Text-Message-Based Depression Prevention for High-Risk Youth in the ED

针对急诊科高危青少年的基于短信的抑郁症预防

• 批准号: 8641721
• 负责人: Megan Larin Ranney
• 金额: $ 18.28万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8641721
• 关键词: 17 year old; Accident and Emergency department; Address; Adherence; Adolescent; Aggressive behavior; Alcohols; Anxiety; Attention; Beck depression inventory; Behavioral; Caring; Client satisfaction; Clinical Trials; Cognitive; Cognitive Therapy; Communities; Complement; Conflict (Psychology); Data Analyses; Depressed mood; Development; Emergency Department Physician; Emergency Department patient; Emotional; Enrollment; Evaluation; Fellowship; Focus Groups; Funding; Future; Gender; Goals; Grant; Guidelines; Healthcare; Healthy People 2020; Intervention; Interview; K-Series Research Career Programs; Lead; Learning; Link; Location; Measures; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Morbidity - disease rate; National Institute of Mental Health; Nutritional; Participant; Patients; Persons; Physicians; Population; Population Heterogeneity; Post-Traumatic Stress Disorders; Prevention; Preventive; Preventive Intervention; Process; Protocols documentation; Public Health; Qualitative Research; Questionnaires; Randomized; Recording of previous events; Regulation; Relative (related person); Reporting; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Services; Source; Staging; Structure; System; Target Populations; Techniques; Technology; Teenagers; Testing; Text; Time; Training; Training Activity; Translating; United States National Institutes of Health; Violence; Visit; Work; Youth; base; career development; depression prevention; depressive symptoms; design; dual diagnosis; effective intervention; efficacy testing; eligible participant; fighting; high risk; high risk sexual behavior; improved; innovation; innovative technologies; mortality; motivational enhancement therapy; patient oriented; peer; peer victimization; peer violence; pilot trial; practical application; prevent; primary outcome; programs; public health relevance; secondary outcome; skills; therapy development; treatment as usual; trend; usability; violence prevention

DESCRIPTION (provided by applicant): This integrated research and training plan will prepare Dr. Ranney, a fellowship-trained, practicing emergency physician, to become an independently funded physician-researcher with expertise in emergency department (ED)-based mental health interventions. Dr. Ranney's long-term research goal is to become an expert in developing effective, easily-disseminated, technology-augmented mental health interventions for high-risk ED patients. Her short-term goals, for this K23 Mentored Patient Oriented Career Development Award, are to (1) gain expertise in the development and evaluation of technology-augmented ED depression interventions, and (2) to test the hypothesis that a brief in-ED + longitudinal text-message ("ED+text") indicated depression prevention intervention is acceptable and feasible for high-risk youth. Depressive symptoms and peer violence are common, significant, and strongly correlated causes of morbidity, mortality, and ED visits among adolescents. The ED is often the primary source of care for high-risk youth with depressive symptoms and history of peer violence. The ED is well established as a location for mental health intervention, yet few resources are available to high-risk youth. Most adolescent ED patients use text-messaging. Text-message behavioral change has been shown effective. In this project, Dr. Ranney and mentors will develop and pilot a single-session in-ED + 8 week longitudinal text-message program ("ED+text") to reduce depressive symptoms, for adolescent ED patients with depressive symptoms and a history of peer violence. Under the guidance of a strong mentorship team of NIH-funded researchers, Dr. Ranney will achieve five specific training goals: (1) Gain advanced training in ED-based mental health research, focusing on the link between depression and violence; (2) Develop expertise in use of technology, particularly text-messaging, to enhance intervention delivery and evaluation; (3) Become a skilled user of qualitative research methodology to inform intervention development; (4) Learn how to design and conduct a clinical trial of an ED-based depression prevention intervention; (5) Develop skills in longitudinal data analysis for clinical trials. Dr. Ranney's training activities will be complemented by an innovative research plan allowing practical application of her new skills. Using a staged approach, Dr. Ranney will, first, conduct focus groups to develop our innovative "ED+text" intervention content; next, refine the intervention through an iterative process of open trials; finally, test the acceptability and feasibility of the intervention through a randomized piot study (n=100). This work is a crucial step toward preventing depression and co-occurring disorders among a high-risk population that does not typically seek out services. It addresses a current lack of easily-accessible preventive interventions, addressing NIMH Strategic Objectives 3 (treatment development for diverse populations) and 4 (strengthening public health impact), as well as critical Adolescent and Mental Health objectives of Healthy People 2020.

描述（由申请人提供）：这项综合研究和培训计划将使Ranney博士，一位接受过奖学金培训的急诊医生，成为一名独立资助的医生兼研究员，在急诊科（ED）的心理健康干预方面具有专业知识。Ranney博士的长期研究目标是成为为高危ED患者开发有效、易于传播、技术增强的心理健康干预措施的专家。她的短期目标是(1)获得技术增强ED抑郁干预措施的开发和评估方面的专业知识，(2)验证一个简短的ED+纵向短信（“ED+文本”）表明抑郁症预防干预对于高危青少年是可以接受和可行的假设。抑郁症状和同伴暴力是青少年发病率、死亡率和急诊科就诊的常见、重要且密切相关的原因。急诊科通常是照顾有抑郁症状和同伴暴力史的高危青少年的主要来源。作为心理健康干预的场所，急诊科已经得到了很好的确立，但对高危青少年来说，资源却很少。大多数青少年急症患者使用短信。短信行为改变已被证明是有效的。在这个项目中，Ranney博士和他的导师们将开发和试点一个为期8周的ED+纵向短信项目（“ED+短信”），以减轻有抑郁症状和同伴暴力史的青少年ED患者的抑郁症状。在由美国国立卫生研究院资助的研究人员组成的强大导师团队的指导下，Ranney博士将实现五个具体的培训目标：(1)在以教育学为基础的心理健康研究方面获得高级培训，重点关注抑郁与暴力之间的联系；(2)发展使用技术，特别是短信的专门知识，以加强干预措施的实施和评价；(3)熟练运用定性研究方法为干预措施的发展提供信息；(4)学习如何设计和实施基于ed的抑郁症预防干预的临床试验；(5)培养临床试验纵向数据分析技能。Ranney博士的培训活动将辅以一个创新的研究计划，允许她的新技能的实际应用。Ranney博士将采用分阶段的方法，首先，通过焦点小组的方式，开发我们创新的“ED+text”干预内容；接下来，通过公开试验的迭代过程来完善干预措施；最后，通过随机试验研究（n=100）检验干预的可接受性和可行性。这项工作是在不寻求服务的高风险人群中预防抑郁症和同时发生的疾病的关键一步。它解决了目前缺乏容易获得的预防干预措施的问题，解决了NIMH战略目标3（针对不同人群的治疗开发）和4（加强公共卫生影响），以及2020年健康人关键的青少年和精神卫生目标。