Wa'Kan Ye'Zah: Enhancing caregivers' and children's well-being through an evidence-based and culturally informed prevention intervention

WaKan YeZah：通过基于证据和文化背景的预防干预措施提高护理人员和儿童的福祉

• 批准号: 10331849
• 负责人: Teresa Brockie
• 金额: $ 88.08万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10331849
• 关键词: 5 year old; Address; Adolescence; Adolescent; Adverse event; Affect; Age; Behavior; Behavioral; Caregivers; Child; Child Development; Child Rearing; Child Welfare; Cognitive Therapy; Communities; Community Health Aides; Control Groups; Development; Discipline; Effectiveness of Interventions; Elements; Emotional; Ensure; Evidence based intervention; Experimental Designs; Family; Funding; Future; Goals; Head Start Program; Health; Health Promotion; Indigenous; Individual; Informal Social Control; Intervention; Learning; Life; Life Cycle Stages; Mental Depression; Mental Health; Names; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; Native Americans; Outcome; Parents; Participant; Personal Satisfaction; Phase; Plant Roots; Population; Problem behavior; Randomized; Randomized Controlled Trials; Readiness; Research; Research Personnel; Risk; Risk Factors; Self-Injurious Behavior; Sioux Indians; Stress; Substance abuse problem; Suicide; Symptoms; Testing; Training Programs; Translational Research; Trauma; Trust; Wolves; Work; Youth; active control; base; behavioral health; behavioral outcome; commune; design; disorder prevention; early childhood; effectiveness evaluation; effectiveness testing; empowerment; evidence base; experience; externalizing behavior; health disparity; improved; indigenous community; innovation; intergenerational; nutrition education; patient engagement; peer; prevent; preventive intervention; protective factors; reduce symptoms; substance use; substance use prevention; suicidal risk; teacher; trial design; tribal community; uptake; young adult

The overall goal of this study is to develop, adapt and evaluate an intergenerational prevention intervention, named “Wa’ Kan ye’ zah (Little Holy One),” with Fort Peck Assiniboine and Sioux caregivers and their 3-to-5- year-old children. The intervention aims to: 1) reduce symptoms of historical trauma and everyday stress among parents/caregivers, 2) improve parenting, and 3) improve children’s emotional and behavioral developmental outcomes to reduce future risk for suicide and substance use. The scientific premise of this work is rooted in understanding that high rates of historical and current trauma in Native communities compromise caregivers’ mental health and parenting, which in turn affect early childhood behavior problems and adverse events that increase children’s risk for suicide and substance use in adolescent and young adulthood. Without intervention, this intergenerational cycle may repeat. Wa’ Kan ye’ zah will combine adapted elements of: 1) Trauma-Focused Cognitive Behavioral Therapy, an evidence-based intervention proven effective to reduce stress, depression and trauma-related symptoms, 2) Family Spirit, an evidence-based parent training program to promote positive early child development in Native American communities, and 3) cultural components informed by tribal-specific risk and protective factors for suicide and substance abuse identified in community-based studies that led to this proposal. The intervention will consist of 12 weekly individual lessons taught to parents and children (ages 3 to 5) at the Poplar and Wolf Point Head Start facilities by indigenous community health workers, a delivery strategy selected to enhance participant engagement, local acceptability and sustainability. Intervention timing is focused at a critical developmental phase—when primary attachment is still to parents, but while children are transitioning to greater self-regulation and cooperation with teachers and peers in Head Start classrooms. This study will use a randomized control trial (RCT) with an embedded single-case experimental design (SCED) to determine the effectiveness of the intervention on mental health and behavioral outcomes among N=120 parent-child dyads, while empirically exploring the added benefit of specific cultural components on parent/caregiver outcomes. on mental health and behavioral outcomes among N=120 parent-child dyads, while exploring the added benefit of cultural components on parent outcomes. The study plan is situated within a well-established trust relationship with tribal communities, innovative formative research that led to this proposal, and an experienced, multi- disciplined study team led by an indigenous PI.

这项研究的总体目标是开发，适应和评估代际预防干预措施， 命名为“ wa’kan ye’zah（小神圣），佩克堡Assiniboine和Sioux Caregivers及其3-5-- 一岁的孩子。干预措施的目的是：1）减轻历史创伤的症状和每天的压力 在父母/照顾者中，2）改善育儿，3）改善孩子的情感和行为 发展结果，以减少自杀和物质使用的未来风险。科学前提 工作源于理解，当地社区的历史和当前创伤率很高 妥协看护人的心理健康和育儿，进而影响幼儿行为问题 和不良事件，这些事件增加了儿童在青少年和年轻人中的自杀风险和物质使用的风险 成年。没有干预，这种代际周期可能会重复。 wa’kan ye’zah将结合适应的 元素：1）以创伤为重点的认知行为疗法，这是一种基于证据的干预措施 有效减轻压力，抑郁和与创伤有关的症状，2）家庭精神，一种基于循证的 父母培训计划旨在促进美国原住民社区积极的早期儿童发展，3） 由特定于部落的风险和自杀和滥用药物的保护因素所告知的文化组成部分 在导致该建议的基于社区的研究中确定。干预将包括12周 在白杨和沃尔夫角（Wolf Point Head）启动设施中向父母和孩子（3至5岁）教授的个人课程（3至5岁） 由土著社区卫生工作者，一项旨在加强参与参与的交付策略， 当地的可接受性和可持续性。干预时机集中在关键的发展阶段 - 主要的依恋仍然是父母，但是当孩子过渡到更大的自我调节和 与老师和同龄人的合作，在开始课堂上。这项研究将使用随机对照试验 （RCT）具有嵌入式单盘实验设计（SCED），以确定 n = 120个亲子二元组中心理健康和行为结果的干预，而经验上 探索特定文化组成部分对父母/照顾者结果的额外好处。关于心理健康 n = 120个亲子二元组之间的行为结果，同时探索文化的额外好处 父母结果的组成部分。研究计划位于与公认的信任关系中 部落社区，创新的形成性研究，导致了这一建议，以及多种经验 由土著PI领导的纪律研究团队。