Reducing Risk: A Comprehensive mHealth Sleep Health Intervention for Adolescents at Risk for Depression and Anxiety Disorders

降低风险：针对有抑郁症和焦虑症风险的青少年的综合移动健康睡眠健康干预措施

• 批准号: 10248499
• 负责人: Lauren Asarnow
• 金额: $ 16.62万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-22 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10248499
• 关键词: Adolescence; Adolescent; Adult; Affect; Aftercare; Anxiety; Anxiety Disorders; Area; Behavioral; Biological; Biological Markers; Biology; Car Phone; Chronic; Clinical; Complex; Computers; Coping Skills; Data; Development; Diagnosis; Disease; Dose; Evidence based intervention; Experimental Designs; Goals; Health Personnel; Health Services Accessibility; Healthcare; Hydrocortisone; Improve Access; International; Internet; Intervention; K-Series Research Career Programs; Lead; Measurement; Measures; Mediating; Mental Depression; Mental Health; Mental disorders; Mentors; Morbidity - disease rate; Outcome; Parents; Participant; Patient Self-Report; Pharmaceutical Preparations; Pittsburgh Sleep Quality Index; Prevalence; Prevention; Prevention strategy; Primary Health Care; Provider; Psychopathology; Public Health; Randomized; Recovery; Regulation; Research; Risk; Risk Factors; Risk Marker; Sampling; Science; Scientist; Severities; Sleep; Sleep Disorders; Sleeplessness; Statistical Methods; Stress; Symptoms; Technology; Testing; Training; Visit; Work; Youth; actigraphy; alertness; anxiety symptoms; barrier to care; behavioral health; career; circadian; community setting; critical period; depressive symptoms; design; diaries; effective intervention; effectiveness implementation study; effectiveness implementation trial; evidence base; experience; follow-up; handheld mobile device; high risk; improved; innovation; insight; longitudinal analysis; longitudinal dataset; mHealth; modifiable risk; mortality; novel; online intervention; patient oriented; poor sleep; prevent; primary care services; primary outcome; psychologic; response; sleep health; stress reactivity; vigilance

Project Summary This application for a Mentored Patient-Oriented Career Development Award (K23) aims to support additional training and research that will enable the candidate to achieve her career goal of becoming an independent clinical scientist conducting research aimed at preventing mental illness among adolescents. Adolescence is a critical period characterized by dramatic increases in rates of depression and anxiety disorders, hereafter referred to as internalizing disorders (IDs). Problems with sleep health are ubiquitous and modifiable targets that precede and predict the development of IDs. This project uses an experimental design to (a) improve sleep health (through a sleep focused treatment), (b) determine whether a sleep focused treatment improves ID symptoms, and a known biological marker of risk for IDs, cortisol reactivity and recovery in response to a stress exposure, and (c) elucidate target mechanisms underlying the effect of poor sleep health on ID symptoms, and cortisol measures. The present study will test an innovative adaptation of Transdiagnostic Sleep and Circadian Intervention (TranS-C), a sleep health treatment that improves sleep and mental health and effectively treats the most common sleep health deficits among adolescents, each of which was previously shown to be independently associated with increased risk for IDs. To overcome the challenge of low availability of qualified providers as a barrier to treatment access, we adapted TranS-C for mobile device delivery (referred to as mTranS-C), thereby leveraging the high rates of mobile phone use among adolescents. To further increase access, we will test mTranS-C within primary care services, a proven strategy for improving access to behavioral health care. The application builds on the candidates’ prior work in transdiagnostic mechanisms of mental illness, identifying targets for intervention and the prevention of IDs, and evidence based interventions for sleep problems. The proposed training plan emphasizes the following training areas for the candidate: (1) develop expertise in mHealth technology/science, (2) the biology and objective measurement of cortisol, and (3) statistical methods for analyzing longitudinal data sets. An inter-disciplinary team of mentors and consultants consisting of international leaders in the areas of sleep interventions, mHealth technology/science, developmental psychopathology, cortisol measurement, and statistical methods, collectively will provide the expertise to help the candidate meet her training objectives.

项目概要 本申请以患者为导向的职业发展奖 (K23) 旨在支持更多 培训和研究将使候选人能够实现成为独立的职业目标 临床科学家进行旨在预防青少年精神疾病的研究。青春期是一个 以抑郁症和焦虑症发病率急剧上升为特征的关键时期 称为内化障碍（ID）。睡眠健康问题是普遍存在且可改变的目标 早于并预测 ID 的发展。该项目采用实验设计来 (a) 改进 睡眠健康（通过睡眠重点治疗），(b) 确定睡眠重点治疗是否有所改善 ID 症状，以及 ID 风险的已知生物标志物、皮质醇反应性和对 ID 的反应的恢复 压力暴露，以及 (c) 阐明睡眠健康状况不佳对智力障碍影响的目标机制 症状和皮质醇测量。本研究将测试跨诊断的创新适应 睡眠和昼夜节律干预 (TranS-C)，一种改善睡眠和心理健康的睡眠健康治疗 并有效治疗青少年中最常见的睡眠健康缺陷，其中每一个缺陷都曾被 研究显示与 ID 风险增加独立相关。克服低可用性的挑战 作为获得治疗的障碍，我们采用了 TranS-C 来进行移动设备交付（称为 为 mTranS-C），从而利用青少年中手机的高使用率。为了进一步 增加可及性，我们将在初级保健服务中测试 mTranS-C，这是一种行之有效的改善可及性的策略 行为健康护理。该应用程序建立在候选人之前在跨诊断机制方面的工作基础上 精神疾病、确定干预目标和预防智力障碍以及基于证据的干预措施 对于睡眠问题。拟议的培训计划强调候选人的以下培训领域：（1） 发展移动医疗技术/科学方面的专业知识，(2) 皮质醇的生物学和客观测量，以及 (3)分析纵向数据集的统计方法。由导师和跨学科团队组成 由睡眠干预、移动医疗技术/科学领域的国际领导者组成的顾问， 发展精神病理学、皮质醇测量和统计方法将共同提供 帮助候选人实现培训目标的专业知识。