Connecting Patients and Therapists Using a Tech-Based Treatment Support System

描述(申请人提供)：抑郁症是导致残疾的第二大原因，也是美国疾病负担最高的。PI的职业目标是成为一名独立的调查者，设计、评估和实施基于技术的治疗和预防抑郁症的新干预措施。行为干预技术(BITS)在治疗抑郁症方面显示出巨大的前景，需要专家能够将基于经验的行为改变技术的理解与技术的有效设计和应用结合起来。本提案概述了通过将培训和研究计划转化为成功的R01提案来实现这一目标的计划。该培训计划充分利用了候选人在西北大学范伯格医学院和NIMH资助的行为干预技术中心的强大制度支持和环境，该中心由该提案的主要导师领导。PI的职业目标所需的培训目标创造了以下方面的专业知识：1)BITS的创建和评估，特别是用于现有医疗保健系统；2)以用户为中心的设计和可用性测试；3)传播和实施；以及4)高级专业发展。这项计划建立在PI临床心理学背景的基础上，包括他过去对基于互联网的心理和行为健康自助干预的研究，包括抑郁症的治疗和预防、增进幸福感和戒烟，以及临床上对认知行为治疗的关注。在本K08中，PI将扩展他的工作，以包括BITS传播的新模式(例如，移动应用程序)和环境(社区诊所)。这项研究的长期目标是将BITS整合到现有的医疗保健环境中，从而提高现有抑郁症心理治疗的有效性。为此，该研究计划将开发一种基于技术的治疗支持系统(TSS)，具有面向患者和治疗师的功能，作为抑郁症认知行为治疗的辅助工具，从而提高其疗效。这将通过以下具体目标来实现： 1)进行以用户为中心的设计和可用性测试，以完善TSS的功能和工具，并确定其使用的可行性和可接受性；2)与常规治疗相比，对TSS作为抑郁症治疗的辅助工具进行随机试点试验；3)获得评估TSS疗效的初步数据，与疗效相关的机制变化，以及促进或阻碍其采用、实施和可持续性的系统层面因素。这些研究有望推进BITS的设计，改进和增加它们在临床环境中的使用，并最终增加循证实践的影响。此外，这些研究将为R01进行更大规模的随机对照试验提供初步数据。PI将通过心理学和工程学专家的指导获得关键的跨学科技能。通过这些经验，私家侦探将获得作为一名独立调查员成功职业生涯所需的专业知识。

DESCRIPTION (provided by applicant): Depression is the second leading cause of disability and has the highest burden of disease in the US. The PI's career goal is to become an independent investigator designing, evaluating, and implementing novel technology-based interventions for the treatment and prevention of depression. Behavioral intervention technologies (BITs), showing great promise in treating depression, require experts who can integrate an understanding of empirically-based techniques for behavior change with the effective design and application of technologies. This proposal outlines a plan to achieve this goal, through the culmination of training and research plans into a successful R01 proposal. The training plan takes full advantage of the candidate's strong institutional support and environment at Northwestern University's Feinberg School of Medicine and the NIMH- funded Center for Behavioral Intervention Technologies, which is led by the primary mentor for this proposal. Training goals necessary to the PI's career goal create expertise in: 1) creation and evaluation of BITs, especially for use in existing healthcare systems; 2) user-centered design and usability testing; 3) dissemination and implementation; and 4) advanced professional development. This plan builds on the PI's background in clinical psychology, including his past research on Internet-based, self-help interventions for mental and behavioral health including depression treatment and prevention, well-being promotion, and smoking cessation, and a clinical focus on cognitive-behavioral treatments. In this K08, the PI will expand his work to include new modes (e.g., mobile application) and settings (community clinics) of dissemination of BITs. The long-term goal of the research is to integrate BITs into existing healthcare settings thus increasing the efficacy of existing psychological treatments for depression. To this end, the research plan will develop a technology-based treatment support system (TSS) with both patient and therapist-facing features to be used as an adjunct for cognitive-behavioral therapy for depression thus increasing its efficacy. This will be achieved through the following specific aims: 1) conduct user-centered design and usability testing to refine features and tools of the TSS and determine feasibility and acceptability of their use patients and therapists; 2) conduct a randomized pilot trial of the TSS as an adjunct to depression treatment compared to regular treatment alone; and 3) obtain preliminary data assessing efficacy the TSS, changes in mechanisms to be related to efficacy, and system-level factors that would facilitate or retard its adoption, implementation, and sustainability. These studies are expected to advance the design of BITs, improve and increase their use in clinical settings, and ultimately increase the impact of evidence-based practices. Furthermore, these studies will provide the preliminary data for an R01 to conduct a larger RCT. The PI will obtain critical interdisciplinary skills through mentorship from experts in psychology and engineering. Through these experiences, the PI will gain the expertise necessary for a successful career as an independent investigator.