption; Antidepressive Agents; Award; Behavior; Belief; Caregivers; Caring; Clinical; Clinical Trials; Clinical Trials Design; Cognitive Therapy; Communities; Data; Depressive disorder; Development; Diagnosis; Disparity; Drops; Educational workshop; Electronic Health Record; Evidence based intervention; Evidence based treatment; Face; Family; Feedback; Female; Focus Groups; Foundations; Fright; Gender; Goals; Growth; Health; Health Personnel; Health Professional; High Prevalence; Hispanic; Immigrant; Immigrant family; Interview; Judgment; Latina; Latino; Latinx; Latinx population; Linguistics; Major Depressive Disorder; Male Adolescents; Measurement; Mental Depression; Mental Health; Mental Health Services; Mental health promotion; Methods; Modeling; North Carolina; Outcome; Parents; Patient Self-Report; Patients; Perception; Pharmaceutical Preparations; Psychotherapy; Qualitative Research; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Sampling; Schedule; Series; Services; Surveys; Teenagers; Testing; Thinking; Time; Training; Treatment Efficacy; Visit; Youth; arm; behavioral health; care seeking; career; child depression; depressive symptoms; design; ethnic minority population; evidence base; experience; follow-up; health disparity; health equity; implementation evaluation; implementation outcomes; implementation process; implementation science; implementation strategy; improved; innovation; interpersonal therapy; male; patient oriented; peer; peer support; pilot trial; preference; premature; prevent; primary care clinic; programs; recruit; substance use; suicidal; treatment as usual; treatment trial

PROJECT SUMMARY/ABSTRACT Despite experiencing a higher prevalence of depressive symptoms, Latinx adolescents are significantly less likely to receive treatment for Major Depressive Disorder (MDD) and are more likely to drop out of psychotherapy prematurely than their non-Latinx White peers. Research is needed to develop patient- and family-focused implementation strategies to promote Latinx adolescents' initiation of and retention in psychotherapy for depression. The candidate aims to identify, refine, and test a patient- and family-focused implementation strategy to target barriers to psychotherapy attendance among Latinx youth. In Aim 1, a national sample of Latino adolescents (n=15), parents (n=15), and healthcare providers (n=5) will participate in focus groups to identify preferred strategies to promote psychotherapy attendance. In Aim 2, a series of design thinking workshops will be carried out with a community advisory board (N=8) to refine and develop the content of the implementation strategy. Qualitative descriptive methods and rapid content analysis will be employed in aims 1 and 2. In Aim 3, the candidate will conduct a clinical trial to determine the preliminary effect of the patient- and family-focused implementation strategy on psychotherapy attendance and depressive symptoms among Latinx adolescents (N=60) and identify facilitators, barriers, and early implementation outcomes (acceptability, adoption, feasibility, and fidelity) related to the implementation of the strategy and psychotherapy among Latinx adolescents. Latinx adolescents diagnosed with MDD or Persistent Depressive Disorder and referred to psychotherapy will be recruited from primary care clinics in North Carolina and randomly assigned to the implementation strategy or treatment as usual group (n=30 each). Measurements will be taken at baseline, 12 weeks, and 24 weeks. Wilcoxon Two-Sample Tests will be used to compare group differences in the percent of scheduled psychotherapy visits attended at 24 weeks. Wilcoxon Signed Rank Tests will be used to determine change in the depressive symptoms from baseline to week 12, and baseline to week 24. Qualitative interviews with Latinx adolescents, parents, and healthcare providers will be conducted to complete a multi-method evaluation of implementation process outcomes. The results of the study will lay a foundation for a full-scale R01 randomized controlled trial. The identified patient- and family-focused implementation strategy might also serve as a model for addressing behavioral health disparities among other groups of ethnic minority and immigrant youth. During this award, the candidate will also obtain critical training in implementation science, adaptation of programs for Latinx families, adolescent depression treatment, and clinical trial design. The proposed award will support the candidate's long-term goal of promoting mental health equity among Latinx adolescents and her transition into an independent, health disparities researcher.

项目摘要/摘要 尽管经历了更高的抑郁症状患病率，Latinx青少年明显更少 可能接受严重抑郁障碍(MDD)治疗的人，更有可能退出 心理治疗比他们的非拉丁裔白人同龄人过早。需要研究来发展患者-和 以家庭为重点的实施战略，以促进拉美裔青少年开始和保持 抑郁症的心理治疗。候选人的目标是识别、提炼和测试以患者和家庭为中心的患者 针对拉丁裔青年参加心理治疗的障碍的实施战略。在目标1中，一个 全国抽样的拉丁裔青少年(n=15)、父母(n=15)和保健提供者(n=5)将参加 焦点小组，以确定促进心理治疗出勤率的首选策略。在《目标2》中，一系列设计 将与社区咨询委员会(N=8)一起开展思考研讨会，以完善和发展内容 实施战略的一部分。将采用定性描述方法和快速内容分析 目标1和目标2。在目标3中，候选人将进行临床试验，以确定 以患者和家庭为中心的心理治疗就诊和抑郁症状实施策略 在拉丁裔青少年(N=60)中开展，并确定促进者、障碍和早期实施结果 (可接受性、采纳性、可行性和忠诚度)与战略和心理治疗的实施有关 在拉丁裔青少年中。被诊断为MDD或持续性抑郁障碍的拉丁裔青少年 将从北卡罗来纳州的初级保健诊所招募心理治疗人员，并随机分配 实施策略或常规治疗组(n=30)。测量时间为 基线、12周和24周。将使用Wilcoxon双样本检验来比较以下方面的组差异 在24周时参加心理治疗的预定就诊比例。将使用Wilcoxon签名的等级测试 以确定从基线到第12周，以及从基线到第24周抑郁症状的变化。 将对拉美裔青少年、父母和医疗保健提供者进行定性访谈，以完成 对实施过程成果进行多方法评价。研究结果将为以后的研究奠定基础 进行全面的R01随机对照试验。已确定的以患者和家庭为中心的实施 战略也可以作为解决其他种族群体之间行为健康差异的模式 少数民族和移民青年。在此奖项期间，候选人还将在以下方面获得关键培训 实施科学，拉丁裔家庭方案的改编，青少年抑郁症的治疗，以及 临床试验设计。拟议的奖励将支持候选人促进心理健康的长期目标 拉丁裔青少年的平等以及她转变为一名独立的健康差距研究人员。