MISC-IPV: A Community Based Intervention for Children Traumatized By Intimate Partner Violence

MISC-IPV：针对因亲密伴侣暴力而受到创伤的儿童的社区干预措施

基本信息

批准号：
10468010
负责人：
CARLA SHARP
金额：
$ 38.36万
依托单位：
UNIVERSITY OF HOUSTON
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-12 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10468010
关键词：
Address Adherence Adverse effects Affect African American Age Behavioral Symptoms Buffers Caregivers Caring Cessation of life Child Child Development Child Health Child Rearing Clinical Communities Country County Coupled Data Development Domestic Violence Employment Environment Epidemic Evaluation Exposure to Family Feedback Focus Groups Foundations Future HIV Health Professional Home Imprisonment Individual Interruption Intervention Interview Knowledge Leadership Mediating Mediator of activation protein Mental Health Methodology Modeling Mothers Names National Institute of Child Health and Human Development Outcome Parents Population Process Public Health Questionnaires Randomized Research Series Services Site Standardization Structure Symptoms Target Populations Testing Training Training Programs Trauma Woman Work acceptability and feasibility base caregiver education caregiver interventions caregiving coordinated violence cost design disability effectiveness testing efficacy testing emotional symptom evidence base follow-up health disparity implementation evaluation improved in vivo in vivo evaluation indexing intervention effect intervention program intimate partner violence maternal caregiving prevent process evaluation programs psychosocial public health relevance recruit resilience scale up severe mental illness substance abuser tool trauma symptom traumatic stress traumatized children treatment as usual treatment effect violence exposure

项目摘要

ABSTRACT One in four children (26%) in the U.S. are exposed to intimate partner violence (IPV), with higher rates among children of African American women. IPV exposure constitutes a traumatic stress environment with severe consequences for psychosocial outcomes in children. While maternal caregiving has been identified as a critical buffer against the effects of trauma on children, current IPV parenting interventions suffer from cultural insensitivity , and design and methodological limitations impeding scalability. Our scientific premise is that the adverse effects of IPV trauma on children can be interrupted through an intervention that enhances maternal caregiving capacity, and which is delivered by community-based paraprofessional caseworkers who are already delivering services to IPV-exposed African American women. The objective of this application is to adapt an established caregiver intervention program, Mediational Intervention for Sensitizing Caregivers (MISC), for the IPV and African American context (thereafter named MISC-IPV). MISC-IPV will be evaluated for acceptability, feasibility, and preliminary mechanisms and outcomes, guided by an evidence-based framework consisting of three aims (Adapt, Process Evaluation, Outcome/Mediator Evaluation). For Aim 1, (Adapt), we will adapt MISC through an iterative process involving qualitative interviews and focus groups with caseworkers and mothers in an IPV rehousing program until fit with context is achieved . Cultural adaptation and adaptation for the IPV context will be guided by a Community Advisory Board. For Aim 2 (Implementation and Process Evaluation), we will recruit N = 132 mothers/child pairs (children age 7 to 11) through the Harris County Domestic Violence Coordinating Council (HCDVCC) Collaborative of Houston, TX. Half will be randomly assigned to TAU+MISC-IPV vs. TAU. After initial training of caseworkers, one year of bi-weekly (every two weeks) intervention sessions of TAU+MISC-IPV vs. TAU will be delivered. Feasibility, adherence, and fidelity will be evaluated through percentage of sustained engagement, individual interviews, video-based observations, and questionnaire-based assessment. For Aim 3 (Outcomes and Mediators), we will evaluate the effects of TAU+MISC-IPV vs. TAU to interrupt the traumatizing effects of IPV exposure on children through assessing emotional, behavioral, and trauma symptoms at baseline, 6, 12, and 18 months in the children recruited in Aim 2. The mediational effects of enhanced caregiving capacity will be assessed through video observations and increase in knowledge. At the end of this formative study, we will have established the foundational assessments and intervention to apply for a multi-site RCT to fully test the efficacy, mediators, and moderators of MISC-IPV. This project will make possible a culturally sensitive, developmentally transportable, scalable, and sustainable evidence- and community-based intervention with proven in-vivo mechanisms of change that may serve as a model for future IPV programs also in different populations, that address the needs of IPV-exposed mothers and children simultaneously.

抽象的美国四分之一的儿童 (26%) 遭受过亲密伴侣暴力 (IPV)，其中儿童的比例更高的孩子非裔美国人女性。 IPV 暴露构成了一种具有严重创伤性应激环境对儿童心理社会结果的影响。虽然孕产妇护理已被确定为目前的 IPV 育儿干预措施对儿童创伤影响至关重要文化不敏感，以及阻碍可扩展性的设计和方法限制。我们的科学前提是 IPV 创伤对儿童的不利影响可以通过增强孕产妇保护的干预措施来中断。护理能力，由社区辅助专业个案工作者提供，他们已经向 IPV 提供服务非裔美国人女性。该应用程序的目的是调整既定的护理人员干预计划，针对护理人员敏感度的调解干预 (MISC)，对于 IPV 和非裔美国人上下文（此后命名为 MISC-IPV）。 MISC-IPV 将接受评估以基于证据的指导为可接受性、可行性以及初步机制和结果框架由三个目标组成（适应、过程评估、结果/调解者评估）。对于目标 1，（适应），我们将通过迭代过程包括定性访谈和焦点小组 IPV 安置计划中的社工和母亲直到实现与上下文的契合。文化适应 IPV 环境的适应将由社区咨询委员会指导。对于目标 2（实施和过程评估），我们将招募 N = 132 母子对（7 至 11 岁的儿童）通过 Harris 德克萨斯州休斯顿县家庭暴力协调委员会 (HCDVCC) 协作组织。一半将是随机分配到 TAU+MISC-IPV 与 TAU。对个案工作者进行初步培训后，为期一年，每两周一次（每两周）将举办 TAU+MISC-IPV 与 TAU 的干预课程。可行性、坚持性、忠诚度将通过持续参与的百分比、个人访谈、基于视频的方式进行评估观察和基于问卷的评估。对于目标 3（结果和调解者），我们将评估 TAU+MISC-IPV 与 TAU 的效果对比，通过以下方式中断 IPV 暴露对儿童造成的创伤影响：评估儿童基线、6、12 和 18 个月时的情绪、行为和创伤症状目标 2 中招募的人员。将通过视频评估增强护理能力的中介效果观察和增长知识。在这项形成性研究结束时，我们将建立基础评估和干预申请多中心随机对照试验，全面测试疗效、中介因素、以及 MISC-IPV 的版主。该项目将使文化敏感、发展性的可移植、可扩展、可持续的基于证据和社区的干预措施，经过验证的体内变化机制可以作为未来针对不同人群的 IPV 计划的模型，同时满足暴露于 IPV 的母亲和儿童的需求。