The Development of PATH, a Program to Support NICU Parent Mental Health Through the Transition from Hospital to Home

PATH 的开发，一个通过从医院到家庭的过渡来支持 NICU 家长心理健康的计划

基本信息

批准号：
10449924
负责人：
Susanne Klawetter
金额：
$ 16.58万
依托单位：
PORTLAND STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10449924
关键词：
Accident and Emergency department Acute Address Administrator Adoption Advisory Committees Affect Anxiety Award Awareness Behavior Therapy Biometry Birth Breast Feeding COVID-19 pandemic Caring Case Series Child Child Development Child Health Child Rearing Clinical Clinical Oncology Supplement (K12)Cognitive Collaborations Community Mental Health Services Data Data Collection Development Doctor of Philosophy Effectiveness Eligibility Determination Ensure Family Funding Goals Hand Health Personnel Health Services Research Healthcare Systems Home Hospitalization Hospitals Improve Access Infant Infant Health Learning Logistics Maintenance Maternal Mortality Mental Depression Mental Health Mental Health Services Mental disorders Mentorship Methods Neonatal Intensive Care Units Nurses Outcome Parents Perinatal Post-Traumatic Stress Disorders Premature Infant Prevalence Preventive healthcare Preventive service Primary Health Care Procedures Program Acceptability Public Health Informatics Qualitative Research Randomized Randomized Controlled Trials Reach Effectiveness Adoption Implementation and Maintenance Research Research Activity Research Personnel Review Committee Risk Rural Health Self Efficacy Services Site Social Workers Statistical Methods Structure Suicide Symptoms Testing Time Training Training Activity Transportation Universities Work acceptability and feasibility base behavioral outcome care providers care systems career clinical practice clinically significant depressive symptoms effectiveness implementation study effectiveness implementation trial experience health care service health economics health information technology high risk hospital readmission implementation science improved innovation meetings multidisciplinary perinatal health pilot test pragmatic implementation professor programs randomized trial rurality screening skills social stigma socioeconomics success telehealth tenure track urgent care

项目摘要

Project Summary/Abstract This application for a K08 Award includes training and research activities that support my transition to an independent mental health services researcher focused on improving services for parents with mental illness. I am a PhD-trained clinical social worker and tenure-track Assistant Professor at Portland State University, with a background in providing mental health services to parents and families. I am completing an Institutional K12 Award to study the mental health needs of parents in the neonatal intensive care unit (NICU). This K08 Award will build off my qualitative research and advance my research career by providing protected time, mentorship, and structured support to 1) learn implementation science methods, 2) increase my understanding of integrated mental health services, 3) obtain skills to conduct rigorous randomized control trials, including statistical methods necessary to analyze results, and 4) gain the skills necessary to become a leader in the field of parent mental health services research. My multidisciplinary mentorship team brings expertise in deployment-focused and participatory methods, health services research, implementation science, parent mental health research, randomized control trials, health economics, health informatics, rural health, and biostatistics. Parents of NICU-hospitalized preterm infants are at extremely high risk for mental health conditions with potentially devastating consequences. Yet, perinatal systems of care do not systematically support NICU parent mental health. The U.S. Preventive Services Task Force and state-level Maternal Mortality Review Committees have called upon perinatal systems of care to prioritize parent mental health. The objectives of this proposal are to develop and pilot test a telehealth-based mental health screening and engagement program that supports parents as they transition from the NICU to home. The program will use a stepped-care approach to screen parents for depression, anxiety, and PTSD; provide a brief behavioral intervention to those who screen as having at least a low risk of these conditions; and provide a warm hand-off to community mental health services for those at medium to high risk. We will achieve the study objectives by meeting 3 specific aims: 1) to use a RE-AIM framework to develop the program in collaboration with former NICU parents and NICU and primary care stakeholders; 2) to conduct an iterative case series to work out practical implementation details and logistics, refine the mental health screening and engagement program, and qualitatively assess purported mechanisms of action; and 3) to conduct a pilot randomized control trial to assess the program's acceptability and feasibility; to test its preliminary efficacy in targeting mental health self- efficacy and other potential mechanisms of action; and to better understand facilitators to adoption, implementation, and maintenance. The proposed activities will provide preliminary data and allow for the refinement of data collection procedures necessary for an R01 application to conduct a Type 1 hybrid effectiveness/implementation trial in multiple NICUs across the U.S.

项目概要/摘要本 K08 奖申请包括支持我过渡到 K08 奖的培训和研究活动独立心理健康服务研究人员致力于改善对患有精神疾病的父母的服务。我是波特兰州立大学的一名受过博士学位培训的临床社会工作者和终身教授助理教授，具有向父母和家庭提供心理健康服务的背景。我正在完成机构 K12 课程奖励研究新生儿重症监护病房（NICU）父母的心理健康需求。本次K08奖将通过提供受保护的时间、指导、建立我的定性研究并推进我的研究生涯和结构化支持 1) 学习实施科学方法，2) 增加我对综合心理健康服务，3) 获得进行严格随机对照试验的技能，包括分析结果所需的统计方法，以及 4）获得成为该领域领导者所需的技能家长心理健康服务研究领域。我的多学科导师团队带来了以下方面的专业知识以部署为中心的参与式方法、卫生服务研究、实施科学、家长心理健康研究、随机对照试验、卫生经济学、卫生信息学、农村卫生和生物统计学。 NICU 住院早产儿的父母面临极高的心理健康风险具有潜在破坏性后果的情况。然而，围产期护理系统并没有系统地支持 NICU 家长的心理健康。美国预防服务工作组和州级孕产妇死亡率审查委员会呼吁围产期护理系统优先考虑父母的心理健康。这该提案的目标是开发和试点测试基于远程医疗的心理健康筛查和参与计划，为父母从新生儿重症监护室过渡到家庭提供支持。该程序将使用一个采取阶梯式护理方法，筛查父母是否患有抑郁、焦虑和创伤后应激障碍 (PTSD)；提供简短的行为对那些经筛选至少患有这些疾病的风险较低的人进行干预；并提供热情的交接为中高风险人群提供社区精神卫生服务。我们将通过以下方式实现学习目标满足 3 个具体目标：1）使用 RE-AIM 框架与前任合作开发该计划 NICU 家长以及 NICU 和初级保健利益相关者； 2）进行迭代案例系列来计算实际的实施细节和后勤工作，完善心理健康筛查和参与计划，并定性评估所谓的行动机制； 3) 进行试点随机对照试验评估该计划的可接受性和可行性；测试其针对心理健康自我的初步功效功效和其他潜在的作用机制；并更好地了解采用的促进者，实施和维护。拟议的活动将提供初步数据并允许完善 R01 应用程序进行 1 类混合所需的数据收集程序在美国多个 NICU 进行的有效性/实施试验