Implementing a Digital Adolescent Behavioral Health Screening, Literacy, and Low-Intensity Intervention for Common Adolescent Mental Health Problems in Kenya

摘要 低收入和中等收入国家（LMIC）的精神、神经和物质（MNS）负担障碍 是巨大的，但解决MNS负担的解决方案在全球青少年心理健康方面仍然有限 research.技术的迅速发展和广泛使用有可能通过以下方式解决MNS负担问题： 为服务转型提供新的解决方案;然而，电子卫生尚未得到系统的研究， 在中低收入国家开展预防性心理健康干预。这项建议分两阶段进行的R21/R33研究，旨在回应 LMIC中青少年MNS疾病的负担日益加重，迫切需要通过检测提供预防服务 移动健康干预措施的可用性、可行性（R21阶段）和有效性（R33阶段）， 筛选和赋予青年生活权力（mSELY），以促进肯尼亚青少年的心理健康。的 mSELY是一种预防性干预工具，供青少年和/或其照顾者作为自助工具使用。 支助方式。mSELY-A专为青少年设计，mSELY-P专为父母/护理人员设计。 mSELY整合了4个主要的精神健康服务功能：i）为青少年提供全面的筛查 社会情绪/心理健康和相关风险（在多个RDoC领域）; ii）优势和劣势 青少年的行为概况; iii）量身定制的心理健康素养和促进战略，以及iv） 量身定制的推荐资源。为了促进可访问性并扩大覆盖面，mSELY将嵌入 在已经为青少年提供服务的各种社区组织中。另外还有按 将采用任务转移的青年赋权方法，培养一个由“伙伴-社区”组成的团队， 卫生工作者（A-CHW）支持mSELY的实施。该项目是概念化的， 社会行动理论，mHealth/技术接受模型和实施成果框架。 具体目标是：（1）建立数字和公共卫生方法的研究和服务能力， 青少年心理健康促进;（2）采用以用户为中心的设计来测试和增强 mSELY-A和P（R21第1年），并测试mSELY-A单独给药、mSELY-P单独给药的可行性和疗效，以及 mSELY-A + P组合在青年服务社区组织中的应用;（3）测试mSELY-A + P优化版本的有效性 mSELY-A和P使用群集随机对照试验（cRCT）;以及4）传播和探索大数据 使用工具包数据的分析方法，以改善数字工具包决策支持功能和准确性 精神健康精准护理的重要性

ABSTRACT The burden mental, neurological, and substance (MNS) disorders in low-and middle-income countries (LMICs) is tremendous, but solutions for addressing the MNS burden remain limited in global adolescent mental health research. The rapid growth and widespread use of technology has the potential to address MNS burden by offering new solutions for transforming services; however, e-Health has not been systematically studied for preventive mental health intervention in LMICs. This proposed two-phase R21/R33 study seeks to respond to the growing burden of adolescent MNS disorders and urgent preventive service needs in LMIC by testing usability, feasibility (R21 phase) and effectiveness (R33 phase) of a mHealth intervention, mHealth Toolkit for Screening & Empowering Lives of Youth (mSELY), to promote adolescent mental health in Kenya. The mSELY is a preventive intervention tool to be used by adolescents and/or their caregivers as a self-help support modality. The mSELY-A is designed for adolescents and mSELY-P is designed for parents/caregivers. The mSELY integrates 4 key mental health service functions: i) comprehensive screening for adolescent social-emotional/mental health and relevant risks (in multiple RDoC domains); ii) a strength and weakness profile for an adolescent’s behaviors; iii) tailored mental health literacy and promotion strategies, and iv) tailored referral resources. To promote accessibility and to have broader reach, the mSELY will be embedded in diverse community based organizations (CBOs) that already provide services to adolescents. In addition, a youth empowerment approach of task-shifting will be applied to train a team of adolescent-peer-community- health workers (A-CHWs) to support the mSELY implementation. This project is conceptualized within the Social Action Theory, mHealth/Technology Acceptance Model, and Implementation Outcomes Framework. The specific aims are: (1) to build research and service capacity for digital and public health approaches of adolescent mental health promotion; (2) to employ a user-centered design to test and enhance usability of the mSELY-A and P (in R21 Year 1) and to test feasibility and efficacy of mSELY-A alone, mSELY-P alone, and combination of mSELY-A + P in youth-served CBOs; (3) to test the effectiveness of the optimized versions of mSELY-A and P using a cluster-randomized control trial (cRCT); and 4) to disseminate and explore big data analytic approaches using the Toolkit data to improve Digital-Toolkit decision support functions and accuracy of mental health precision care.