Using a Mentoring AfterSchool Program to Improve Adolescent Mental Health and Physical Activity: A Pilot Study

项目总结 这一职业发展奖将确立候选人凯瑟琳·阿林豪斯博士的独立身份。 具有开发、实施和评估以社区为基础的 旨在解决身心健康之间相互联系的战略性干预措施 优化减少缺乏服务的青年患心血管疾病的风险。 心血管疾病是世界范围内主要的死亡原因。大多数儿科预防项目都侧重于 关键的可改变的身体健康行为，如体育活动、饮食和最近的睡眠。虽然很重要 作为预防的组成部分，对身体健康的关注可能会忽视心理健康和 幸福感是心血管疾病发展的预防因素。干预的遗漏 最近，旨在预防抑郁症的比率大幅上升，突显了这一点 青少年抑郁症状。为了减少罹患心血管疾病的高危青年的数量，我们需要 创建可获得和有吸引力的预防干预措施，协同解决青少年心理和心理问题 身体健康需要并有现实的途径来大规模传播。为了满足这一迫切需求， 阿林豪斯博士设计了一个课外项目，利用导师模式同时解决 青年的身心健康。虽然受到欢迎，但有关干预的挑战触手可及 在概念验证研究中遇到的问题需要进一步修订和加强。阿林豪斯博士的K01 该项目将返回到干预优化的设计阶段，并与现有和新的学校场地合作 加强和修改干预措施，以扩大其覆盖范围和影响。干预措施的初步测试 将在新的学校场地进行，以确定进一步修订的需求并协调研究 为未来的全动力、真实世界的疗效试验做准备的方法学。具体来说，阿林豪斯博士将 使用信息量大的定性方法协作确定干预的增强和修订 利益攸关方改善干预范围和影响(目标1)，然后将进行为期两年的准 试验性交叉试点试验，以表征可行性、可接受性和初步影响物理 青少年和青年导师的活动和抑郁结果(目标2)。这些研究的目的是 将为Arlinghaus博士提供实践经验，以应用定性方法技能的教学培训， 内容领域了解心理健康和体力活动之间的联系，加速计技能， 社区干预研究的设计与实施。她将得到一个 在这些领域都有专业知识的多学科导师团队。该提案涉及NHLBI 优化心血管疾病预防新战略和实施研究的优先事项 确定以社区为基础的实施战略如何解决心血管疾病的不平等问题。

PROJECT SUMMARY This career development award will establish the candidate, Dr. Katherine Arlinghaus, as an independent investigator with expertise in the development, implementation, and evaluation of community-based, interventions that are strategically designed to address the interconnection between physical and mental health to optimize the reduction of risk for cardiovascular disease development among underserved youth. Cardiovascular disease is the leading cause of death worldwide. Most pediatric prevention programs focus on key modifiable physical health behaviors like physical activity, diet, and more recently sleep. While important components for prevention, the physical health focus can overlook the importance of mental health and wellbeing as a preventative factor for cardiovascular disease development. The omittance of intervention explicitly aimed at preventing depression has been highlighted by the recent substantial increases in rates of youth depression symptoms. To reduce the number of youth at high risk for developing CVD, we need to create accessible and appealing prevention interventions that synergistically address youth mental and physical health needs and have realistic pathways to large-scale dissemination. To address this critical need, Dr. Arlinghaus designed an afterschool program that uses a mentorship model to simultaneously address mental and physical health among youth. While well-liked, challenges regarding intervention reach encountered during the proof-of-concept study require further revision and augmentation. Dr. Arlinghaus’s K01 project will return to the design phase of intervention optimization and work with current and new school sites to augment and revise the intervention to increase its reach and impact. Preliminary testing of the intervention will be conducted at the new school sites to identify needs for further revisions and harmonize research methodologies to prepare for a future fully-powered, real-world efficacy trial. Specifically, Dr. Arlinghaus will use informative qualitative methods to collaboratively identify intervention augmentations and revision with stakeholders to improve intervention reach and impact (Aim 1), and will then conduct a two year quasi- experimental crossover pilot trial to characterize the feasibility, acceptability and preliminary impact on physical activity and depression outcomes among adolescents and young adult mentors (aim 2). These research aims will provide hands-on-experience for Dr. Arlinghaus to apply didactic training in qualitative methods skills, content area knowledge of the connection between mental health and physical activity, accelerometry skills, and community-based intervention study design and implementation. She will be supported by a multidisciplinary team of mentors with expertise in each of these areas. This proposal addresses NHLBI priorities to optimize novel cardiovascular disease prevention strategies and implementation research and identify how community-based implementation strategies can address cardiovascular disease inequities.