Bullying Prevention Intervention for Adolescent Primary Care Patients

项目摘要 该R21应用程序建议开发和试点评估一种基于临床的技术-- 加强对青少年网络欺凌受害者的二级预防干预。约25%的 青少年(13-17岁)报告了过去一年的网络受害情况。网络受害与众多 长期的负面心理社会影响，包括自杀、抑郁和药物使用。儿科医生 目前为青少年提供各种主题的门诊预防干预。他们一直都是 鼓励对青少年进行网络受害筛查和咨询；然而，没有有效的网络- 临床环境中存在预防受害的干预措施。简短的面对面干预和纵向干预 短信干预在改变青少年行为方面是可接受的、可行的和有效的，包括 与发生肉体侵害有关的。借鉴以前的工作，此应用程序建议使用 制定干预措施的严格两步过程，包括短暂的临床网络受害 预防会议，随后是为期八周的量身定制的双向短信程序。两部分 干预的重点将是：(A)提高参与者的自我效能感，重置有关网络的规范- 受害者和(B)改善参与者的情绪调节和认知结构 网络受害。在目标1中，将开发基于社会认知学习的新型干预 理论，研究团队之前的工作，对青少年的半结构化访谈，以及迭代 在一系列开放的试点测试期间进行的精炼过程。在目标2中，小说在以下方面的可行性和可接受性 临床+短信干预将通过试点随机对照试验(n=50)进行评估。 此外，研究小组将确定一种创新方法测量网络的可行性 受害，直接从参与者的手机下载参与者的匿名社交互动 以前试行的计算机程序，并开发初步编码方案来识别受害者。如果 干预措施的可行性和有效性被证明是可行的，这项研究有望为未来的大规模干预提供参考 在临床环境中嵌入技术强化干预的有效性研究。建议数 干预措施将产生广泛的公共卫生影响，为临床医生提供一个亟需的工具来减少网络- 青少年中的受害及其后果，涉及《消除对妇女一切形式歧视公约》的远景主题和关键问题 2020年青少年健康人目标。

Project Summary This R21 application proposes the development and pilot evaluation of a clinically-based, technology- augmented secondary prevention intervention for adolescent victims of cyber-bullying. Approximately 25% of adolescents (age 13-17) report past-year cyber-victimization. Cyber-victimization correlates with numerous negative long-term psychosocial effects, including suicidality, depression, and substance use. Pediatricians currently provide in-clinic preventive interventions to adolescents on a variety of topics. They have been encouraged to screen and counsel adolescents on cyber-victimization; however, no effective cyber- victimization prevention interventions exist for the clinical setting. Brief in-person interventions and longitudinal text-message interventions are acceptable, feasible, and effective at changing adolescent behaviors, including those related to occurrence of physical victimization. Drawing on prior work, this application proposes using a rigorous two-step process to develop an intervention consisting of a brief in-clinic cyber-victimization prevention session, followed by an eight-week tailored, two-way text-messaging program. The two-part intervention will focus on (a) enhancing participants' self-efficacy and resetting norms regarding cyber- victimization and (b) improving participants' emotional regulation and cognitive restructuring in the face of cyber-victimization. In Aim 1, the novel intervention will be developed based on social cognitive learning theory, prior work by the research team, semi-structured interviews with adolescents, and an iterative refinement process during a series of open pilot tests. In Aim 2, the feasibility and acceptability of the novel in- clinic + text-message intervention will be assessed through a pilot randomized controlled trial (n=50). Additionally, the study team will establish the feasibility of an innovative method for measuring cyber- victimization, downloading participants' anonymized social interactions directly from their phones using a previously-piloted computer program, and developing preliminary coding schemes to identify victimization. If the intervention is shown feasible and effective, this study is expected to inform a future large scale effectiveness study to embed a technology-augmented intervention in the clinical setting. The proposed intervention would have broad public health implications, giving clinicians a much-needed tool to reduce cyber- victimization and its consequences in adolescents, addressing both NICHD Vision Themes and critical adolescent objectives of Healthy People 2020.