Transforming adolescent mental health through accessible, scalable, technology-supported small-group instruction

通过可获取、可扩展、技术支持的小组教学改变青少年心理健康

• 批准号: 10705076
• 负责人: Mark J Van Ryzin
• 金额: $ 69.43万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705076
• 关键词: Academic support; Achievement; Active Learning; Address; Adolescence; Adolescent; Anxiety; Award; COVID-19 pandemic; Cognitive Therapy; Computer software; Data; Depressed mood; Development; Disadvantaged; Discrimination; Disparity; Education; Emotional; Ensure; Equity; Ethnic Origin; Feeling; Feeling hopeless; Feeling suicidal; Female; Friendships; Fright; Geography; Healthcare; Heterogeneity; High School Student; Hispanic; Instruction; Latina Population; Link; Loneliness; Mental Depression; Mental Health; Meta-Analysis; Minority Groups; Minority Men; Monitor; Outcome; Performance; Population; Prevention approach; Prevention program; Prevention strategy; Primary Prevention; Problem behavior; Public Health; Race; Racial Equity; Recommendation; Reporting; Research; Risk; Risk Factors; Rural; Schools; Services; Social isolation; Stigmatization; Stress; Students; Suicide; Suicide attempt; Suicide prevention; Surveys; Symptoms; Teaching Method; Technology; Testing; Time; Training; Victimization; Youth; access disparities; anxious; black men; bullying; coronavirus pandemic; cost; cost effectiveness; depressive symptoms; design; dosage; ethnic disparity; experience; help-seeking behavior; high school; implementation fidelity; innovation; insight; interest; intervention effect; pandemic disease; peer; prevent; prevention service; programs; protective factors; racial disparity; randomized trial; risk minimization; scale up; substance use; suicidal; teacher; trend; universal prevention; uptake; validation studies; web based software; willingness

Abstract Internalizing symptoms (i.e., anxiety, depressive symptoms, suicidality) are alarmingly common among adolescents. In 2019, nearly 37% of high school students reported feeling anxious, sad, or hopeless, representing an increase from 2017 (i.e., 31%), and nearly 19% seriously considered suicide1, an increase from 2017 (17%). The coronavirus pandemic has exacerbated this problem, with research finding that social isolation resulting from the pandemic was linked to higher levels of stress, fear, loneliness, anxiety, depression, and suicide ideation among adolescents2-3. Importantly, ethnic/racial disparities have been documented in internalizing symptoms, with more negative outcomes for Latinas and Black males39-45. Current universal school-based approaches to prevention have reported uneven or limited effects, or no effects at all6-12. Questions have also been raised regarding cost and accessibility49-59. Despite the uneven track record of universal school-based (Tier 1) approaches, which has led some to recommend an emphasis on targeted (Tier 2) approaches48, they possess several advantages. First, given the demographic heterogeneity in risk factors, as well as disparate access to high-quality, culturally-sensitive health care23, schools remain attractive as they can ensure equitable access to primary prevention services. Second, universal programs avoid the difficulty of identifying adolescents at risk12, and third, they minimize the risk of stigmatizing adolescents who seek out or are referred to services20-22. In this project, submitted to the Transformative Research Award initiative (RFA- RM-21-017), we will use cooperative learning (CL) as a universal (Tier 1) school-based prevention program to target malleable peer-based risk factors and subsequently evaluate how change in these mechanisms can reduce adolescent internalizing symptoms. CL targets various forms of maladaptive peer relations that create stress and comprise a significant risk factor for internalizing symptoms in adolescence; CL also promotes peer protective factors that can reduce the likelihood of internalizing symptoms (e.g., peer acceptance)27-34. CL has also been found to promote more cross-race interaction and interracial attraction, greater cross-ethnic academic support, and more frequent cross-ethnic friendships95-97. To support teachers in implementing CL, we will use a Web-based software platform that provides an accessible, high-fidelity mechanism to deliver CL lessons. We will not only test for intervention effects, but will also evaluate the relative strength of specific, theoretically-derived change mechanisms, and uncover key issues/barriers related to implementation that will allow us to dynamically adjust our implementation approach to achieve maximum impact during subsequent scale-up. Our project is designed to establish feasibility with teachers and schools and counter potential threats to implementation fidelity while also creating a roadmap to enhanced scalability and sustained implementation. Significant results from this project could inspire broad uptake of our approach in educational contexts, potentially addressing a significant public health need during a time of crisis due to the COVID-19 pandemic.

摘要 内化症状（即，焦虑，抑郁症状，自杀）是惊人的普遍， 青少年。在2019年，近37%的高中生表示感到焦虑，悲伤或绝望， 比2017年有所增加（即，31%），近19%的人认真考虑过自杀1， 2017年（17%）。冠状病毒大流行加剧了这一问题，研究发现， 大流行导致的隔离与更高程度的压力、恐惧、孤独、焦虑、抑郁 和自杀意念2 -3。重要的是，种族/民族差异已记录在案， 内化症状，拉丁裔和黑人男性的负面结果更多39 -45。现行universal 据报告，以学校为基础的预防办法效果不均衡或有限，或根本没有效果6 -12。 还提出了关于费用和可获得性的问题49 -59。尽管有不平衡的记录， 普遍的以学校为基础的（第1层）方法，这导致一些人建议强调有针对性的（第1层）方法， 2)48、有几个优点。首先，鉴于风险因素的人口异质性， 以及不同的获得高质量，文化敏感的医疗保健23，学校仍然具有吸引力，因为它们 可以确保公平获得初级预防服务。其次，通用程序避免了 第三，他们最大限度地减少了青少年寻求或 参见服务20 -22。在这个项目中，提交给变革研究奖倡议（RFA- RM-21-017），我们将使用合作学习（CL）作为一个普遍的（第1层）校本预防计划， 针对可塑性同伴为基础的风险因素，并随后评估如何改变这些机制， 减少青少年内化症状。CL针对各种形式的适应不良的同伴关系， 压力和包括一个重要的风险因素内化症状在青春期; CL还促进同伴 可以降低内化症状可能性的保护性因素（例如，同侪接受）27-34. c1具有 也被发现可以促进更多的跨种族互动和种族间的吸引力， 学术支持，以及更频繁的跨种族友谊95 -97。为支援教师推行合作学习， 我们将使用一个基于网络的软件平台，提供一个可访问的、高保真的机制来提供CL lessons.我们不仅将测试干预效果，而且还将评估特定的， 从理论上推导出的变革机制，并揭示与实施有关的关键问题/障碍， 使我们能够动态调整我们的实施方法，以在随后的 按比例放大。我们的项目旨在与教师和学校建立可行性，并应对潜在的威胁 实现保真度，同时创建增强可扩展性和持续实现的路线图。 该项目的重大成果可以激励我们在教育背景下广泛采用我们的方法， 在2019冠状病毒病大流行的危机时期，这可能解决重大的公共卫生需求。