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兰尼博士作为一名接受过奖学金培训的执业急诊医生，成为一名独立资助的医生兼研究员，拥有基于急诊科(ED)的心理健康干预方面的专业知识。兰尼博士的长期研究目标是成为一名专家，为高危ED患者开发有效、易于传播、技术强化的心理健康干预措施。她的短期目标是：(1)获得技术强化的ED抑郁症干预措施的开发和评估方面的专业知识；(2)检验这样一种假设，即简短的ED+纵向短信(“ED+TEXT”)表明抑郁症预防干预对高危青年是可接受和可行的。抑郁症状和同伴暴力是青少年发病率、死亡率和急症就诊的常见、显著和密切相关的原因。教育署往往是有抑郁症状和朋辈暴力史的高危青少年的主要照顾来源。教育署已确立为心理健康干预中心，但为高危青少年提供的资源却寥寥无几。大多数青少年ED患者使用短信。短信行为的改变已经被证明是有效的。在这个项目中，兰尼博士和导师们将开发并试行一项单期In-ED+8周纵向短信计划(“ED+TEXT”)，以减轻抑郁症状，适用于有抑郁症状和同伴暴力史的青少年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)获得基于ED的精神健康研究的高级培训，重点关注抑郁症和暴力之间的联系；(2)发展使用技术的专业知识，特别是短信，以加强干预的实施和评估；(3)成为定性研究方法的熟练使用者，为干预的发展提供信息；(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)发展临床试验的纵向数据分析技能。兰尼博士的培训活动将得到一项创新的研究计划的补充，该计划允许实际应用她的新技能。兰尼博士将采用分阶段的方法，首先领导焦点小组开发我们创新的“ED+TEXT”干预内容；然后，通过开放试验的迭代过程来细化干预；最后，通过随机的Piot研究(n=100)来测试干预的可接受性和可行性。这项工作是在通常不寻求服务的高危人群中预防抑郁症和共生疾病的关键一步。它解决了目前缺乏易于获得的预防干预措施的问题，涉及NIMH战略目标3(针对不同人群的治疗发展)和目标4(加强对公共健康的影响)，以及2020年青少年和心理健康的关键目标。