Harnessing Network Science to Personalize Scalable Interventions for Adolescent Depression

利用网络科学对青少年抑郁症进行个性化的可扩展干预措施

基本信息

批准号：
10786569
负责人：
Jessica Lee Schleider
金额：
$ 28.36万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-14 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10786569
关键词：
Adolescent Age Asian Americans Belief Benefits and Risks Black American Caregivers Caring Child Clinical Clinical Trials Consent Data Development Ethics Exclusion Family Feeling suicidal Funding Gatekeeping Gender Goals Health Services Accessibility Healthcare Hispanic Americans Improve Access Institutional Review Boards Intervention Interview Knowledge Laws Link Mental Depression Mental Health Mental Health Services Mental Tests Methods Native Americans Parental Consent Parents Persons Pharmaceutical Preparations Policies Population Positioning Attribute Procedures Process Public Health Race Research Research Personnel Research Support Running Safety Sampling Science Secure Severities Sex Orientation Sexual and Gender Minorities Shapes Socioeconomic Status Surveys Symptoms Teenagers Therapy trial United States National Institutes of Health Universities Work Youth aged child depression depressive symptoms ethnic minority evidence base experience gender minority insight parent grant physical conditioning prevent racial minority recruit research study response safety testing self help sexual minority social media treatment research waiver

项目摘要

Project Summary/Abstract Up to 80% of U.S. adolescents with depression will never access treatment. An often-overlooked contributor to this discrepancy is teens’ inability to access care independently. Historically, teens’ access to mental health treatment and research has required parental consent, yet many teens cite parents as a barrier to accessing mental health support. Positioning parents as gatekeepers to treatment may prevent all but the most privileged teens from accessing depression-related support. To date, some (but not all) U.S. states have enacted laws allowing youth aged ≥12 to consent, without a parent, to mental health care, and emerging research supports the safety and utility of these policies. For instance, across multiple NIH-funded trials, my research team has secured waivers of parent consent from our University IRB, allowing us to run trials of online single-session interventions (SSIs) in which teens with depression can self-refer into our studies (DP5OD028123-S1). Our results show that teens can safely engage in online SSIs, and that SSIs can reduce depression severity up to 3 months later. Waiving parental consent requirements also seemed to boost our sample’s diversity, allowing us to recruit population-congruent proportions of Black, Hispanic, Asian, and Native American adolescents in a recent nationwide trial (N=2,452). Most youth therapy trials include samples that are >90% white. Thus, national policies allowing teens to self-refer into certain kinds of mental health support may improve access to care for diverse adolescents. Despite this possibility, there are no formal policies for researchers, clinicians, or families for facilitating adolescents’ self-referral into mental health research or treatment. Characterizing teens’ perspectives is a necessary step toward creating youth-centered policies to guide circumstances under which teens should (and should not) be able to self-refer into mental health interventions and research. Therefore, the goal of this supplement project is to characterize adolescents’ views on teens’ self-referral into mental health research and treatment, integrating survey-based and interview data from adolescents with depression (N=30 from the Parent Grant sample, whose parents were involved in study consent, and N=15 drawn a social media-recruited sample, whose parents will not be involved in study consent). Specific aims are (1) to characterize what adolescents view as the benefits and risks of teens accessing mental health support without parent knowledge/consent; (2) to gauge whether adolescents’ views on this topic differ for supports that are offered in-person versus online; supports that do versus do not involve a therapist (i.e., self-help); and whether teens perceive their identities and symptoms as shaping their views on parental knowledge/consent in teen mental health research and treatment; and (3) to compare responses to (1) and (2) across teens whose parents were and were not involved in study consent procedures. This study will yield necessary insights toward policies on adolescents’ independent participation in mental health treatment and research, with sweeping implications for teens’ access to mental health care.

项目摘要/摘要多达80％的美国青少年患有抑郁症的青少年将永远无法接受治疗。经常被忽视的贡献者这种差异是青少年无法独立访问护理。从历史上看，青少年可以进入心理健康治疗和研究需要父母的同意，但是许多青少年将父母作为进入的障碍心理健康支持。将父母定位为看门人进行治疗可能会阻止除最特权以外的所有人青少年获得与抑郁症相关的支持。迄今为止，一些（但不是全部）美国已制定了法律允许≥12岁的青年在没有父母的情况下同意精神卫生保健，而新兴的研究支持这些政策的安全性和效用。例如，在多次NIH资助的试验中，我的研究团队拥有我们大学IRB获得了父母同意的有保障护理者，使我们能够对在线单会进行试用抑郁症的青少年可以自我引用我们的研究（DP5OD028123-S1）的干预措施（SSI）。我们的结果表明，青少年可以安全参与在线SSI，而SSI可以将抑郁症的严重程度降低到3个几个月后。放弃父母同意要求似乎也提高了我们样本的多样性，使我们允许我们招募黑人，西班牙裔，亚洲和美国原住民青少年的人口一致比例最近的全国试验（n = 2,452）。大多数青年疗法试验包括白色> 90％的样品。那，国家政策允许青少年自我参考某些类型的心理健康支持可能会改善获得的机会照顾潜水员的青少年。尽管有可能，研究人员，临床医生或促进青少年自我推荐进入心理健康研究或治疗的家庭。描述青少年观点是制定以青年为中心的政策来指导情况的必要步骤青少年应该（也不应该）能够自我参考心理健康干预和研究。所以，这个补充项目的目的是将青少年对青少年自我推荐的观点描述为精神上的观点健康研究和治疗，整合抑郁症青少年的基于调查和访谈的数据（n = 30来自父母的赠款样本，父母参与学习同意，n = 15绘制社交媒体招募的样本，其父母将不参与学习同意。具体目标是（1）表征青少年视为青少年获得心理健康支持的好处和风险的特征家长知识/同意；（2）衡量青少年对此主题的看法是否对支持提供面对面与在线提供；与DO的支持不涉及治疗师（即自助）；是否青少年认为自己的身份和符号塑造了他们对青少年父母知识/同意的看法心理健康研究和治疗；（3）比较青少年的回答（1）和（2）父母曾经并且没有参与研究同意程序。这项研究将产生必要的见解采取有关青少年独立参与心理健康治疗和研究的政策，并对青少年获得精神卫生保健的影响。