Suffoletto Brian, Goldstein Tina, Brent David
Department of Emergency Medicine, Stanford University, Palo Alto, CA, United States.
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States.
JMIR Form Res. 2021 Nov 9;5(11):e30580. doi: 10.2196/30580.
Many adolescents with depression do not pursue mental health treatment following a health care provider referral. We developed a theory-based automated SMS text message intervention (Text to Connect [T2C]) that attempts to reduce cognitive barriers to the initiation of mental health care.
In this two-phase study, we seek to first understand the potential of T2C and then test its engagement, usability, and potential efficacy among adolescents with depression and their parents or caregivers.
In phase 1, we conducted focus groups with adolescents with depression (n=9) and their parents or caregivers (n=9) separately, and transcripts were examined to determine themes. In phase 2, we conducted an open trial of T2C comprising adolescents with depression referred to mental health care (n=43) and their parents or caregivers (n=28). We assessed usability by examining program engagement, usability ratings, and qualitative feedback at the 4-week follow-up. We also assessed potential effectiveness by examining changes in perceived barriers to treatment and mental health care initiation from baseline to 4 weeks.
In phase 1, we found that the themes supported the T2C approach. In phase 2, we observed high engagement with daily negative affect check-ins, high usability ratings, and decreased self-reported barriers to mental health treatment over time among adolescents. Overall, 52% (22/42) of the adolescents who completed follow-up reported that they had attended an appointment with a mental health care specialist. Of the 20 adolescents who had not attended a mental health care appointment, 5% (1/20) reported that it was scheduled for a future date, 10% (2/20) reported that the primary care site did not have the ability to help them schedule a mental health care appointment, and 15% (3/20) reported that they were no longer interested in receiving mental health care.
The findings from this study suggest that T2C is acceptable to adolescents with depression and most parents or caregivers; it is used at high rates; and it may be helpful to reduce cognitive barriers to mental health care initiation.
许多患有抑郁症的青少年在医疗服务提供者转诊后并未寻求心理健康治疗。我们开发了一种基于理论的自动短信干预措施（“短信连接”[T2C]），旨在减少启动心理健康护理的认知障碍。
在这项两阶段研究中，我们首先试图了解T2C的潜力，然后测试其在患有抑郁症的青少年及其父母或照顾者中的参与度、可用性和潜在疗效。
在第1阶段，我们分别对患有抑郁症的青少年（n = 9）及其父母或照顾者（n = 9）进行了焦点小组访谈，并对访谈记录进行检查以确定主题。在第2阶段，我们对T2C进行了开放试验，参与者包括被转诊至心理健康护理机构的患有抑郁症的青少年（n = 43）及其父母或照顾者（n = 28）。我们在4周随访时通过检查项目参与度、可用性评分和定性反馈来评估可用性。我们还通过检查从基线到4周期间治疗和心理健康护理启动的感知障碍变化来评估潜在效果。
在第1阶段，我们发现这些主题支持T2C方法。在第2阶段，我们观察到青少年对每日负面情绪检查的参与度很高、可用性评分很高，并且随着时间的推移自我报告的心理健康治疗障碍有所减少。总体而言，完成随访的青少年中有52%（22/42）报告他们已预约了心理健康护理专家。在未预约心理健康护理的20名青少年中，5%（1/20）报告预约时间在未来，10%（2/20）报告初级保健机构无法帮助他们预约心理健康护理，15%（3/20）报告他们不再有兴趣接受心理健康护理。
这项研究的结果表明，T2C为患有抑郁症的青少年以及大多数父母或照顾者所接受；其使用率很高；并且它可能有助于减少启动心理健康护理的认知障碍。
