Developing a Digital Intervention for Adolescent Nonsuicidal Self-injury

制定针对青少年非自杀性自残的数字干预措施

• 批准号: 10740718
• 负责人: Kaylee Payne Kruzan
• 金额: $ 17.62万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740718
• 关键词: 14 year old; 17 year old; Address; Adolescence; Adolescent; Advocacy; Affect; Anxiety; Assessment tool; Attenuated; Attitude; Award; Behavior; Behavioral; Cognitive; Collaborations; Conduct Clinical Trials; Data; Development; Disclosure; Dissemination and Implementation; Distress; Early Intervention; Emotional; Ensure; Ethnic Origin; Evidence based practice; Frequencies; Future; Gender; Goals; Hospitalization; Informal Social Control; Intervention; Interview; Leadership; Link; Mental Depression; Mental Health; Methodology; Methods; Modeling; Motivation; Participant; Pathway interactions; Persons; Population; Positioning Attribute; Prevalence; Process; Quality of life; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Activity; Research Personnel; Research Project Grants; Resources; Risk; Self Assessment; Severities; Stigmatization; Suicide; Suicide attempt; Testing; Time; Tissues; Training; adolescent health; advocacy organizations; barrier to care; behavior change; career; cost; demographics; design; digital; digital delivery; digital intervention; digital mental health; early onset; effectiveness-implementation RCT; effectiveness/implementation hybrid; effectiveness/implementation trial; efficacy testing; evidence base; experience; follow-up; health literacy; help-seeking behavior; high risk; high-risk adolescents; implementation design; implementation evaluation; improved; iterative design; literacy; meetings; non-suicidal self injury; pilot trial; preference; prevent; primary outcome; programs; psychiatric comorbidity; psychoeducation; psychoeducational; psychologic; recruit; secondary outcome; skills; skills training; social stigma; suicidal; suicidal morbidity; suicidal risk; therapy design; treatment effect; usability; user centered design; web site

PROJECT SUMMARY/ABSTRACT Nonsuicidal self-injury (NSSI) affects an estimated 17% of adolescents worldwide. Earlier onset in adolescence is linked to more severe trajectories of NSSI, suicide plans, and poorer quality of life. Though early intervention for NSSI is critical, most adolescents with NSSI do not seek professional help, and many do not self-disclose their behaviors to anyone in person, limiting access to support and preventing pathways to treatment. While several psychological interventions have been effective in reducing adolescent NSSI, structural barriers (e.g., time, cost), attitudinal barriers (e.g., stigma, mental health literacy), and the prevalence of non-disclosure constrain their accessibility and reach. Digital mental health interventions (DMHIs) present an opportunity to reach this high-risk and non-treatment-engaged population and increase their access to evidence-based psychological strategies. Indeed, adolescents report receptivity to digital interventions and engage in NSSI help-seeking online at high rates. However, to date there are no publicly available DMHIs designed to support this adolescent population. In collaboration with Mental Health America (MHA), the nation's largest mental health advocacy organization, the proposed K01 application will address this gap by designing and evaluating a DMHI attuned to the unique needs and preferences of adolescents (14-17 years) who engage in NSSI. This project will leverage a moment of online information-seeking through MHA's website, to deliver a low-intensity DMHI focused on acquisition and practice of evidence-based skills to improve self-regulation and deliver help-seeking information, to ultimately reduce NSSI frequency and encourage future treatment engagement. Partnering with MHA to deliver the DMHI provides a clear dissemination pathway and access to a diverse group of adolescents who are not in treatment. To design the DMHI, I will employ user-centered design activities, which involve key stakeholders in the research and design process to ensure adolescents' needs and preferences are reflected in the final DMHI. I will also engage MHA stakeholders in the development of a strategic implementation and dissemination plan through their website. I will then pilot a randomized controlled trial (RCT) of the DMHI with 80 adolescents (14-17 years of age) randomized on a 1:1 basis to receive the DMHI (n=40) or an active psychoeducational control (n=40) for the duration of 8 weeks. This K01 will be a critical first step in positioning me to achieve my career goal and become a leading independent researcher in digital mental health. My four training aims are designed to support this overarching goal by extending my expertise in: 1) UCD and summative methods including usability testing for DMHIs and support further development of expertise in 2) the conduct of clinical trials, 3) scalable implementation methodologies, and 4) treatment models for adolescent NSSI. Accomplishment of these training goals and the proposed research project will provide the skills necessary for the development of an R01 of a fully powered hybrid implementation-effectiveness trial testing the efficacy of the DMHI.

项目总结/摘要 非自杀性自伤（NSSI）影响着全球约17%的青少年。早期发作， 青春期与更严重的NSSI轨迹，自杀计划和更差的生活质量有关。虽然 对NSSI的早期干预至关重要，大多数患有NSSI的青少年不寻求专业帮助， 不亲自向任何人透露自己的行为，限制获得支持的机会，并阻止 治疗虽然一些心理干预措施在减少青少年NSSI方面有效， 结构性障碍（例如，时间、成本）、态度障碍（例如，耻辱，心理健康素养），以及患病率 不披露限制了其可获得性和可及性。数字心理健康干预（DMHIs）提供了一个 有机会接触到这些高风险和不接受治疗的人群，并增加他们获得 基于证据的心理学策略事实上，青少年对数字干预的接受程度， 参与NSSI帮助寻求在线高利率。然而，到目前为止，还没有公开的DMHI 旨在支持这些青少年人口。与美国精神卫生协会（MHA）合作， 作为美国最大的心理健康倡导组织，拟议的K 01应用程序将通过以下方式解决这一差距： 设计和评估适合青少年（14-17岁）独特需求和偏好的DMHI 参与NSSI的人。该项目将利用在线信息寻求通过MHA的时刻， 网站，提供低强度的DMHI，重点是获取和实践基于证据的技能， 改善自我规管和提供求助信息，以最终减少发生非社会服务意外的次数， 鼓励未来的治疗参与。与MHA合作提供DMHI提供了一个明确的 传播途径和接触未接受治疗的各种青少年群体的机会。设计 DMHI，我将采用以用户为中心的设计活动，其中涉及研究和设计的关键利益相关者 确保青少年的需求和偏好反映在最终的DMHI中。我也会让MHA 通过其网站向利益攸关方提供战略执行和传播计划的信息。我 然后将对80名青少年（14-17岁）进行DMHI的随机对照试验（RCT） 以1：1的比例随机接受DMHI（n=40）或积极的心理教育对照（n=40）， 持续8周。这个K 01将是我实现职业目标的关键的第一步， 成为数字心理健康领域领先的独立研究人员。我的四个培训目标旨在 通过扩展我在以下方面的专业知识来支持这一总体目标：1）UCD和总结性方法，包括可用性 测试DMHI，并支持进一步发展专业知识，2）临床试验的进行，3）可扩展 实施方法，和4）青少年NSSI的治疗模式。完成这些 培训目标和拟议的研究项目将提供必要的技能， R 01的一个完全动力的混合实施效果试验测试的DMHI的功效。