A trauma informed intervention to improve mental health and school success for urban eighth graders

创伤知情干预措施可改善城市八年级学生的心理健康和学业成功

基本信息

批准号：
10174974
负责人：
Tamar Mendelson
金额：
$ 43.13万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-11 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10174974
关键词：
17 year old Academic achievement Achievement Address Adolescence Adolescent Adolescent Development Affect African American Age Baltimore Behavior Behavioral Biometry Child Child Mental Health Child Traumatic Stress Chronic stress Cities Clinical Cognitive Communities Competence Control Groups Cost Analysis Crime Data Data Reporting Decision Making Disadvantaged Distress Emotional Evaluation Event Failure Family Funding Goals Health Health education Human Resources Income Informal Social Control Intervention Link Low income Mediator of activation protein Mental Health Methods Middle School Student Mission Modeling National Institute of Child Health and Human Development National Institute of Mental Health Nature Occupations Outcome Perception Performance Pilot Projects Poverty Prevention program Prevention trial Problem behavior Professional counselor Psychologist Psychotherapy Public Health Randomized Randomized Controlled Trials Records Research Research Personnel Resources Risk Schools Services Shapes Social Functioning Social Workers Standardization Stress Structure Students Surveys Symptoms Techniques Testing Training Trauma Trust Unemployment Urban Community Violence Work Youth active control aged anxiety symptoms assault base behavioral outcome cost depressive symptoms disparity reduction eighth grade emotion regulation emotional functioning evidence base follow-up group intervention high risk high school implementation science improved improved outcome inner city innovation medical specialties member mental health personnel mindfulness neighborhood disadvantage ninth grade novel physical assault positive youth development post intervention programs recruit scale up school district screening seventh grade stakeholder perspectives student participation success teacher trauma exposure trauma symptom treatment group urban school urban underserved violence exposure young adult

项目摘要

ABSTRACT. Approximately half of all 14-17 years olds in the U.S. are estimated to be victims of physical assault; chronic stress and trauma exposure are particularly prevalent for youth growing up in high-crime urban communities. Emotion regulation difficulties due to stress and trauma exposure contribute to disparities in mental health problems and school failure, with low-income and African American youth at much higher risk than their higher-income, White counterparts. Schools serving high-crime communities, however, do not offer universal trauma-informed strategies to support student success. RAP Club is a school-based group prevention program aimed at improving emotion regulation and decision-making in urban upper middle school students to improve their transition to high school. The program fills key gaps in current school practices, including a trauma-informed approach, universal delivery to all students without pre-screening, transdiagnostic effects on internalizing problems as well as behavioral issues, and a focus on upper middle school students. Our team adapted RAP Club from Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS), a group treatment for adolescents based on empirically supported mindfulness and cognitive- behavioral techniques. Using a novel delivery method, RAP Club is co-facilitated by school mental health personnel and young adult community members to promote student engagement. In our NIMH-funded pilot research, the program improved classroom behavior, social functioning, and academic competence. The program improved outcomes for students at varying levels of baseline distress—even low levels—suggesting its appropriateness as a universal model. Building on that work, the proposed R01 trial will test whether urban eighth grade students randomly assigned to RAP Club show improved emotional, behavioral, and academic outcomes in eighth and ninth grades compared to those assigned to Healthy Topics, a health education control group. Intervention and control programs will each be delivered by different school personnel with co- facilitation by young adult community members. The research will be conducted in 32 Baltimore City Public Schools serving urban communities with high rates of violence exposure. We will collect teacher- and student- reported data on student self-regulation, emotional functioning, classroom behavior, and academic performance at pre- and post-intervention and 4-month follow up, as well as student data at 12-month follow up. We will gather school record data on academic indicators in the year before, year of, and year following study participation. We will evaluate factors relevant to program implementation and potential sustainability, including stakeholder perspectives and cost data. The RAP Club model of trauma-informed, universal support has potential for widespread dissemination in school districts serving disadvantaged youth nationwide.

摘要：据估计，美国 14-17 岁青少年中约有一半是身体伤害的受害者。袭击；慢性压力和创伤暴露对于在犯罪率高的城市长大的青少年来说尤其普遍压力和创伤暴露导致的情绪调节困难导致了不同社区之间的差异。心理健康问题和学业失败，低收入和非裔美国青年面临的风险要高得多然而，与高收入社区的白人学校相比，这些学校不提供这些服务。支持学生成功的通用创伤知情策略 RAP 俱乐部是一个以学校为基础的团体。旨在改善城市高中生情绪调节和决策的预防方案帮助学生改善向高中的过渡，该计划填补了当前学校实践的关键空白，包括创伤知情方法、无需预先筛查、跨诊断的情况下向所有学生普遍提供服务对内化问题和行为问题的影响，并关注高中生。我们的团队改编自《青少年应对慢性压力的结构化心理治疗》中的 RAP Club （SPARCS），一种基于经验支持的正念和认知的青少年团体治疗 RAP 俱乐部采用一种新颖的行为技巧，由学校心理健康部门共同推动。在我们 NIMH 资助的试点项目中，我们的工作人员和年轻成人社区成员促进学生参与。研究表明，该项目改善了课堂行为、社会功能和学术能力。该计划改善了处于不同基线痛苦水平（甚至是低水平）的学生的成绩，表明在此工作的基础上，拟议的 R01 试验将测试城市是否适合。被随机分配到 RAP 俱乐部的八年级学生表现出情绪、行为和学业方面的改善与分配给健康主题（健康教育控制）的结果相比，八年级和九年级的结果干预和控制计划将由不同的学校人员与共同实施。该研究将在 32 个巴尔的摩市公共场所进行。我们将收集暴力暴露率较高的城市社区的学校。报告有关学生自我调节、情绪功能、课堂行为和学业的数据干预前后和 4 个月随访的表现，以及 12 个月随访的学生数据我们将收集前年、后年学业指标的学校记录数据。我们将评估与计划实施和潜在可持续性相关的因素，包括利益相关者的观点和成本数据的创伤知情普遍支持的 RAP 俱乐部模型。有可能在学区广泛传播，为全国弱势青年提供服务。