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，获得有效的小儿心理健康治疗是公共卫生的主要关注 小儿提供者的稀少导致等待时间长，金融伯恩和污名构成了重大障碍 治疗。数字心理健康有望记住我们在及时提供的许多慢性问题 对儿童的无障碍心理健康干预措施。考虑到这一点，我们创造了一个基于应用的心脏的Mightier 评价生物反馈电子游戏平台，旨在教授和促进情感调节技能的实践。 自2016年推出以来，Mightier已达到17,000个家庭，每月增长率约为 10％，每月保留90％。 Mightier背后的技术得到了三项显示的支持 临床效率，自商业启动以来，有75％的家庭报告的家庭 改进。但是，我们的核心使命仍在增加获得护理的机会，直接面向消费者 数字健康的分配也面临访问挑战。我们建议获得有效的数字精神 可以通过结识已经知道要寻求护理的家庭来增加健康干预措施：传统 医疗保健系统。我们已经与全国性的行为健康保险提供商合作，以试行 将强大与传统医疗诊所相结合。 拟议的研究将企业将强大的融合到两个行为健康诊所中 我们的付款人合作伙伴。为了模拟现实世界的整合，医疗保健提供者将负责参考 患有慢性情绪失调的儿童会员。一旦由他们的提供者确定，孩子将是 随机分为强大或对照组使用6个月。通过这项工作，我们将证明 通过减少长期医疗保健利用率对各种利益相关者的强大价值（AIM 1），确认 强大的使用结果减少了情绪失调，易怒和父母压力的症状（AIM 2）。 最终，这项工作将为大规模整合数字医疗保健等方向铺平道路 传统的医疗保健途径，同时提高了Mightier吸引有需要的儿童的能力。