Bullying Prevention Intervention for Adolescent Primary Care Patients

项目摘要 这项R21申请提出了一项基于临床的技术开发和试点评估， 加强对网络欺凌青少年受害者的二级预防干预。大约25%的 青少年（13-17岁）报告了去年的网络受害情况。网络受害与许多 负面的长期心理社会影响，包括自杀倾向、抑郁和物质使用。儿科医生 目前正在就各种主题向青少年提供门诊预防干预。他们一直 鼓励对青少年的网络受害情况进行筛查和咨询;然而，没有有效的网络- 在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 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 与身体伤害的发生有关的。借鉴以前的工作，本申请提出使用 严格的两步过程，以制定干预措施，包括简短的诊所内网络受害 预防会议，然后是一个为期八周的定制，双向短信程序。两部分 干预将侧重于（a）提高参与者的自我效能和重新设定有关网络的规范， 受害和（B）改善参与者的情绪调节和认知重建， 网络受害在目标1中，将基于社会认知学习开发新的干预措施 理论，研究团队的前期工作，对青少年的半结构化访谈，以及一个迭代的 在一系列开放的试点测试过程中进行改进。在目标2中，小说在- 将通过一项初步随机对照试验（n=50）对诊所+短信干预进行评估。 此外，研究小组将建立一种测量网络安全的创新方法的可行性， 受害者，使用一个直接从他们的手机下载参与者的匿名社交互动， 这是一个非常重要的问题，它涉及到以前试行的计算机程序，并制定初步的编码计划，以确定受害情况。如果 该干预措施是可行和有效的，该研究有望为未来大规模的干预提供参考。 有效性研究，以在临床环境中嵌入技术增强的干预措施。拟议 干预将产生广泛的公共卫生影响，为临床医生提供急需的工具，以减少网络， 受害及其对青少年的后果，既涉及NICHD的远景主题， 《2020年健康人》的青少年目标。

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.