Leveraging Longitudinal Survey and EHR data to Dissect the Impact of COVID-19 related Stressors and Infections on Child Mental Health and Suicide Risks
利用纵向调查和 EHR 数据剖析 COVID-19 相关压力源和感染对儿童心理健康和自杀风险的影响
基本信息
- 批准号:10757554
- 负责人:
- 金额:$ 323.16万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-01 至 2026-08-31
- 项目状态:未结题
- 来源:
- 关键词:AcuteAddressAdolescentAdultAmericanAreaBlack raceBrainCOVID-19COVID-19 impactCOVID-19 pandemicCOVID-19 pandemic effectsCategoriesChildChild Mental HealthClinicalCommunitiesCommunity SurveysContainmentDataDecision MakingDiagnosisDimensionsDiseaseEconomicsElectronic Health RecordEthnic OriginExposure toFamilyFeeling suicidalFemaleFoodGoalsHealthHealth behaviorHispanicHousingIncomeInfectionInterventionJob lossKnowledgeLinkLong COVIDLongitudinal SurveysLongitudinal cohortMachine LearningMeasuresMediatingMediationMental HealthMental disordersMethodologyMethodsMinorityModelingNational Institute of Mental HealthOutcomePatternPhasePhenotypePoliciesPolicy MakingPopulationPopulations at RiskPsychiatryPublic HealthRaceRecoveryRelapseResearchResearch PriorityRiskSARS-CoV-2 exposureSARS-CoV-2 infectionSamplingSchoolsStrategic PlanningStructural RacismSuicide attemptSurveysTestingTimeTravelUnemploymentUpdateVaccinationVaccinesagedcausal modelcognitive developmentcohortcoronavirus diseasedata reductiondisparity reductioneconometricsepidemiological modelethnic minorityevidence baseflugirlshealth care availabilityhealth datahealth disparityhigh riskhigh risk populationimprove minority healthindexinginnovationlong term consequences of COVID-19longitudinal datasetmodifiable riskneighborhood disadvantagenovelpandemic diseasepandemic impactpopulation basedpre-pandemicpreventpsychosocialpublic health prioritiesracial minorityschool closuresegregationsexsocialsocial health determinantsstressorsuicidal behaviorsuicidal risktrend
项目摘要
The adverse impact of the COVID-19 pandemic on child mental health has become a public health priority.
Suicidal ideation and suicide attempts among children increased by 70-130% in 2020-2021 compared to the
pre-pandemic period. Pre-existing social determinants of health (SDoH) and changes in pandemic-related
SDoH have exacerbated child mental health disparities. However, the long-term impact of COVID, including
Long COVID, the broader secondary impact of the lingering pandemic, and pandemic policies on child mental
health, is largely unknown. It is urgent and time-sensitive to identify high-risk children and modifiable targets to
reduce COVID-related new/worsening mental health and suicidal ideation and suicide attempts that could have
major consequences for the transition to adulthood. This proposed project will identify urgent and modifiable
factors to alleviate the negative impact of COVID-19 on child mental health. Our specific objective is to
examine the long-term impact of pandemic-related SDoH and policies on child mental health and suicidal
ideation, and suicide attempts. Our central hypothesis is that children who were girls, racial/ethnic minorities,
with pre-existing mental illness, infected by SARS-CoV-2, and exposed to greater SDoH and containment
policies will have new and worsening mental health and suicidal ideation and suicide attempts in the long term.
These hypotheses have been formulated on the basis of our strong preliminary data from the proposed
population-level data from the Adolescent Brain Cognitive Development study (>11000 children) and electronic
health records in the National COVID Cohort Collaborative (>170000 children). Our recent JAMA Psychiatry
study strengthens the evidence that pandemic-related SDoH worsened child mental health disproportionately
among those who were females, Black, Hispanic children, and those living in deprived areas. This R01
application will extend our prior empirical and methodological expertise in the following specific aims: 1)
quantify new and worsening child mental health and suicidal ideation and suicide attempts, as well as their
trajectories across the COVID pandemic. 2) examine the direct and indirect (mediation/moderation) impact of
pandemic-related SDoH on child mental health and suicidal ideation and suicide attempts, and 3) determine
the effects of COVID-19 policies on child mental health and suicidal ideation and suicide attempts. The key
innovation is to apply novel causal models from epidemiology and economics to estimate the long-term impact
of COVID-19 infections, pandemic-related SDoH, and policies on mental health and suicidal ideation and
suicide attempts among children from two large-scale, nationwide, longitudinal datasets. We will reduce data
dimensionality and create novel SDoH and policy indexes to capture the time-varying exposures to changes in
SDoH. Our findings will meet urgent and critical public health needs to prevent the widening mental health
disparities worsened by the COVID-19 pandemic, by refocusing on SDoH and informing structural and
psychosocial interventions. Addressing minority mental health is closely aligned with the NIMH Strategic Plan.
COVID-19大流行对儿童心理健康的不利影响已成为公共卫生优先事项。
2020-2021年,儿童的自杀意念和自杀企图与2019年相比增加了70-130%。
大流行前的时期。先前存在的健康社会决定因素和与流行病有关的
SDoH加剧了儿童心理健康的差距。然而,COVID的长期影响,包括
长期的新冠疫情、挥之不去的大流行的更广泛的次要影响以及对儿童心理的大流行政策
健康,基本上是未知的。确定高危儿童和可修改的目标是紧迫和及时的,
减少与COVID相关的新的/恶化的心理健康和自杀意念和自杀企图,
对成年期的过渡有重大影响。该拟议项目将确定紧急和可修改的
减少COVID-19对儿童心理健康的负面影响。我们的具体目标是
研究与流行病相关的SDoH和政策对儿童心理健康和自杀的长期影响
意念和自杀企图我们的中心假设是,女孩,种族/民族少数,
患有精神疾病,感染了SARS-CoV-2,并暴露于更大的SDoH和遏制措施
长期而言,这些政策将产生新的和恶化的心理健康和自杀意念和自杀企图。
这些假设是根据我们从拟议的研究中获得的强有力的初步数据制定的。
青少年大脑认知发展研究的人群水平数据(>11000名儿童)和电子
国家COVID队列协作(>170000名儿童)中的健康记录。我们最近的JAMA精神病学
研究加强了与流行病相关的SDoH不成比例地恶化儿童心理健康的证据
其中包括女性、黑人、西班牙裔儿童以及生活在贫困地区的儿童。R01
应用程序将扩展我们以前的经验和方法的专业知识,在以下具体目标:1)
量化新的和恶化的儿童心理健康和自杀意念和自杀企图,以及他们的
新冠疫情的发展轨迹。2)检查直接和间接(调解/缓和)影响
流行病相关的SDoH对儿童心理健康和自杀意念和自杀企图的影响,以及3)确定
COVID-19政策对儿童心理健康、自杀意念和自杀企图的影响。关键
创新是应用流行病学和经济学的新因果模型来估计长期影响
COVID-19感染,流行病相关的SDoH,以及心理健康和自杀意念的政策,
来自两个大规模的全国性纵向数据集的儿童自杀企图。我们将减少数据
维度,并创建新的SDoH和政策指数,以捕捉随时间变化的风险,
SDOH。我们的研究结果将满足紧急和关键的公共卫生需求,以防止心理健康问题的扩大。
2019冠状病毒病大流行加剧了不平等,通过重新关注SDoH和告知结构和
心理社会干预。解决少数民族心理健康问题与NIMH战略计划密切相关。
项目成果
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