Improving Care for Anxiety in Pediatric Settings

改善儿科焦虑症的护理

• 批准号: 7092776
• 负责人: DENISE A CHAVIRA
• 金额: $ 15.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7092776
• 关键词: Hispanic Americans; anxiety disorders; audiotape; behavioral /social science research tag; child mental health service; child psychology; clinical research; clinical trials; counseling; health care service utilization; health services research tag; human subject; human therapy evaluation; interview; medically underserved population; mental health education; middle childhood (6-11); parents; patient oriented research; primary care physician; questionnaires

DESCRIPTION (provided by applicant): This Mentored Research Scientist Development Award (K01) will provide the applicant with skills to pursue an independent program of research to ultimately improve treatment for children with anxiety disorders in primary care settings. This award will be pursued within the context of the San Diego Child and Adolescent Services Research Center and the University of California San Diego where the candidate's sponsor will be Dr. Ann Garland and co-sponsor, Dr. Murray Stein. This award will allow the applicant to build on strong existing training in child anxiety and treatment outcome research. The applicant is seeking new training and experience in mental health services research to address critical issues related to service engagement (e.g., initial uptake and ongoing use of services) in order to advance effectiveness studies for traditionally underserved populations, namely those with anxiety disorders and Latino youth. The proposed training plan includes coursework and mentoring in: 1) theoretical and empirical models of health services research, 2) service utilization in Latinos, 3) qualitative methodologies, 4) service engagement and effectiveness intervention strategies, and 5) multilevel and longitudinal data analysis. The primary goal of the proposed research is to identify child and parent factors that affect service engagement and to use this information to adapt and pilot test an evidence based child anxiety intervention in the primary care setting. A secondary goal is to examine factors that affect engagement for Latino families. The research plan relies on a mixed method approach including qualitative and quantitative strategies. Participants will be recruited from pediatric primary care settings. Qualitative interviews will be conducted with 30 parents of anxious youth with met and unmet treatment need. A quantitative study with 150 families of anxious youth will also be used to identify predisposing, enabling, and need characteristics that influence engagement. Equipped with parent perspectives about barriers to care, a child anxiety treatment will be adapted to include engagement strategies and to be feasible in primary care. Families of anxious youth (N= 26) will be randomized to receive an evidence based anxiety intervention with engagement strategies or supportive therapy (N = 26). Data regarding functional and symptom improvement, treatment acceptability, initial uptake and adherence will be used to design and parameterize a larger effectiveness trial for child anxiety disorders in primary care.

描述（由申请人提供）：该指导研究科学家发展奖（K01）将为申请人提供从事独立研究计划的技能，以最终改善初级保健机构中焦虑症儿童的治疗。该奖项将在圣地亚哥儿童和青少年服务研究中心和加州大学圣地亚哥分校的背景下进行，其中候选人的赞助者将是 Ann Garland 博士，共同赞助者是 Murray Stein 博士。该奖项将使申请人能够以儿童焦虑和治疗结果研究方面现有的强大培训为基础。申请人正在寻求心理健康服务研究方面的新培训和经验，以解决与服务参与相关的关键问题（例如服务的初始接受和持续使用），以推进对传统上服务不足的人群（即患有焦虑症和拉丁裔的人群）的有效性研究青年。拟议的培训计划包括以下方面的课程和指导：1）卫生服务研究的理论和实证模型，2）拉丁美洲人的服务利用，3）定性方法，4）服务参与和有效性干预策略，以及5）多层次和纵向数据分析。拟议研究的主要目标是确定影响服务参与的儿童和家长因素，并利用这些信息来调整和试点测试初级保健机构中基于证据的儿童焦虑干预措施。第二个目标是研究影响拉丁裔家庭参与度的因素。该研究计划依赖于包括定性和定量策略的混合方法。参与者将从儿科初级保健机构招募。我们将对 30 名焦虑青少年的家长进行定性访谈，他们的治疗需求已得到满足和未得到满足。一项对 150 个焦虑青少年家庭进行的定量研究也将用于确定影响参与度的倾向、支持和需求特征。根据家长对护理障碍的看法，儿童焦虑治疗将进行调整，纳入参与策略，并在初级护理中可行。焦虑青少年的家庭 (N = 26) 将被随机分配接受基于证据的焦虑干预，包括参与策略或支持治疗 (N = 26)。有关功能和症状改善、治疗可接受性、初始接受和依从性的数据将用于设计和参数化初级保健中儿童焦虑症的更大规模有效性试验。