Digital Delivery of Evidence-Based Mental Health Content and Mentoring to Adolescents

以数字方式向青少年提供循证心理健康内容和指导

• 批准号: 10758731
• 负责人: Michael David Pullmann
• 金额: $ 55.84万
• 依托单位: APPA HEALTH INC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10758731
• 关键词: Accountability; Address; Adolescent; Adolescent and Young Adult; Advertising; Affect; Age Years; Anxiety; Behavioral; Caregivers; Caring; Cellular Phone; Clinical; Clinical effectiveness; Cognitive; Cognitive Therapy; Computers; Control Groups; Cost Analysis; Cost Effectiveness Analysis; Coupled; Data; Development; Drops; Early Intervention; Education; Educational process of instructing; Effectiveness; Elements; Employment; Ensure; Equity; Financial Hardship; Friends; Funding; Goals; Health; Health Personnel; Internet; Intervention; Knowledge; Learning; Light; Marketing; Meaning and purpose; Measurement; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methodology; Outcome; Participant; Personal Satisfaction; Persons; Phase; Pilot Projects; Prevention; Prevention strategy; Procedures; Quality of life; Randomized; Randomized, Controlled Trials; Reporting; Research; Resources; Risk; Sales; Sampling; Schools; Science; Services; Silicon; Small Business Innovation Research Grant; Structure; Supervision; Symptoms; Teenagers; Theory of Change; Therapeutic; TikTok; Training; Treatment Efficacy; United States; Universities; Use Effectiveness; Waiting Lists; Washington; Youth; aged; anxiety symptoms; arm; caregiver strain; child depression; commercialization; cost; cost effective; cost effectiveness; depressive symptoms; design; diadenosine pyrophosphate; digital; digital delivery; digital mental health; digital platform; digital tool; effectiveness research; effectiveness study; effectiveness trial; evidence base; experience; implementation strategy; improved; innovation; participant retention; peer coaching; peer support; physical conditioning; pilot test; pilot trial; premature; programs; psychoeducation; psychoeducational; psychosocial; randomized, clinical trials; recruit; self esteem; self help; severe mental illness; skills; social relationships; symptomatic improvement; tool; video delivery; young adult

PROJECT SUMMARY. This direct to Phase II SBIR proposal will study Appa Health, an adolescent-facing mental health smartphone and computer app. Appa combines (1) delivery of short-form digital evidence-based mental health content, emphasizing Cognitive Behavioral Therapy, via educational videos delivered by mental health experts who are internet influencers, with (2) trained and supervised near-peer mentors with relatable lived experiences who use supportive accountability to facilitate adolescents’ use of the evidence-based content. According to Appa’s theory of change, near-peer mentoring directly impacts adolescents’ mental health and well-being via relational and instrumental support, but also indirectly through the acquisition of evidence-based skills (e.g., cognitive restructuring, behavioral activation) taught via educational videos. We will examine the psychosocial mechanisms of the two primary elements of Appa, establish the effectiveness of Appa on adolescent depression and anxiety, other measures of functioning, and theoretical mechanisms, and examine the cost-effectiveness of the full Appa experience as well as a video-only condition that Appa is considering marketing. Aim 1 will collect initial data and improve study procedures via a small pilot study. Seventy-five adolescents aged 13-18 with elevated scores on measures of depression and/or anxiety will be randomly assigned to one of three conditions: (1) near-peer mentoring and digital tools (Full Appa), (2) digital content only (Appa Light), and (3) waitlist control. Results will be used to optimize methodology to achieve study goals with minimum burden and maximum retention. Aims 2 & 3 will examine Appa’s cost and effectiveness via a well-powered randomized clinical trial replicating the pilot trial using 400 adolescents. Variables will include clinical outcomes such as adolescent symptoms of depression, anxiety, and well-being, as well as treatment mechanisms and proximal outcomes. Because of the mental health workforce shortage, this study will have an impact on science by demonstrating the effectiveness of using laypersons (near-peer mentors) combined with expert digital content delivery and clinical supervision to support adolescents’ mental health. This study is innovative in the unique combination of near-peer mentoring with evidence-based content delivered via youth-targeted TikTok-style videos conducted by existing internet influencers. Questions on how to increase adolescent engagement with and use of evidence-based skills are important to intervention developers. The data from this study will directly impact Appa’s commercialization plan. Appa is scaling quickly, expanding from direct-to-consumer sales to partnerships with schools and self-funded employers, both of which are eager for documented clinical outcomes and identification of replicable mechanisms of change to ensure quality as Appa scales services. Cost-effectiveness analyses will drive development and design decisions (e.g., focusing resources on mentorship, content, or the mentorship-content integration), as well as commercialization decisions regarding target organizations and advertising.

项目摘要。这项直接进入第二阶段 SBIR 的提案将研究 Appa Health，这是一个面向青少年的项目 心理健康智能手机和计算机应用程序。 Appa 结合了 (1) 提供基于证据的简短数字 心理健康内容，通过心理中心提供的教育视频强调认知行为疗法 具有互联网影响力的健康专家，拥有 (2) 名经过培训和监督、具有相关性的近同伴导师 使用支持性问责制来促进青少年使用基于证据的经验 内容。根据阿帕的变革理论，近同伴指导直接影响青少年的心理 健康和福祉通过关系和工具支持，但也间接通过获得 通过教育视频教授基于证据的技能（例如认知重建、行为激活）。我们将 检查 Appa 两个主要要素的心理社会机制，确定 Appa 的有效性 应用程序关于青少年抑郁和焦虑、其他功能测量和理论机制，以及 检查完整 Appa 体验的成本效益以及 Appa 的纯视频条件 考虑营销。目标 1 将通过小型试点研究收集初始数据并改进研究程序。 75 名 13-18 岁的青少年在抑郁和/或焦虑测量中得分较高，将接受 随机分配到以下三个条件之一：(1) 近同伴指导和数字工具 (Full Appa)，(2) 数字化 仅内容 (Appa Light)，以及 (3) 候补名单控制。结果将用于优化方法以实现 以最小负担和最大程度保留的学习目标。目标 2 和 3 将检查 Appa 的成本和 通过一项强有力的随机临床试验来验证有效性，该试验使用 400 名青少年复制了试点试验。 变量将包括临床结果，例如青少年抑郁、焦虑和幸福感的症状， 以及治疗机制和近期结果。由于精神卫生劳动力短缺， 这项研究将通过展示使用非专业人士（近同行）的有效性来对科学产生影响 导师）与专家数字内容交付和临床监督相结合，以支持青少年的心理 健康。这项研究的创新之处在于将同伴指导与基于证据的独特结合起来 现有互联网影响者通过针对年轻人的 TikTok 风格视频提供内容。问题 关于如何增加青少年参与和使用基于证据的技能对于干预很重要 开发商。这项研究的数据将直接影响 Appa 的商业化计划。阿帕正在扩展 迅速从直接面向消费者的销售扩展到与学校和自筹资金的雇主的合作伙伴关系 其中渴望记录临床结果并确定可复制的改变机制 确保 Appa 扩展服务的质量。成本效益分析将推动开发和设计 决策（例如，将资源集中在指导、内容或指导与内容的整合上），以及 有关目标组织和广告的商业化决策。