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Abstract：
BACKGROUND: Youth who experience traumatic events are at a substantially higher risk of engaging in substance use and sexual risk behaviors and problems (eg, HIV acquisition) than their non-trauma-exposed counterparts. Evidence-based substance use and risky sexual behavior prevention may reduce the risk of these outcomes. Trauma-focused mental health treatment provides a window of opportunity for the implementation of such preventive work with these youth. However, overburdened clinicians face challenges in adding prevention content while implementing evidence-based treatments. Mobile health (mHealth) tools can help reduce this burden in delivering prevention curricula. Trauma-Informed Prevention for Substance Use and Risky Sexual Behavior (TIPS) is an mHealth app that was developed to aid trauma-focused cognitive behavioral therapy (TF-CBT) clinicians in the implementation of an evidence-based risk behavior prevention curriculum.
OBJECTIVE: The goal of this paper is to describe the rationale for and development of the TIPS app and present the results of a mixed methods approach for the initial evaluation of its usability.
METHODS: Participants included clinicians (n=11), adolescents (n=11), and caregivers (n=10) who completed qualitative interviews and an adapted version of the Website Analysis and Measurement Inventory.
RESULTS: In total, 4 overarching themes emerged from the participants\' answers to the qualitative interview questions, demonstrating a generally positive response to the app. The themes were (1) strength of app content, (2) suggestions about app content, (3) esthetics and usability, and (4) benefits to the patient and session implementation. Clinicians, adolescents, and caregivers all agreed that the content was very relevant to adolescents and used examples and language that adolescents could relate to. All 3 groups also discussed that the content was comprehensive and addressed issues often faced by adolescents. All 3 groups of users made suggestions about the esthetics, which mostly comprised suggestions to change the font, color, or pictures within the app. Of all the groups, adolescents were most positive about the esthetics and usability of the app. Results from the Website Analysis and Measurement Inventory further illustrated the users\' favorable reaction to the TIPS app, with 100% (11/11) of clinicians, 100% (10/10) of caregivers, and most adolescents (7/11, 64%) selecting strongly agree or somewhat agree to the following statement: \"This app has much that is of interest to me.\" Adolescents generally found the app easier to use than did caregivers and clinicians.
CONCLUSIONS: The TIPS app shows promise as an mHealth tool for TF-CBT clinicians to integrate evidence-based substance use, risky sexual behavior, and HIV prevention during treatment. Future research, including a randomized controlled trial comparing TF-CBT implementation with and without the inclusion of the app, is necessary to evaluate the feasibility and efficacy of the app in reducing the risk of substance use and risky sexual behavior among trauma-exposed adolescents.
BACKGROUND: ClinicalTrials.gov NCT03710720; https://clinicaltrials.gov/study/NCT03710720.
OBJECTIVE: The goal of this paper is to describe the rationale for and development of the TIPS app and present the results of a mixed methods approach for the initial evaluation of its usability.
METHODS: Participants included clinicians (n=11), adolescents (n=11), and caregivers (n=10) who completed qualitative interviews and an adapted version of the Website Analysis and Measurement Inventory.
RESULTS: In total, 4 overarching themes emerged from the participants\' answers to the qualitative interview questions, demonstrating a generally positive response to the app. The themes were (1) strength of app content, (2) suggestions about app content, (3) esthetics and usability, and (4) benefits to the patient and session implementation. Clinicians, adolescents, and caregivers all agreed that the content was very relevant to adolescents and used examples and language that adolescents could relate to. All 3 groups also discussed that the content was comprehensive and addressed issues often faced by adolescents. All 3 groups of users made suggestions about the esthetics, which mostly comprised suggestions to change the font, color, or pictures within the app. Of all the groups, adolescents were most positive about the esthetics and usability of the app. Results from the Website Analysis and Measurement Inventory further illustrated the users\' favorable reaction to the TIPS app, with 100% (11/11) of clinicians, 100% (10/10) of caregivers, and most adolescents (7/11, 64%) selecting strongly agree or somewhat agree to the following statement: \"This app has much that is of interest to me.\" Adolescents generally found the app easier to use than did caregivers and clinicians.
CONCLUSIONS: The TIPS app shows promise as an mHealth tool for TF-CBT clinicians to integrate evidence-based substance use, risky sexual behavior, and HIV prevention during treatment. Future research, including a randomized controlled trial comparing TF-CBT implementation with and without the inclusion of the app, is necessary to evaluate the feasibility and efficacy of the app in reducing the risk of substance use and risky sexual behavior among trauma-exposed adolescents.
