Healthy Relationships on the Autism Spectrum: Feasibility and Target Engagement

自闭症谱系的健康关系：可行性和目标参与

• 批准号: 10574808
• 负责人: Emily F Rothman
• 金额: $ 25.95万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10574808
• 关键词: 18 year old; Adult; Advocate; Affect; Age; Behavior; Child; Clinical; Clinical Trials; Collaborations; Communities; Consent; Data; Dropout; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Enrollment; Ensure; Evidence based intervention; Exploration, Preparation, Implementation, and Sustainment; Eye; Feeling; Feeling hopeless; Feeling suicidal; Friends; Friendships; Goals; Grant; Health; Hybrids; Impairment; Intervention; K-18 conjugate; Life; Link; Loneliness; Manuals; Masks; Mediation; Mental Depression; Methods; Modeling; Motivation; National Institute of Mental Health; Outcome; Participant; Patients; Pediatric epidemiology; Persons; Preparation; Process; Program Appropriateness; Provider; Randomized; Randomized, Controlled Trials; Research; Sampling; Secondary to; Services; Sex Orientation; Social isolation; Strategic Planning; Teacher Professional Development; Testing; Thinking; Thinness; Time; Training; United States National Institutes of Health; Victimization; Vulnerable Populations; Work; active control; adult with autism spectrum disorder; autism spectrum disorder; autistic; behavioral health; bullying; community setting; contextual factors; cost; dating violence; design; epidemiologic data; evidence base; experience; feasibility testing; follow-up; implementation design; implementation/effectiveness; improved; innovation; meetings; novel; online delivery; patient engagement; peer; peer violence; pilot test; programs; psychiatric symptom; public health relevance; recruit; satisfaction; sex; sexual violence; skills; social; social anxiety; social skills; suicidal; teacher; teacher community; violence prevention; willingness

PROJECT SUMMARY/ABSTRACT Autistic people are vulnerable to traumatic social experiences such as relational bullying and sexual violence by peers. Social anxiety and unhappiness with the quality of peer relationships are impairing problems for many. There are too few social skills interventions for autistic adults that have been tested through randomized controlled trials (RCTs). This project will test mechanism engagement and feasibility of Healthy Relationships on the Autism Spectrum (HEARTS). The HEARTS intervention was developed through a NIMH K18 (2020- 2022) and feasibility tested with a sample of N=55 autistic adults ages 18-40 years old from across the US. HEARTS is a six-session class delivered in real time online. HEARTS is novel because it was developed through a community-based participatory process with autistic adults, the class sessions are co-delivered by one autistic and one non-autistic facilitator who work as a team, and the curriculum uses a neurodiversity- embracing stance instead of a deficit model approach. Specifically, HEARTS does not teach social skills such as small talk, making eye contact, practice at conversational turn-taking, or other skills that may contribute to autistic “masking” or camouflaging. Instead, HEARTS draws on evidence-based violence prevention programming and teaches autistic participants to recognize the differences between healthy and unhealthy relationships, how to meet people and start new friendships or romantic relationships, how to negotiate sexual consent, recognize boundaries, and end friendships or dating relationships when needed—while respecting, rather than seeking to minimize or eliminate, autistic differences. The goal of the proposed clinical trial is to demonstrate that the target mechanism can be engaged and to pilot all methods (e.g., randomization, facilitator training) in preparation for a fully powered trial to test HEARTS’ effectiveness. HEARTS is highly scalable in that it was intentionally created for online delivery. In the HEARTS K18 non-experimental feasibility test, participation was associated with positive changes in outcomes including social motivation. In the proposed RCT we will test HEARTS acceptability and participant engagement; fidelity of the facilitators to the original manual; and provider satisfaction with HEARTS (N=160). We will also test mechanism engagement. We hypothesize that HEARTS participants will demonstrate significant decreases in hostile automatic thoughts, decreased rejection sensitivity, and increased social motivation, relative to participating completing the active control condition (ACC). We will also test clinical impact. We hypothesize that participants who complete HEARTS will demonstrate statistically significant improvement in satisfaction with quality of peer relationships (clinical outcome), relative to ACC participants. We will recruit 160 research participants in partnership with the Asperger/Autism Network (AANE) organization, and benefit from a 5-person autistic Advisory Board. Consistent with stated priorities in the IACC Strategic Plan for autism research, the proposed research constitutes a new and innovative approach to promoting wellness and health for autistic adults.

项目摘要/摘要 自闭症患者容易受到创伤的社会经历，例如关系欺凌和性暴力 由同龄人。社交动画和对同伴关系质量的不满是损害问题的问题 许多。通过随机测试的加速成年人的社交技能干预措施很少 对照试验（RCT）。该项目将测试健康关系的机制参与度和可行性 在自闭症谱系（心）上。心脏干预是通过NIMH K18（2020-- 2022年）和可行性，用n = 55岁的成年人从美国各地测试了18-40岁的成年人。 Hearts是一门六节课，可实时在线交付。心是新颖的，因为它是开发的 通过与成年人加速的社区参与过程，班级会议由 一个令人印象深刻的非自主促进者，他是一个团队，课程使用神经多样性 - 拥抱立场，而不是赤字模型方法。具体而言，心脏不教社交技能 作为闲聊，进行眼神交流，在对话转折中练习或其他可能有助于 自闭症“掩盖”或伪装。相反，心脏借鉴了循证暴力预防 编程并教会加速参与者认识到健康和不健康之间的差异 人际关系，如何结识人并建立新朋友或浪漫关系，如何谈判性 同意，认识界限，结束朋友或在需要时约会关系，而尊重 而不是试图最大程度地减少或消除加速差异。拟议的临床试验的目的是 证明目标机制可以参与并试行所有方法（例如随机化，促进器 训练）准备进行全功率试验以测试心脏的有效性。心脏高度可扩展 它是故意创建用于在线交货的。在心脏K18非实验性可行性测试中， 参与与包括社会动机在内的结果的积极变化有关。在提议中 RCT我们将测试心脏的可接受性和参与度；促进者对原始的忠诚 手动的;提供者对心脏的满意度（n = 160）。我们还将测试机制参与。我们 假设心脏参与者将表现出敌对自动思想的大幅下降， 相对于参加活跃的参与，降低了拒绝敏感性，并增加了社会动机 控制条件（ACC）。我们还将测试临床影响。我们假设完成的参与者 心脏将在对同伴关系的质量方面表现出统计学上的显着改善 （临床结果），相对于ACC参与者。我们将与160名研究参与者合作 Asperger/Autism网络（AANE）组织，并受益于5人的自闭症顾问委员会。 与IACC自闭症研究战略计划中既定的优先事项一致，拟议的研究 构成了一种促进加速成年人的健康和健康的新的创新方法。