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

项目摘要 这个职业发展奖将确立候选人，凯瑟琳阿林豪斯博士，作为一个独立的 具有开发、实施和评估基于社区的， 从战略上设计干预措施，以解决身心健康之间的相互联系 优化降低得不到充分服务的青年患心血管疾病的风险。 心血管疾病是全世界死亡的主要原因。大多数儿科预防计划的重点是 关键的可改变的身体健康行为，如身体活动，饮食，最近睡眠。虽然重要 预防的组成部分，身体健康的重点可能会忽视心理健康的重要性， 健康作为心血管疾病发展的预防因素。干预的省略 明确旨在预防抑郁症，最近的发病率大幅增加突出了这一点。 青年抑郁症的症状为了减少患上心血管疾病的高危青少年人数，我们需要 制定可获得和有吸引力的预防干预措施，协同解决青年心理和 身体健康的需要，并有现实的途径大规模传播。为了满足这一关键需求， 博士Arlinghaus设计了一个课后计划，使用导师模式，同时解决 青年的身心健康。虽然深受欢迎，但有关干预的挑战 在概念验证研究中遇到的问题需要进一步修改和扩充。Dr. Arlinghaus的K01 该项目将回到干预优化的设计阶段，并与现有和新的学校网站合作 加强和修订干预措施，以扩大其范围和影响。干预措施的初步测试 将在新校址进行，以确定进一步修订的需要，并协调研究 为未来的全面、真实世界的疗效试验做准备。具体来说，阿林豪斯博士将 使用信息定性方法，协同确定干预措施的增强和修订， 利益相关者，以改善干预的范围和影响（目标1），然后将进行为期两年的准， 实验交叉试点试验，以表征可行性，可接受性和对物理的初步影响 青少年和青年导师的活动和抑郁结果（目标2）。这些研究目的 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， 内容领域的知识之间的联系心理健康和身体活动，加速技能， 社区干预研究的设计和实施。她将得到一个 在每个领域都有专业知识的多学科导师团队。本提案涉及NHLBI 优先优化新型心血管疾病预防策略和实施研究， 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.