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准备接受奖学金培训的急诊医师Ranney博士成为一名具有独立资助的医师研究者，并具有急诊科（ED）基于心理健康干预措施的专业知识。 Ranney博士的长期研究目标是成为为高风险ED患者开发有效，易于触发，技术增强的心理健康干预措施的专家。她的短期目标是为K23指导的以患者为导向的职业发展奖，是（1）在技术增强技术的ED抑郁症干预措施的开发和评估方面获得专业知识，（2）检验以下假设：简短的内部 +纵向文本消息（ED +文本）表明，预防抑郁症的预防干预是可接受的，是对高级和可行的高级青年。 抑郁症状和同伴暴力是常见的，显着的且与青少年访问的发病率和ED访问的原因。 ED通常是具有抑郁症状和同伴暴力病史的高风险青年护理的主要来源。急诊室是精神健康干预措施的一个地方，但高风险青年几乎没有资源。大多数青少年ED患者都使用文本消息。文本消息行为改变已显示出有效。在这个项目中，Ranney博士和导师将开发并试行一次单次ED + 8周的纵向文字消息计划（“ ED +文本”），以减轻抑郁症状，以供患有抑郁症状和同伴暴力病史的青少年ED患者。 在由NIH资助的研究人员组成的强大指导团队的指导下，兰尼博士将实现五个具体的培训目标：（1）在基于ED的心理健康研究中获得高级培训，重点是抑郁与暴力之间的联系； （2）发展技术使用方面的专业知识，尤其是文本消息，以增强干预交付和评估； （3）成为定性研究方法的熟练用户，以指导干预开发； （4）学习如何设计和进行基于ED的抑郁症预防干预的临床试验； （5）开发纵向数据分析的技能进行临床试验。 Ranney博士的培训活动将通过创新的研究计划进行补充，允许实际应用她的新技能。兰尼博士将使用分阶段的方法进行焦点小组，以开发我们创新的“ ED+文本”干预内容；接下来，通过开放试验的迭代过程来完善干预措施；最后，通过随机Piot研究（n = 100）测试干预措施的可接受性和可行性。 这项工作是防止通常不会寻求服务的高风险人群中抑郁症和同时发生疾病的关键一步。它解决了目前缺乏易于访问的预防性干预措施，解决了NIMH战略目标3（不同人群的治疗发展）和4（增强公共卫生影响），以及健康人2020年健康人的关键青少年和心理健康目标。