A Mightier healthcare system: Introducing a game-based pediatric mental health intervention into payor-sponsored care to evaluate financial and clinical outcomes

更强大的医疗保健系统：将基于游戏的儿科心理健康干预引入付款人赞助的护理中，以评估财务和临床结果

• 批准号: 10256051
• 负责人: Jason Kahn
• 金额: $ 73.32万
• 依托单位: NEUROMOTION, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10256051
• 关键词: Address; Adolescent; Age; Ambulatory Care; Back; Biofeedback; Boat; Boston; California; Caring; Child; Child health care; Childhood; Chronic; Clinic; Clinical; Clinical Data; Control Groups; Data; Diagnosis; Economic Burden; Face; Family; Financial Hardship; Growth; Health; Health Insurance; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Heart Rate; Home; Hospital Departments; Insurance Carriers; Intervention; Investments; Measures; Mediating; Mental Health; Mind; Mission; Modeling; National Institute of Mental Health; Outcome; Outpatients; Parents; Participant; Patients; Pediatric Hospitals; Phase; Physiological; Play; Population; Provider; Psychiatry; Public Health; Randomized; Reporting; Research; Signal Transduction; Small Business Innovation Research Grant; Stress; Symptoms; System; Technology; Texas; Time; United States; Video Games; Visit; Wait Time; Weight maintenance regimen; Work; applied behavior analysis; autistic children; barrier to care; base; behavioral health; care seeking; clinical efficacy; cost; design; digital health; digital healthcare; digital intervention; digital mental health; emotion dysregulation; emotion regulation; evidence base; executive function; follow-up; health care service utilization; health care settings; heart rate monitor; intervention cost; meetings; neural network; reduce symptoms; skills; social stigma; stem; traditional care; treatment as usual

PROJECT SUMMARY Access to effective pediatric mental health treatment is a major public health concern in the United States as paucity of pediatric providers leading to long wait times, financial burden, and stigma pose significant barriers to treatment. Digital mental health promises to remedy many chronic problems we face in providing timely and accessible mental health interventions to children. With that in mind, we created Mightier, an app-based heart rate biofeedback videogame platform designed to teach and facilitate practice of emotional regulation skills. Since launching in 2016, Mightier has reached 17,000 families, with a monthly growth rate of approximately 10%, and month to month retention of 90%. The technology behind Mightier is backed by three trials showing clinical efficacy and since commercial launch 75% of families who have engaged with the product report improvement. However, our core mission remains increasing access to care, and the direct-to-consumer distribution of digital health also faces access challenges. We propose that access to effective digital mental health interventions can be increased by meeting families where they already know to seek care: the traditional healthcare system. We have partnered with a nationwide behavioral health insurance provider to pilot the integration of Mightier with traditional healthcare clinics. The proposed research will pilot the integration of Mightier into the two behavioral health clinics identified by our payor partner. To simulate real-world integration, healthcare providers will be responsible for referring children with chronic emotional dysregulation to Mightier. Once identified by their providers, children will be randomized into Mightier or control groups for 6 months of use. Through this work we will demonstrate the value of Mightier to various stakeholders via decreased long-term healthcare utilization (aim 1), confirm that Mightier use results in decreased symptoms of emotional dysregulation, irritability, and parent stress (aim 2). Ultimately this work will pave the way forward for large scale integration of digital healthcare and more traditional healthcare avenues while simultaneously increasing Mightier’s ability to reach children in need.

项目摘要 在美国，获得有效的儿科心理健康治疗是一个主要的公共卫生问题， 儿科提供者的缺乏导致等待时间长、经济负担和耻辱感构成了重大障碍 接受治疗数字心理健康有望解决我们面临的许多慢性问题， 为儿童提供心理健康干预。考虑到这一点，我们创建了Mightier，一个基于应用程序的心脏 率生物反馈视频游戏平台，旨在教授和促进情绪调节技能的实践。 自2016年推出以来，Mightier已覆盖17，000个家庭，每月增长率约为 10%，月留存率90%。Mightier背后的技术得到了三项试验的支持， 临床疗效和自上市以来，75%的家庭参与了产品报告 改进.然而，我们的核心使命仍然是增加获得护理的机会， 数字健康的分布也面临着获取挑战。我们建议，获得有效的数字心理 可以通过与那些已经知道寻求护理的家庭会面来增加卫生干预措施： 医疗保健系统。我们与一家全国性的行为健康保险提供商合作， Mightier与传统医疗诊所的整合。 拟议中的研究将试点将Mightier整合到两个行为健康诊所， 我们的付款人合作伙伴。为了模拟真实世界的整合，医疗保健提供者将负责将 患有慢性情绪失调的儿童到Mightier。一旦他们的供应商确定，儿童将 随机分为Mightier组或对照组，使用6个月。通过这项工作，我们将证明 通过降低长期医疗保健利用率（目标1），Mightier对各利益相关者的价值，证实 更强的使用导致情绪失调，易怒和父母压力的症状减少（目的2）。 最终，这项工作将为数字医疗保健等的大规模整合铺平道路 传统的医疗保健途径，同时提高Mightier的能力，以达到有需要的儿童。