BACKGROUND: ClinicalTrials.gov NCT03710720; https://clinicaltrials.gov/study/NCT03710720.
摘要：
背景：经历创伤事件的年轻人参与物质使用和性风险行为和问题的风险要高得多（例如，HIV获取）比他们的非创伤暴露者。基于证据的物质使用和危险的性行为预防可以降低这些结果的风险。以创伤为重点的心理健康治疗为这些青年开展此类预防工作提供了机会之窗。然而,负担过重的临床医生在实施循证治疗的同时，在增加预防内容方面面临挑战。移动健康（mHealth）工具可以帮助减轻提供预防课程的负担。创伤信息预防物质使用和危险性行为（TIPS）是一个mHealth应用程序，旨在帮助以创伤为中心的认知行为疗法（TF-CBT）临床医生实施基于证据的风险行为预防课程。
目的：本文的目的是描述TIPS应用程序的基本原理和开发，并介绍混合方法方法的结果，以初步评估其可用性。
方法：参与者包括临床医生（n=11），青少年（n=11），和护理人员（n=10）谁完成了定性访谈和网站分析和测量清单的改编版。
结果：总计，参与者对定性访谈问题的回答产生了4个总体主题，展示了对应用程序的普遍积极的反应。主题是(1)应用程序内容的强度，(2)关于app内容的建议,(3)美学和可用性，(4)对患者和会话实施的好处。临床医生,青少年,和照顾者都同意内容与青少年非常相关，并使用了青少年可能涉及的例子和语言。所有三个小组还讨论了内容是全面的，并解决了青少年经常面临的问题。所有三组用户都提出了关于美学的建议，其中主要包括更改字体的建议，颜色,或应用程序内的图片。在所有的团体中，青少年对应用程序的美学和可用性最为积极。网站分析和测量清单的结果进一步说明了用户对TIPS应用程序的良好反应，100%(11/11)的临床医生，100%（10/10）的照顾者，大多数青少年（7/11，64％）选择强烈同意或有点同意以下声明：“这个应用程序有很多我感兴趣的。“青少年通常发现该应用程序比护理人员和临床医生更容易使用。
结论：TIPS应用程序有望作为TF-CBT临床医生整合循证药物使用的mHealth工具，危险的性行为,在治疗期间预防艾滋病毒。未来的研究，包括一项随机对照试验，比较TF-CBT的实施和不包括应用程序，有必要评估该应用程序在减少创伤暴露青少年中使用物质和危险性行为的风险方面的可行性和有效性。
背景：ClinicalTrials.govNCT03710720;https://clinicaltrials.gov/study/NCT03710720。
目的：本文的目的是描述TIPS应用程序的基本原理和开发，并介绍混合方法方法的结果，以初步评估其可用性。
方法：参与者包括临床医生（n=11），青少年（n=11），和护理人员（n=10）谁完成了定性访谈和网站分析和测量清单的改编版。
结果：总计，参与者对定性访谈问题的回答产生了4个总体主题，展示了对应用程序的普遍积极的反应。主题是(1)应用程序内容的强度，(2)关于app内容的建议,(3)美学和可用性，(4)对患者和会话实施的好处。临床医生,青少年,和照顾者都同意内容与青少年非常相关，并使用了青少年可能涉及的例子和语言。所有三个小组还讨论了内容是全面的，并解决了青少年经常面临的问题。所有三组用户都提出了关于美学的建议，其中主要包括更改字体的建议，颜色,或应用程序内的图片。在所有的团体中，青少年对应用程序的美学和可用性最为积极。网站分析和测量清单的结果进一步说明了用户对TIPS应用程序的良好反应，100%(11/11)的临床医生，100%（10/10）的照顾者，大多数青少年（7/11，64％）选择强烈同意或有点同意以下声明：“这个应用程序有很多我感兴趣的。“青少年通常发现该应用程序比护理人员和临床医生更容易使用。
结论：TIPS应用程序有望作为TF-CBT临床医生整合循证药物使用的mHealth工具，危险的性行为,在治疗期间预防艾滋病毒。未来的研究，包括一项随机对照试验，比较TF-CBT的实施和不包括应用程序，有必要评估该应用程序在减少创伤暴露青少年中使用物质和危险性行为的风险方面的可行性和有效性。
背景：ClinicalTrials.govNCT03710720;https://clinicaltrials.gov/study/NCT03710720。
