Supporting Mental Health in Underserved Youth: Engagement with Digital Mental Health Technologies in Pediatric Primary Care

项目总结/摘要 心理健康障碍是儿童最常见的疾病。然而，数以百万计的青少年没有得到 心理健康护理风险最大的是来自服务不足人群的青少年（例如，社会经济地位低下; 种族/民族和/或性别/性少数群体），他们在精神健康筛查和护理方面面临无数障碍。 因此，传统的方法，以达到服务不足的青少年与心理健康障碍是行不通的， 导致终身健康差距和重大的公共卫生影响。符合 NIMH国家心理健康咨询理事会工作组报告中提出的建议， 这个K08应用程序是使用和调整现有的数字心理健康技术，以促进参与， 评估、检测、治疗和提供儿科心理健康服务。具体而言是 加速创造到维持模式将指导青少年 评估，检查和治疗（教）系统到儿科初级保健诊所服务青少年和家庭从 芝加哥西区在目标1中，PI和她的导师团队将与服务不足的青少年合作， （n = 20）和他们的父母（n = 20），以确定针对参与的最大障碍以及最大道德 对TeACH系统的文化相关性、可用性和有用性的关注和要求。在目标2中， 实施教师系统的计划将通过观察、访谈和共同设计来完善 与儿科初级保健儿科医生和工作人员的研讨会。在目标3中，Teach系统将 实施到初级保健诊所，并在随机试验中评估：1）参与和 实施结果; 2）通过分析差异，评估健康差距的补救措施 结果（例如，种族、保险状况、个人对心理健康的看法）。这 创新的研究将告知一般数字心理健康技术参与所需的适应性， 服务不足的青少年，并确定实施实践，以支持教学系统在儿科小学 护理机构。PI和她的指导团队还将确定TeACH的可行性和满意度 系统，为PI计划在多个初级保健诊所扩展该系统做准备， 未来的R01提案。拟议的研究和职业发展计划从逻辑上建立在PI的 儿科/行为健康、以用户为中心的设计和移动的健康（mHealth）方面的基础培训 评价提供机会获得以下方面的知识和技能：1）儿科健康差异; 2） 传播和实施科学;以及3）部署数字心理健康的特定伦理 为服务不足的人群提供技术。由多学科专家小组和机构 环境投资于支持创新举措，以改善精神和行为健康的 服务不足的人群，这K08将推出PI进入一个成功的职业生涯，作为一个独立的临床 科学家

Project Summary/Abstract Mental health disorders are the most common disease of childhood. Yet, millions of teens do not receive mental health care. Most at risk are teens from underserved populations (e.g., low socioeconomic status; racial/ethnic and/or gender/sexual minority), who face a myriad of barriers to mental health screening and care. As such, traditional methods for reaching underserved teens with mental health disorders are not working, resulting in life-long health disparities and a significant public health impact. Consistent with the recommendations made in the NIMH National Advisory Mental Health Council Workgroup report, the goal of this K08 application is to use and adapt existing digital mental health technologies to advance the engagement, assessment, detection, treatment, and delivery of services for pediatric mental health. Specifically, the Accelerated Creation-to-Sustainment Model will guide the development and implementation of the Teen Assess, Check, and Heal (TeACH) System into a pediatric primary care clinic serving teens and families from the West Side of Chicago. In Aim 1, the PI and her mentorship team will collaborate with underserved teens (n=20) and their parents (n=20) to identify strategies to target top barriers to engagement as well as top ethical concerns and requirements for cultural relevance, usability, and usefulness of the TeACH System. In Aim 2, the plan for implementing the TeACH System will be refined through observations, interviews, and co-design workshops with pediatric primary care pediatricians and staff. In Aim 3, the TeACH System will be implemented into a primary care clinic and evaluated in a randomized trial for: 1) engagement and implementation outcomes; and 2) assessment of remediation of health disparities by analyzing differential outcomes (e.g., race, insurance status, individual perceptions of mental health) in a randomized trial. This innovative research will inform general digital mental health technology engagement adaptations needed for underserved teens and identify implementation practices to support the TeACH System in pediatric primary care settings. The PI and her mentorship team will also determine the feasibility and satisfaction of the TeACH System in preparation for the PI’s planned expansion of the System across multiple primary care clinics in a future R01 proposal. The proposed research and career development plans logically build from the PI’s foundational training in pediatrics/behavioral health, user-centered design, and mobile health (mHealth) evaluation to provide opportunities to gain knowledge and skills in: 1) pediatric health disparities; 2) dissemination and implementation science; and 3) ethics specific to deploying digital mental health technologies for underserved populations. Supported by an interdisciplinary team of experts and in institutional environment invested in supporting innovative initiatives to improve the mental and behavioral health of underserved populations, this K08 will launch the PI into a successful career as an independent clinical scientist.