Preventing Depression of Chinese American Adolescents through Mobile Health Application

通过移动的健康应用预防华裔青少年抑郁 项目总结/摘要 华裔美国青少年（CAA），传统上被视为模范少数民族，经历严重的 文化适应压力和抑郁，自杀意念和种族相关压力的比例最高， 萧条这些心理健康问题，再加上由于污名化而对心理保健造成的文化障碍， 构成了一个重大的心理健康差距。自2000年以来，美国对华裔的歧视 COVID-19疫情加剧了CAA的困境。该提案通过发展 一个新的移动的健康应用程序（MHA）RRE（放松，反映，授权），以提供一个文化定制， 个性化和互动式预防，以减少CAA抑郁症状，并改善他们的 心理健康建议的RRE将建立在我们以前的工作和整合理论 正念认知疗法和批判意识的概念。目标1.开发RRE， CAA。为了开发一种适合文化和发展的预防CAA的方法，我们将采用生态学方法， 有效性框架，征求20个CAA的意见（按性别、年龄、文化适应水平和社会经济地位平衡） 在RRE发展的所有阶段，在语言、人员、内容、 概念、方法、背景和设计。考虑到组内差异，RRE将 个性化帮助CAA制定自己的预防抑郁症策略。我们将与 佛罗里达互动媒体中心开发RRE，并有六个CAA测试RRE功能和可用性 并提供改进反馈。为检验再生能源的初步成效，我们会进行一项试验计划， 对110名年龄在14-18岁之间的CAA社区样本的研究。我们将使用自适应随机分配55 参与者接受RRE，每周5天，持续3个月，55名参与者接受对照组，每周接受一次 3个月的健康登记短信。目标2.评估可行性和可接受性。评估 包括主观（CAA对通过移动的应用进行RRE的可行性和可接受性的响应 评定量表和开放式问题）和目标（CAA访问RRE的频率和持续时间 自动记录）。目标3.调查CAAs在抑郁症状，应对方面的变化 自我效能和心理健康。RRE组和对照组的受试者将完成 结果测量（抑郁、应对自我效能、心理健康）和影响因素 在三个时间点（基线、第12周末、第14周末、第16周末、第17周末、第18周末、第19周末、第1 周和第16周。我们预计RRE组的CAA表现出较低水平的抑郁症状， 在第12周和第16周，应对自我效能和心理健康水平高于对照组。 此外，RRE组中的CAA在结局方面比对照组表现出更大的改善 从基线至第12周和第16周的测量。开发和测试RRE以解决CAA心理问题 健康差距将对公共健康产生重大影响，因为RRE对其他少数群体的扩展性很高。

Preventing Depression of Chinese American Adolescents through Mobile Health Application Project Summary/Abstract Chinese American adolescents (CAAs), traditionally perceived as a model minority, experience serious acculturative stress and depression, with the highest rates of suicide ideation and race-related stress and depression. These mental health problems, coupled with cultural barriers to mental health care due to stigma, constitute a major mental health disparity. Recent discrimination against Chinese Americans since the COVID-19 pandemic has exacerbated CAAs’ distress. This proposal addresses the disparity by developing a new mobile health application (MHA) RRE (Relax, Reflect, Empower) to provide a culturally tailored, personalized, and interactive prevention to reduce CAA depressive symptoms and improve their psychological wellbeing. The proposed RRE will build upon our previous work and integrate theoretical concepts of Mindfulness-Based Cognitive Therapy and Critical Consciousness. Aim 1. Develop RRE for CAAs. To develop a culturally and developmentally tailored prevention for CAAs, we will apply the ecological validity framework by soliciting input from 20 CAAs (balanced by gender, age, acculturation level, and SES) at all stages of the RRE development for cultural and age appropriateness in language, persons, contents, concepts, methods, contexts, and design. In consideration of within-group diversities, the RRE will be personalized to help CAAs generate their own strategies to prevent depression. We will collaborate with the Florida Center for Interactive Media to develop RRE and have six CAAs test RRE functionality and usability and provide feedback for improvement. To Examine Preliminary Efficacy of RRE, we will conduct a pilot study of a community sample of 110 CAAs, ages 14-18. We will use adaptive randomization to assign 55 participants to RRE for 5 days/week for 3 months and 55 to the control group who will receive a weekly wellness check-in text message for 3 months. Aim 2. Evaluate Feasibility and Acceptability. Assessments include both subjective (CAAs’ responses on feasibility and acceptability of RRE through Mobile Application Rating Scale and open-ended questions) and objective (CAAs’ frequency and duration of RRE access automatically recorded) measures. Aim 3. Investigate CAAs’ Changes in Depressive Symptoms, Coping Self-Efficacy, and Psychological Wellbeing. Participants in both RRE and control groups will complete measures of outcomes (depression, coping self-efficacy, psychological wellbeing) and influencing factors (acculturative stress, experiences of discrimination, life events) at three time points: baseline, the end of 12th week and 16th week. We expect CAAs in RRE group to exhibit lower levels of depressive symptoms and higher levels of coping self-efficacy and psychological well-being than the control group at Weeks 12 and 16. Additionally, CAAs in the RRE group will exhibit greater improvement than the control group in the outcome measures from baseline to Weeks 12 and 16. The development and testing of RRE to address CAA mental health disparities will have significant public health impact as RRE is highly scalable for other minority groups.