Digital Delivery of Evidence-Based Mental Health Content and Mentoring to Adolescents

项目总结。这项直接到第二阶段SBIR的提案将研究面向青少年的Appa Health 心理健康智能手机和电脑应用程序。APPA结合(1)基于证据的短格式数字交付 心理健康内容，强调认知行为治疗，通过心理健康提供的教育视频 具有互联网影响力的健康专家，(2)受过培训和监督的近乎同行的导师 使用支持性问责促进青少年使用循证调查的亲身经历 内容。根据阿帕的变化理论，近同伴辅导直接影响青少年的心理 健康和福祉，通过关系和工具支持，但也间接通过收购 通过教育视频传授循证技能(例如，认知结构调整、行为激活)。我们会 检查APPA的两个主要要素的心理社会机制，建立有效性 APPA关于青少年抑郁和焦虑、其他功能测量和理论机制的研究 检查完整的Appa体验以及Appa的纯视频条件的成本效益 考虑市场营销。AIM 1将通过一项小型试点研究收集初始数据并改进研究程序。 75名年龄在13-18岁之间的青少年在抑郁和/或焦虑方面得分上升 随机分配到以下三种条件之一：(1)近同行指导和数字工具(完整的Appa)，(2)数字 仅内容(Appa Light)，以及(3)等待列表控制。结果将用于优化方法，以实现 以最小的负担和最大的保留来研究目标。AIMS 2和3将审查APPA的成本和 通过一项强大的随机临床试验对400名青少年进行复制试点试验的有效性。 变量将包括临床结果，如青少年的抑郁、焦虑和幸福感症状， 以及治疗机制和近期结果。由于精神卫生工作人员短缺， 这项研究将通过演示使用非专业人员(近距离同行)的有效性来对科学产生影响 导师)与专家数字内容交付和临床监督相结合，以支持青少年的心理 健康。本研究在近距离辅导与循证指导的独特结合上具有创新性 通过现有互联网影响力人士制作的针对年轻人的TikTok风格视频提供内容。问题 关于如何增加青少年对循证技能的参与和使用对干预很重要 开发商。这项研究的数据将直接影响Appa的商业化计划。Appa正在扩大规模 迅速从直接面向消费者的销售扩展到与学校和自筹资金的雇主的合作伙伴关系，两者都是 其中一些人渴望记录临床结果并确定可复制的改变机制 在APPA扩展服务的同时确保质量。成本效益分析将推动开发和设计 决策(例如，将资源集中在指导、内容或指导-内容集成上)，以及 关于目标组织和广告的商业化决策。

PROJECT SUMMARY. This direct to Phase II SBIR proposal will study Appa Health, an adolescent-facing mental health smartphone and computer app. Appa combines (1) delivery of short-form digital evidence-based mental health content, emphasizing Cognitive Behavioral Therapy, via educational videos delivered by mental health experts who are internet influencers, with (2) trained and supervised near-peer mentors with relatable lived experiences who use supportive accountability to facilitate adolescents’ use of the evidence-based content. According to Appa’s theory of change, near-peer mentoring directly impacts adolescents’ mental health and well-being via relational and instrumental support, but also indirectly through the acquisition of evidence-based skills (e.g., cognitive restructuring, behavioral activation) taught via educational videos. We will examine the psychosocial mechanisms of the two primary elements of Appa, establish the effectiveness of Appa on adolescent depression and anxiety, other measures of functioning, and theoretical mechanisms, and examine the cost-effectiveness of the full Appa experience as well as a video-only condition that Appa is considering marketing. Aim 1 will collect initial data and improve study procedures via a small pilot study. Seventy-five adolescents aged 13-18 with elevated scores on measures of depression and/or anxiety will be randomly assigned to one of three conditions: (1) near-peer mentoring and digital tools (Full Appa), (2) digital content only (Appa Light), and (3) waitlist control. Results will be used to optimize methodology to achieve study goals with minimum burden and maximum retention. Aims 2 & 3 will examine Appa’s cost and effectiveness via a well-powered randomized clinical trial replicating the pilot trial using 400 adolescents. Variables will include clinical outcomes such as adolescent symptoms of depression, anxiety, and well-being, as well as treatment mechanisms and proximal outcomes. Because of the mental health workforce shortage, this study will have an impact on science by demonstrating the effectiveness of using laypersons (near-peer mentors) combined with expert digital content delivery and clinical supervision to support adolescents’ mental health. This study is innovative in the unique combination of near-peer mentoring with evidence-based content delivered via youth-targeted TikTok-style videos conducted by existing internet influencers. Questions on how to increase adolescent engagement with and use of evidence-based skills are important to intervention developers. The data from this study will directly impact Appa’s commercialization plan. Appa is scaling quickly, expanding from direct-to-consumer sales to partnerships with schools and self-funded employers, both of which are eager for documented clinical outcomes and identification of replicable mechanisms of change to ensure quality as Appa scales services. Cost-effectiveness analyses will drive development and design decisions (e.g., focusing resources on mentorship, content, or the mentorship-content integration), as well as commercialization decisions regarding target organizations and advertising.