Scaling a Parenting EBI for Latinx Youth Mental Health in Primary Care

扩大初级保健中拉丁裔青少年心理健康的育儿 EBI

• 批准号: 10284582
• 负责人: C. HENDRICKS BROWN
• 金额: $ 76.98万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10284582
• 关键词: 17 year old; Adolescence; Adolescent; Adoption; Adult; Affect; Age; Anxiety; Behavior; Behavior Therapy; Child; Child Rearing; Childhood; Chronic; Clinic; Communication; Development; Disease; Drug usage; Early Intervention; Education; Effectiveness; Employment; Engineering; Family; Feeling suicidal; Goals; Health; Health Insurance; Hispanics; Impairment; Interruption; Intervention; Knowledge; Latinx; Mediating; Medicine; Mental Depression; Mental Health; Mental disorders; Not Hispanic or Latino; Outcome; Participant; Pathway interactions; Prevention; Prevention program; Primary Health Care; Provider; Psyche structure; Randomized; Recording of previous events; Reporting; Research; Resources; Risk Factors; Schools; Severities; Sexually Transmitted Diseases; Substance Use Disorder; Suicide; Suicide attempt; Symptoms; System; Testing; Thinking; Time; United States National Academy of Sciences; Youth; adolescent health; anxiety symptoms; communication behavior; cost effective; depressive symptoms; design; disparity reduction; drug abuse prevention; drug misuse; drug use behavior; eHealth; effectiveness evaluation; emerging adult; ethnic minority population; evidence base; experience; externalizing behavior; health disparity; hybrid type 1 trial; ideation; implementation process; improved; intervention effect; peer; prevent; preventive intervention; primary care setting; programs; protective factors; reducing suicide; single episode major depressive disorder; social; socioeconomic disadvantage; standard of care; statistics; suicidal behavior; theories; therapy design

Project Summary The prevention of adolescent mental health disorders is an underused but scientifically justified approach to improving the public’s mental health. Youth with mental health disorders before the age of 18 have poorer outcomes in education, social, employment, and health compared with youth without mental health or substance use disorders. Hispanic youth report higher rates of depressive and anxiety symptoms, drug use, suicide ideation and attempts, compared to their non-Hispanic White peers. Interventions designed to interrupt the sequelae of mental health disorders and other poor outcomes are imperative for maximizing health among Hispanic youth. Familias Unidas, which was highlighted in the National Academies of Sciences, Engineering, and Medicine prevention report, has been found to be efficacious and effective in the reduction and/or prevention of adolescent health problems. Familas Unidas has had crossover effects on internalizing symptoms for youth who report low family communication, the intervention’s primary mediational pathway. It has also reduced suicide ideation rates for youth reporting this same mediational pathway of poor family communication. The online adaptation of Familias Unidas, eHealth Familias Unidas, has also been found to reduce adolescent health problems. However, to date, evidence-based preventive interventions such as Familias Unidas and eHealth Familias Unidas have largely been tested in schools and delivered mostly by research staff. Evaluating these interventions in real world studies of primary care and understanding the implementation processes that facilitate or impede the integration of interventions in systems is key to improving mental health and reducing disparities in the U.S. The goal of the proposed application is to evaluate in an effectiveness-implementation type I hybrid trial, an enhanced version of eHealth Familias Unidas for reducing depressive and anxious symptoms as well as suicide behavior in Hispanic youth. Using a randomized rollout design of 18 clinics, the study’s aims are: AIM 1: Evaluate the effectiveness of eHealth Familias Unidas for Mental Health in preventing/reducing depressive, anxiety symptoms, suicide ideation and behavior, and drug misuse among those screened as having poor family communication or elevated levels of depressive or anxiety symptoms, or a history of suicide behavior (ideation or attempts); AIM 2: Determine whether intervention effects are partially mediated by family communication and externalizing behaviors, including drug misuse, and moderated by parental depression; and Exploratory AIM 3: Intervention impact on mental health and drug misuse as well as sustainment will vary by quality of implementation at the levels of clinic and clinician. Participants will be assed at baseline, 3, 6, and 18-months post baseline.

项目概要 预防青少年心理健康障碍是一种未得到充分利用但有科学依据的方法 改善公众的心理健康 18 岁之前患有心理健康障碍的青少年的状况较差。 与没有心理健康或健康问题的青少年相比，他们在教育、社会、就业和健康方面的成果 西班牙裔青年报告抑郁和焦虑症状、吸毒、 与非西班牙裔白人同龄人的自杀意念和企图相比，旨在中断的干预措施。 精神健康障碍和其他不良后果的后遗症对于最大限度地提高人们的健康至关重要 美国国家科学院、工程院重点关注的西班牙裔青年。 和药物预防报告，已被发现在减少和/或 Familas Unidas 的预防青少年健康问题对内化具有交叉影响。 报告家庭沟通不足的青少年的症状，这是干预的主要中介途径。 还降低了年轻人的自杀意念率，报告了贫困家庭的相同中介途径 Familias Unidas 的在线改编版 eHealth Familias Unidas 也被发现可以提高沟通效率。 然而，迄今为止，基于证据的预防干预措施，例如 Familias Unidas 和 eHealth Familias Unidas 已在学校中进行了大部分测试，并主要由 研究人员在初级保健的现实世界研究中评估这些干预措施并了解 促进或阻碍干预措施整合到系统中的实施过程是关键 改善心理健康并减少美国的差距 拟议申请的目标是评估 在一项有效性实施 I 型混合试验中，eHealth Familias Unidas 的增强版用于 使用随机方法减少西班牙裔青少年的抑郁和焦虑症状以及自杀行为。 18 家诊所的推广设计，该研究的目标是： 目标 1：评估 eHealth Familias Unidas 的有效性 促进心理健康，预防/减少抑郁、焦虑症状、自杀意念和行为，以及 那些被筛查为家庭沟通不良或抑郁或抑郁水平升高的人滥用药物 焦虑症状，或自杀行为史（意念或企图）；目标 2：确定是否 干预效果部分由家庭沟通和外化行为（包括药物）介导 滥用，并通过父母抑郁来调节；探索性目标 3：干预对心理健康的影响 药物滥用和维持会因诊所和诊所层面的实施质量而异。 临床医生将在基线、基线后 3、6 和 18 个月对参与者进行评估。