Scaling a smarter and more efficient intervention: Evaluating the feasibility of disseminating a novel mobile app platform to treat depression

扩大更智能、更有效的干预措施：评估传播新型移动应用程序平台治疗抑郁症的可行性

• 批准号: 9165454
• 负责人: JOAQUIN A ANGUERA
• 金额: $ 32.07万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9165454
• 关键词: Behavioral; Case Mixes; Characteristics; Clinical; Clinical Data; Clinical Trials; Communities; Competence; Consent; Data; Data Analytics; Data Collection; Ensure; Equilibrium; Evaluation; Event; Evidence based treatment; Goals; Health Personnel; Hour; Human; Improve Access; Individual; Intervention; Lead; Machine Learning; Measures; Mental Depression; Mental Health; Mental Health Services; Modeling; Mood Disorders; Moods; National Institute of Mental Health; Natural Language Processing; Outcome; Participant; Patients; Performance; Pilot Projects; Population; Process; Provider; Public Health; Quality of Care; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research Priority; Services; System; Testing; Time; Training; arm; base; blind; care seeking; cost effective; dashboard; depressive symptoms; disability; evidence based guidelines; experience; functional outcomes; handheld mobile device; improved; improved outcome; innovation; iterative design; mHealth; mobile application; mobile computing; motivational intervention; novel; post intervention; research and development; response; satisfaction; targeted treatment; technological innovation; tool

ABSTRACT The goal of this project is to conduct a pilot study to test the utility of a Natural Language Processing (NLP) clinical messaging tool to improve the reach and the quality (fidelity and competency) of coaches providing behavioral activation (BA) strategies through a mobile mental health app called Personalized Real-time Intervention for Motivational Enhancement (PRIME). Despite decades of research and development for the treatment of mood disorders, depression has risen from the 5th leading cause of disability to the leading cause in the US. Critical barriers for progress in the field are 1) Poor access to high quality care for consumers; 2) Limited mental health workforce; and 3) Few providers are trained in the delivery of evidence-based treatments. In response to this public health problem, our team is proposing to use a mobile platform to improve access to an evidence based treatment; increase the reach of mental health coaches while supporting the delivery of higher quality of care. We will improve the reach of clinicians by using a NLP-powered messaging tool, which will ensure fidelity to the BA model and clinicians will have access to real-time clinical information about their patients to guide more targeted treatment (competence). By improving the efficiency and competence of mental health coaches in the context of mobile mental health services, we expect patients to make greater gains in depression, mood-related disability, and in achieving personal goals. In order to evaluate the feasibility, tolerability, and overall impact of the enhancements to PRIME, we will spend Year 1 engaging stakeholders in a human centered iterative design process and spend Years 2-3 conducting a pilot randomized controlled trial in which we will randomize 120 individuals with depression to either receive 8- weeks of 1) PRIME 1.0 (current version) OR 2) PRIME 2.0 (version with the NLP-powered clinician dashboard). Using BRIGHTEN, our mobile clinical trial platform, we will recruit participants, consent, screen, evaluate and deliver the intervention entirely remotely. The pilot data from this study will be used to prepare for a R01 study to definitively determine whether PRIME may be used to efficiently and effectively improve outcomes for a significantly larger number of individuals with depression.

抽象的 该项目的目标是进行试点研究以测试自然语言处理 (NLP) 的实用性 临床消息传递工具，用于提高教练提供的范围和质量（忠诚度和能力） 通过名为“个性化实时”的移动心理健康应用程序实施行为激活（BA）策略 动机增强干预（PRIME）。尽管经过数十年的研究和开发 治疗情绪障碍，抑郁症已从第五大致残原因上升为首要原因 在美国。该领域取得进展的关键障碍是 1) 消费者难以获得高质量的护理； 2） 心理健康劳动力有限； 3) 很少有提供者接受过提供基于证据的培训 治疗。针对这一公共卫生问题，我们的团队建议使用移动平台 改善获得循证治疗的机会；扩大心理健康教练的影响范围，同时支持 提供更高质量的护理。我们将通过使用 NLP 驱动的方法来提高临床医生的覆盖范围 消息传递工具，这将确保 BA 模型的保真度，并且临床医生将能够访问实时临床 有关患者的信息，以指导更有针对性的治疗（能力）。通过提高效率 以及心理健康教练在移动心理健康服务方面的能力，我们期望患者 在抑郁症、情绪相关的残疾和实现个人目标方面取得更大的进展。为了 评估 PRIME 增强功能的可行性、耐受性和总体影响，我们将在第 1 年进行评估 让利益相关者参与以人为本的迭代设计流程，并在 2-3 年进行试点 随机对照试验中，我们将随机抽取 120 名抑郁症患者，让他们接受 8- 1) PRIME 1.0（当前版本）或 2) PRIME 2.0（NLP 支持的临床医生版本） 仪表板）。使用我们的移动临床试验平台 BRIGHTEN，我们将招募参与者、同意、筛选、 完全远程评估和实施干预。本研究的试点数据将用于为 一项 R01 研究，以确定 PRIME 是否可用于高效且有效地改进 大量抑郁症患者的结果。