TEEN Connections for Support from Multidisciplinary Professionals & Peers

项目总结摘要 这项研究测试了移动技术如何使青少年及其家人能够管理复杂的日常生活 静脉(IV)家庭肠外营养(HPN)。专业人士通过手机对青少年进行视听评估 IPad可以及早发现抑郁的迹象，糟糕的HPN家庭静脉输液护理，以及通常致命的迹象 四号血液感染。我们的12项综合mTEENConnect干预措施针对严重的青少年问题，使用 我们的全天候网站经过科学验证：(1)国家IV临床和HPN家庭护理指南的插图； (2)处理48个已知反复出现的HPN家庭问题的逐步算法；(3)音乐诱导 午睡，以减少疲劳/抑郁，提高静脉护理的警觉性；以及(4)技能培养游戏 通过加密的安全社交媒体预防感染和抑郁，并增加同伴支持。我们的 自动提示消息“应用程序”加强了专门针对青少年的健康独立生活活动。 我们的小飞行员发现青少年参与了我们的12项干预措施，并对iPad专业人员进行了高度评价 以及青少年视听评估和讨论。在试行了4个月后，这些青少年的人数增加了 生活质量和社会支持，没有抑郁，1名青少年早期发现/治疗静脉感染。 我们使用我们的多点单元或“桥”技术在青少年、父母和 多位专业人士。所有连接都经过加密，以确保隐私和HIPAA合规性。我们的干涉主义者是 一位博士认证的青少年心理学家，她自己资助的远程健康青少年抑郁症 学习。她将使用一份强大的青少年抑郁量表。所有研究人员都接受过培训，以利用我们长期的 并批准了IRB在小组讨论中管理自杀意念和情绪障碍的程序。 具体目标是测试通过iPad向HPN青少年和 他们的父母对：(1)生活质量、健康状况、疲劳、抑郁；(2)青少年的IV感染；以及(3)使用 健康的独立生活活动(技能培养游戏、恢复性音乐引导的午睡和安全的社交活动 与专业人士和同行的媒体)。与之前的研究一样，我们的IT信息工程专家 开发了软件来跟踪所有12次iPad干预的使用情况，并对社交媒体讨论的时长进行计时 在几分钟内，这两个指标都用于结果分析。受试者将匿名评估(1)其 家庭护理准备，(2)iPad社交媒体，以及(3)对移动连接的满意度 医疗保健。嵌套线性混合模型分析用于检验随时间变化的结果。这项临床试验使用一种 青少年循证干预对照小组，允许对结果和 成本。我们的健康团队使用了数据包络分析(DEA)的计量经济效率统计 护理经济学家确定了iPad交付成本与青少年健康服务使用的相对结果。

PROJECT SUMMARY ABSTRACT This study tests how mobile technologies empower teens and their families in managing complex daily lifelong intravenous (IV) home parenteral nutrition (HPN). Professionals' audiovisual assessment of teens via mobile iPads allows for early detection of signs of depression, poor HPN home IV care and the signs of the often fatal IV bloodstream infections. Our 12 integrated mTEENconnect interventions target serious teen problems using our 24/7 website with scientifically validated: (1) illustrations of national IV clinical and HPN home care guides; (2) step-by-step algorithms for managing the 48 known recurring HPN home problems; (3) music-inducing naps to decrease fatigue/depression and increase alertness for IV care; and (4) skill-building games for preventing infections and depression and increasing peer support via encrypted safe social media. Our automated prompted message “applications” reinforce healthy independent living activities specific for teens. Our small pilot found teens engaged in and highly rated each of our 12 interventions and the iPad professional and teen audiovisual assessments and discussions. After 4 months in the pilot, these teens had increased quality of life and social support, no depression, and 1 teen had early detection/treatment of an IV infection. We use our multipoint unit or “bridge” technology for simultaneous interactions among teens, parents, and multiple professionals. All connections are encrypted for privacy and HIPAA compliance. Our interventionist is a PhD certified adolescent psychologist who has conducted her own funded telehealth teen depression studies. She will use a robust teen depression inventory. All research staff are trained to use our long-standing and approved IRB procedures on managing suicide ideation and mood disorders in group discussions. Specific Aims are to test the effects of the mTeenConnect interventions delivered via iPad to HPN teens and their parents on: (1) quality of life, health status, fatigue, depression; (2) teens' IV infections; and (3) use of healthy independent living activities (skill-building games, restorative music-guided naps, and safe social media with professionals and peers). As in previous studies, our IT informatics engineering specialist has developed software to track use of all 12 iPad interventions and to time the length of social media discussions in minutes, both measures used in analyses of outcomes. Subjects will anonymously evaluate (1) their preparedness for home care, (2) the iPad social media, and (3) satisfaction with the mobile connections for health-care. Nested linear mixed model analyses are used to test outcomes over time. This clinical trial uses a teen evidence-based intervention comparator group to allow head-to-head comparisons of outcomes and costs. The econometric efficiency statistics of Data Envelopment Analysis (DEA) are used by our team health care economist to determine the iPad delivery costs relative outcomes and to teens health services use.