Owen Jason E, Kuhn Eric, Jaworski Beth K, McGee-Vincent Pearl, Juhasz Katherine, Hoffman Julia E, Rosen Craig
National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Mhealth. 2018 Jul 26;4:28. doi: 10.21037/mhealth.2018.05.07. eCollection 2018.
Many public health agencies, including the U.S. Department of Veterans Affairs (VA), have identified the use of mobile technologies as an essential part of a larger strategy to address major public health challenges. The VA's National Center for PTSD (NCPTSD), in collaboration with VA's Office of Mental Health and Suicide Prevention and the Defense Health Agency inside the U.S. Department of Defense (DoD), has been involved in the development, evaluation, and testing of 15 mobile apps designed specifically to address the needs and concerns of veterans and others experiencing symptoms of posttraumatic stress disorder (PTSD). These applications include seven treatment-companion apps (designed to be used with a provider, in conjunction with an evidence-based therapy) and eight self-management apps (designed to be used independently or as an adjunct or extender of traditional care). There is growing evidence for the efficacy of several of these apps for reducing PTSD and other symptoms, and studies of providers demonstrate that the apps are engaging, easy-to-use, and provide a relative advantage to traditional care without apps. While publicly available apps do not collect or share personal data, VA has created research-enabled versions of many of its mental health apps to enable ongoing product enhancement and continuous measurement of the value of these tools to veterans and frontline providers. VA and DoD are also collaborating on provider-based implementation networks to enable clinicians to optimize implementation of mobile technologies in care. Although there are many challenges to developing and integrating mHealth into care, including cost, privacy, and the need for additional research, mobile mental health technologies are likely here to stay and have the potential to reach large numbers of those with unmet mental health needs, including PTSD-related concerns.
包括美国退伍军人事务部（VA）在内的许多公共卫生机构，已将移动技术的使用视为应对重大公共卫生挑战的更大战略的重要组成部分。VA的国家创伤后应激障碍中心（NCPTSD）与VA的心理健康与自杀预防办公室以及美国国防部（DoD）内部的国防卫生局合作，参与了15款移动应用程序的开发、评估和测试，这些应用程序专门为满足退伍军人及其他有创伤后应激障碍（PTSD）症状者的需求和关切而设计。这些应用程序包括七款治疗辅助应用程序（设计用于与医疗服务提供者配合使用，并结合循证疗法）和八款自我管理应用程序（设计用于独立使用，或作为传统护理的辅助或延伸）。越来越多的证据表明，其中几款应用程序在减轻PTSD及其他症状方面具有疗效，对医疗服务提供者的研究表明，这些应用程序具有吸引力、易于使用，并且相对于没有应用程序的传统护理具有相对优势。虽然公开可用的应用程序不收集或共享个人数据，但VA已创建了许多其心理健康应用程序的可用于研究的版本，以实现产品的持续改进，并持续衡量这些工具对退伍军人和一线医疗服务提供者的价值。VA和DoD还在基于医疗服务提供者的实施网络方面展开合作，以使临床医生能够优化移动技术在医疗中的应用。尽管将移动健康技术开发并整合到医疗中存在诸多挑战，包括成本、隐私以及对更多研究的需求，但移动心理健康技术很可能会持续存在，并有可能惠及大量有未满足心理健康需求的人群，包括与PTSD相关的问题。
