Digital Mental Health Service for Non-Treatment Seeking Young Adults

为不寻求治疗的年轻人提供数字心理健康服务

• 批准号: 10693183
• 负责人: DAVID CURTIS MOHR
• 金额: $ 13.85万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-04 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10693183
• 关键词: Address; Adherence; Adult; Affect; Anxiety; Anxiety Disorders; Attitude; Behavioral; Characteristics; Chronic; Complex; Coping Skills; Development; Dropout; Early treatment; Effectiveness; Feeling suicidal; Future; Goals; Health Services Accessibility; Human; Individual; Intervention; Investigational Therapies; Learning; Length; Life; Link; Machine Learning; Major Depressive Disorder; Measures; Mediating; Mental Depression; Mental Health; Mental Health Services; Methods; Modeling; Motivation; Outcome; Participant; Patient Recruitments; Persons; Pharmaceutical Preparations; Pharmacotherapy; Process; Psychiatric therapeutic procedure; Psychotherapy; Randomized; Randomized, Controlled Trials; Research; Risk Reduction; Self Management; Services; Severities; Symptoms; Telephone; Text Messaging; Time; United States; Voice; Waiting Lists; Work; adaptive intervention; advocacy organizations; age group; aged; anxiety symptoms; automated intervention; community setting; depressive symptoms; design; diagnostic criteria; digital mental health; digital technology; effectiveness evaluation; experience; feasibility trial; health literacy; human model; improved; interest; iterative design; online community; preference; preventive intervention; psychoeducation; psychoeducational; psychologic; psychological distress; psychological outcomes; psychological symptom; reduce symptoms; screening; secondary outcome; self reliance; skills; social stigma; symptom self management; text messaging intervention; therapy design; treatment duration; treatment trial; web app; web site; young adult

PROJECT SUMMARY Young adults aged 18-24 experience higher levels of mental health problems than any other adult age group. Over one quarter of all young adults living in the United States suffer from a mental health condition. Unfortunately, they are the adult age group who are least likely to seek or receive traditional face-to-face treatments such as in-person psychotherapy or pharmacotherapy. There is evidence that they are, however, interested in using digital mental health interventions (DMHIs), such as mobile and web-based apps, to support symptom self-management and skill building. While evidence suggests mental health apps can effectively reduce symptom severity, they require motivation from the user to open and use the app, which contributes to the high dropout rates. The primary method of addressing dropout has been the use of human coaching, which boosts engagement. SMS text messages arrive through the most commonly used app on the phone, and are therefore likely to be viewed. Initial work in text message interventions suggests good adherence, as effort is low, but effectiveness has been inconsistent. Messages can be perceived as off-target or impersonal, and it is difficult to convey more complex information. This project aims to address these problems by developing and piloting a personalized text messaging platform that uses machine learning to tailor SMS messages to an individual’s needs and preferences, and URL links to provide access to psychoeducational content to contextualize messages, when the length of that content exceeds the limitations of messages. This project will include a partnership with Mental Health America, the nation’s largest mental health advocacy organization. The primary goals of the project are to: (1) Develop an adaptive messaging service for young adults that personalizes messages and psychoeducational content to the needs and preferences of an individual, (2) Conduct a feasibility trial using a sequential multiple assignment randomized treatment (SMART) design, which will evalutate (a) the effectiveness of an adaptive, personalized messaging intervention in reducing engagement relative to a static version; and (b) whether human coaching results in greater symptom reduction and engagement, relative an unguided implementation. This project will, in the near term, allow us to determine the feasibility of this intervention, including whether our adaptive intervention affects treatment psychological and engagement targets, and reduces psychological distress. It will also provide preliminary information on the feasibility of a scalable model of targeted, low- intensity coaching for users who may require additional support above and beyond a fully automated intervention. This will prepare us for our longer-term goal of conducting a fully-powered randomized controlled trial of our adaptive intervention in an online community setting.

项目概要 18-24 岁的年轻人比其他任何年龄段的成年人更容易出现心理健康问题 团体。生活在美国的所有年轻人中有四分之一以上患有心理健康问题。 不幸的是，他们是最不可能寻求或接受传统面对面交流的成年人。 治疗，例如面对面的心理治疗或药物治疗。然而有证据表明，他们 有兴趣使用数字心理健康干预措施 (DMHI)（例如移动和基于网络的应用程序）来支持 症状自我管理和技能培养。虽然有证据表明心理健康应用程序可以有效地 减轻症状严重程度，它们需要用户打开和使用应用程序的动力，这有助于 高辍学率。解决辍学问题的主要方法是使用人工辅导，这 提高参与度。 SMS 文本消息通过手机上最常用的应用程序发送，因此很可能 被查看。短信干预的初步工作显示出良好的依从性，因为努力程度较低，但 效果一直不一致。消息可能会被视为偏离目标或缺乏个性化，这很难 来传达更复杂的信息。该项目旨在通过开发和试点解决这些问题 个性化短信平台，使用机器学习根据个人的需要定制短信 需求和偏好以及 URL 链接，以提供对心理教育内容的访问以进行情境化 当内容的长度超过消息的限制时。该项目将包括一个 与美国最大的心理健康倡导组织 Mental Health America 合作。 该项目的主要目标是： (1) 为年轻人开发自适应消息服务 根据个人的需求和偏好个性化信息和心理教育内容，(2) 使用序贯多重分配随机治疗 (SMART) 设计进行可行性试验， 将评估 (a) 适应性、个性化消息传递干预在减少 相对于静态版本的参与度； (b) 人工指导是否可以更大程度地减轻症状 和参与，相对于无指导的实施。 该项目将在短期内让我们确定这种干预的可行性，包括是否 我们的适应性干预会影响治疗心理和参与目标，并减少心理治疗 苦恼。它还将提供有关有针对性的、低风险的可扩展模型的可行性的初步信息。 为可能需要全自动之外的额外支持的用户提供强度指导 干涉。这将为我们的长期目标做好准备，即进行全功率随机控制 我们在在线社区环境中进行适应性干预的试验。