Development of an empathetic chatbot to monitor perinatal mental health longitudinally

开发具有同理心的聊天机器人来纵向监测围产期心理健康

• 批准号: 10601903
• 负责人: Marianna Kerppola
• 金额: $ 43.11万
• 依托单位: BETTERHOPE LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-10 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10601903
• 关键词: Address; Adherence; Behavior; Child; Clinical; Continuity of Patient Care; Data; Detection; Development; Developmental Delay Disorders; Diagnosis; Discipline of obstetrics; Disclosure; Dropout; Empathy; Enrollment; Ensure; Evidence based treatment; Exercise; Fright; Funding; Goals; Health; Health Technology; Health system; Insurance Carriers; Intellectual Property; Intervention; Interview; Intuition; Judgment; Knowledge; Licensing; Low Birth Weight Infant; Marketing; Maternal Mortality; Measures; Mental Health; Mental disorders; Mobile Health Application; Modeling; Monitor; Mood Disorders; Mothers; Onset of illness; Outcome; Patients; Perinatal; Phase; Postpartum Period; Pregnancy; Pregnancy Complications; Pregnant Women; Premature Birth; Randomized, Controlled Trials; Research; Rights; Risk; Risk Assessment; Secure; Small Business Innovation Research Grant; Suicide; Surveys; Symptoms; Technology; Therapeutic Intervention; Time; United States Preventative Services Task Force; Update; Validation; Woman; adverse childhood events; application programming interface; arm; attentional control; behavioral health; chatbot; clinical practice; commercial application; cost; cost effectiveness; dashboard; design; diagnostic screening; digital; early pregnancy; effective therapy; experience; improved; innovation; maternal morbidity; maternal risk; mobile application; motherhood; perinatal mental health; postnatal; prenatal; programs; prototype; public health relevance; screening; social stigma; technological innovation; technology platform; treatment planning; usability

1 ABSTRACT 2 One in five pre- or postnatal women will develop a perinatal mood disorder (PMD). While temporary and 3 treatable, 50-65% of mothers with PMD symptoms never receive a diagnosis or treatment due to inadequate 4 screening practices. PMDs remain undetected because mothers do not trust clinicians due to fear of judgment, 5 stigma, or even loss of parental rights. Untreated PMDs increase risk for maternal mortality, maternal suicide, 6 preterm birth, low birth weight, and adverse childhood experiences. There is an urgent unmet need for 7 comprehensive, real-time perinatal mental health monitoring to connect women to effective treatment. To meet 8 this need, BetterHope LLC (dba Poisera) is developing a technology platform to systemically monitor, screen, 9 refer, and treat PMDs for women from early pregnancy through 36 months postpartum. The platform includes a 10 mobile health (mHealth) app, where a chatbot conversationally engages mothers in daily reflection exercises 11 about pregnancy, motherhood, and mental health. Each week, the chatbot prompts mothers to complete a 12 state-of-the-art, validated adaptive diagnostic screening for PMDs. When a woman screens positive for PMD 13 symptoms, the Poisera platform connects the woman to a Psychiatric Perinatal Access Program (PPAP), 14 where a behavioral health clinician (BHC) will assess risk, deliver a brief therapeutic intervention, and 15 coordinate long-term treatment. BHCs update her risk profile and treatment information in Poisera’s 16 dashboard, where the patient’s clinician can track treatment progress. PPAPs exist in 30 states. PPAPs are 17 proven to improve PMD symptoms and guarantee continuity of care. Using a chatbot to longitudinally monitor 18 and screen for PMDs is an innovative approach because chatbots promote honest disclosure and increase 19 adherence. Further, the Poisera platform transforms the current, inadequate clinical practice for PMD 20 screening and treatment to one where clinicians are confident their patients receive effective treatment at PMD 21 onset because the information is seamlessly integrated into their clinical workflow. The long-term goal of this 22 research is to eliminate adverse health consequences from PMDs. In this Phase I SBIR, we will demonstrate 23 the Poisera platform meets the needs of both pregnant women and clinicians. In Aim I, we will demonstrate 24 that pregnant women find the Poisera app and chatbot usable. In Aim 2, we will demonstrate obstetric 25 clinicians find the Poisera dashboard usable in their clinical workflows. In Aim 3, we will conduct a two-arm 26 feasibility randomized controlled trial (RCT) to measure screening adherence and determine dropout behavior. 27 These outcomes will inform the design of our Phase II RCT, where we aim to demonstrate the Poisera platform 28 cost-effectively improves PMD outcomes for women from pregnancy to 36 months postpartum. Demonstrating 29 effective outcomes on these measures will provide us with the validation needed to sell the Poisera platform to 30 health systems and health insurers, a $2.8 billion annual market size. 31

1篇摘要 2五分之一的产前或产后妇女会患上围产期情绪障碍（PMD）。虽然是暂时的， 3.可治疗的，50-65%患有PMD症状的母亲从未接受过诊断或治疗， 4筛选方法PMD仍然没有被发现，因为母亲们由于害怕判断而不信任临床医生， 5耻辱，甚至丧失父母的权利。未经治疗的PMD会增加孕产妇死亡、孕产妇自杀的风险， 6早产、低出生体重和不良童年经历。有一个迫切的未满足的需要， 7.全面、实时的围产期心理健康监测，将妇女与有效的治疗联系起来。满足 8这种需要，BetterHope LLC（dba Poisera）正在开发一种技术平台，以系统地监测，筛选， 9个参考，并治疗妇女从怀孕早期到产后36个月的PMD。该平台包括一个 10个移动的健康（mHealth）应用程序，其中聊天机器人与母亲进行日常反思练习 11关于怀孕，母性和心理健康。每周，聊天机器人都会提示妈妈们完成一个 12种最先进的、经验证的PMD自适应诊断筛查。当一个女人的PMD筛查呈阳性时 13个症状，Poisera平台将妇女与精神病学围产期访问计划（PPAP）联系起来， 14行为健康临床医生（BHC）将评估风险，提供简短的治疗干预， 15配合长期治疗。BHC在Poisera的报告中更新了她的风险状况和治疗信息 16仪表板，其中患者的临床医生可以跟踪治疗进度。PPAP在30个州存在。PPAP是 17证明可以改善PMD症状并保证护理的连续性。使用聊天机器人纵向监控 18和PMD的屏幕是一种创新的方法，因为聊天机器人促进诚实的披露， 19坚持此外，Poisera平台改变了PMD当前不充分的临床实践 20个筛查和治疗，其中一个临床医生相信他们的患者在PMD接受有效治疗 21发作，因为信息是无缝集成到他们的临床工作流程。长期目标是 22研究的目的是消除PMD对健康的不良影响。在第一阶段SBIR中，我们将演示 Poisera平台满足孕妇和临床医生的需求。在Aim I中，我们将演示 24孕妇发现Poisera应用程序和聊天机器人可用。在目标2中，我们将展示产科 25名临床医生发现Poisera仪表板可用于其临床工作流程。在目标3中，我们将进行双臂 26项可行性随机对照试验（RCT），用于测量筛选依从性并确定脱落行为。 27这些结果将为我们的II期随机对照试验的设计提供信息，我们的目标是展示Poisera平台 28具有成本效益地改善了妇女从怀孕到产后36个月的PMD结果。展示 这些措施的29个有效结果将为我们提供将Poisera平台销售给 30个健康系统和健康保险公司，每年28亿美元的市场规模。 31