Mobile application for early detection and intervention to reduce psychological distress in informal family caregivers of community dwelling adults with chronic disorders in Thailand

用于早期检测和干预的移动应用程序，以减少泰国社区居民患有慢性疾病的非正式家庭护理人员的心理困扰

• 批准号: 10741239
• 负责人: Hongtu Chen
• 金额: $ 21.79万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10741239
• 关键词: Activities of Daily Living; Adult; Anxiety; Behavioral; Caregivers; Caring; Chronic Disease; Clinical; Communities; Computer software; Country; Development; Diagnosis; Distress; Early Diagnosis; Early Intervention; Effectiveness; Employment; Ensure; Evidence based intervention; Family Caregiver; Family member; Financial Hardship; Frequencies; Goals; Health; Health Technology; Income; Individual; Institutionalization; Intervention; Interview; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mobile Health Application; Outcome; Output; Participant; Patients; Persons; Phased Innovation Awards; Prevention; Privacy; Provider; Psychological Stress; Qualitative Research; Reporting; Research; Risk; Self Care; Self Efficacy; Technology; Testing; Thailand; Training; Western World; adverse outcome; burnout; care recipients; care seeking; caregiver interventions; caregiving; comparison control; coping mechanism; depressive symptoms; design; digital health; digital mental health; eHealth; effectiveness evaluation; evidence base; experience; experimental arm; fall risk; formative assessment; health care delivery; improved; innovation; literacy; low and middle-income countries; mHealth; mobile application; mobile computing; mortality; prevent; programs; psychological distress; randomized, clinical trials; routine care; social culture; social stigma; sociocultural determinant; stressor; success; usability

Project Summary In lower-and-middle income countries (LMICs) like Thailand, family members providing care for adults with chronic disorders experience similar levels of mental health risks to that of their counterparts in higher income countries but have significantly more limited access to mental health care. Despite comparable rates of mental health illness, family caregivers in LMICs have significantly more limited access to mental health care—due to a number of factors, including the limited number of providers trained in mental health care delivery, as well as sociocultural factors, such as stigma and privacy concerns, that may prevent those in need from seeking care, and/or result in significant delays in obtaining diagnosis and treatment. Lack of treatment for caregiver mental health can lead to other adverse consequences for both caregivers and patients, including caregiver burnout, patient abuse, losing employment and elevated financial strain. Despite an accumulating body of evidence of the promise of mobile technology-based innovations for the treatment and prevention of mental health disorders in LMICs, as well the promise for improving mental health outcomes for family caregivers, there is limited research on the development, refinement, and implementation of evidence-based digital health technology into the routine care of family caregivers. The goal of the 5-year project is to develop and test a culturally informed Caregiver Mental Health Mobile Application (hereafter referred to as CAMMA) program that will deliver an evidence-based intervention to reduce mental health problems in family caregivers of adults with chronic disorders in Thailand. The R21 project will allow us to systematically adapt evidence-based self-care intervention contents developed originally in the Western world, and to make it compatible with the sociocultural and technological context in Thailand through qualitative and formative research. The R33 will allow us to test the usability and effectiveness of the mobile technology-enabled intervention in reducing negative mental health outcomes in Thai family caregivers. Specific Aims of the R21 include: 1) Conducting qualitative research on family caregivers of persons with chronic disorders, focusing on their experience with mental health problems, caregiving practice, coping mechanisms, and socio-technological barriers to technology acceptance and use; 2) Develop a mobile application for the delivery of the CAMMA intervention; 3) Conduct a formative evaluation of the CAMMA Intervention Components to ensure acceptability and usability of individual intervention components . Specific aims for the R33 include: 1) Assessing usability of the CAMMA intervention (including all intervention components); 2) Conducting a randomized clinical trial (RCT) to evaluate effectiveness of the CAMMA intervention in reducing psychological distress (depression, anxiety, psychological stress). We hypothesize that participants who receive the CAMMA intervention will show significantly higher reduction in depressive symptoms, anxiety, and psychological stress, compared to controls.

项目摘要 在像泰国这样的中低收入国家（LMICs），家庭成员为患有糖尿病的成年人提供护理， 慢性疾病的精神健康风险水平与高收入人群相似 但获得精神卫生保健的机会要有限得多。尽管精神疾病的发病率 健康疾病，低收入国家的家庭照顾者获得精神卫生保健的机会明显更有限， 一些因素，包括接受过精神卫生保健服务培训的提供者数量有限，以及 社会文化因素，如耻辱感和隐私问题，可能会阻止有需要的人寻求护理， 和/或导致获得诊断和治疗的显著延迟。照顾者精神缺乏治疗 健康可能导致对护理人员和患者的其他不利后果，包括护理人员倦怠， 病人虐待、失业和经济紧张加剧。尽管越来越多的证据表明 基于移动的技术的创新在治疗和预防心理健康方面的前景 LMIC的疾病，以及改善家庭照顾者心理健康结果的承诺， 对发展、完善和实施循证数字健康的研究有限 技术融入家庭护理人员的日常护理。 这个为期5年的项目的目标是开发和测试一个文化上知情的照顾者心理健康移动的 应用程序（以下简称CAMMA）计划，将提供基于证据的干预， 减少泰国成年慢性疾病患者的家庭照顾者的心理健康问题。R21 该项目将使我们能够系统地调整最初开发的循证自我护理干预内容 并使其与泰国的社会文化和技术背景相兼容 通过定性和形成性研究。R33将允许我们测试 移动的技术支持的干预措施减少泰国家庭照顾者的负面心理健康结果。 R21的具体目标包括：1）对患有糖尿病的人的家庭照顾者进行定性研究。 慢性疾病，侧重于他们的心理健康问题，实践，应对经验 （2）制定一个移动的技术标准， 申请提供CAMMA干预; 3） 对非洲多学科综合评估方案进行初步评估 干预组件，确保单个干预组件的可接受性和可用性 . 具体 R33的目标包括：1）评估CAMMA干预（包括所有干预）的可用性 2）进行随机临床试验（RCT）以评估CAMMA的有效性 采取干预措施，减少心理困扰（抑郁、焦虑、心理压力）。我们假设 接受CAMMA干预的参与者将显示出更高的抑郁减少， 症状、焦虑和心理压力。