A Brief Intervention to Enhance Supportive Parenting and Treatment Engagement Among Families Waiting for Trauma-Focused Services

一项简短的干预措施，以加强等待创伤重点服务的家庭的支持性养育和治疗参与

• 批准号: 10644434
• 负责人: Caitlin Rancher
• 金额: $ 12.86万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-14 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644434
• 关键词: Address; Adverse effects; Affect; Aggressive behavior; Applied Skills; Area; Attitude; Award; Benchmarking; Buffers; COVID-19 pandemic; Caregiver support; Caregivers; Caring; Characteristics; Child; Child Abuse and Neglect; Child Development; Child Rearing; Communication; Consolidated Framework for Implementation Research; Consultations; Data; Development; Disadvantaged; Educational process of instructing; Educational workshop; Emotional; Ensure; Epidemic; Faculty; Family; Funding; Future; Goals; Health Personnel; Hybrids; Instruction; Interruption; Intervention; Interview; Knowledge; Literature; Mediator; Mental Health; Mentors; Mentorship; Methodology; Methods; Modeling; Patients; Persons; Phase; Provider; Public Health; Qualitative Methods; Randomized, Controlled Trials; Research; Research Activity; Research Personnel; Rural; Self Efficacy; Services; Statistical Data Interpretation; Suspensions; Technology; Testing; Time; Training; Transportation; Trauma; Underserved Population; Videoconferencing; Violence; Waiting Lists; Work; acceptability and feasibility; barrier to care; brief intervention; career; caregiver interventions; child services; contextual factors; design; dissemination strategy; effective intervention; effectiveness testing; experience; health disparity; implementation framework; implementation science; improved; innovation; pediatric trauma; pilot trial; programs; recruit; research study; response; satisfaction; scale up; service delivery; skills; suicidal; telehealth; tenure track; theories; therapy design; trauma exposure; trauma symptom; traumatic event; traumatized children; treatment as usual; trend; uptake

PROJECT SUMMARY Over two-thirds of children experience traumatic events such as child maltreatment, violence, or sudden or violent loss. Many of these children sustain significant emotional and developmental difficulties including trauma symptoms, aggression, and suicidality. Emotional support from a caregiver is theorized to buffer against the effects of trauma; however, many caregivers lack the self-efficacy and skills to effectively support their child, or struggle to apply these skills during the stressful time following trauma. Unfortunately, programs designed for caregivers following child trauma are scarce. Existing interventions are lengthy (lasting 8-20 sessions) and result in families placed on long waitlists. This proposal asserts the adverse effects of child trauma can be interrupted though a brief intervention (the Project Support Positive Parenting Module) that enhances supportive parenting – delivered via telehealth to families on waitlists for trauma-focused services. Pilot data collected by the candidate suggests this intervention can be delivered by paraprofessionals, improve parenting self-efficacy and emotional support, and increase later trauma-focused treatment attendance. However, the provider characteristics (e.g., knowledge, experiences), as well as inner (e.g., organizational support) and outer (e.g., patient needs, attitudes) contextual factors that influence uptake of a brief intervention for families on the waitlist for trauma services is unknown. Aims 1 and 2 comprise the K99 Mentored Research Phase and Aim 3 comprises the R00 Independent Research Phase. Specific Aims include: 1) examine barriers and facilitators to delivering Project Support via telehealth with n = 20 caregivers and n = 10 treatment providers; 2) examine the feasibility and acceptability of Project Support via telehealth in a mixed-methods proof-of-concept pilot trial with n = 30 families waiting for trauma-focused services and n = 4 treatment providers; and 3) evaluate the preliminary efficacy of Project Support in a randomized controlled trial (Project Support vs. treatment as usual) among n = 100 families waiting for trauma-focused services. The proposed research activities coincide with training that will support the candidate’s transition to an independent investigator. In the K99 phase the candidate will receive training via coursework, workshops, and consultation in: (1) implementation science frameworks and dissemination strategies, (2) qualitative and mixed methodology, and (3) grantsmanship and scientific communication. Mentorship and consultation from experts in child trauma, caregiver-child relationships, implementation science, qualitative methods, and statistical analyses will ensure training goals are met. This proposal will support the candidate’s long-term career goal to become an independently funded tenure track faculty who advances the field of child trauma research by studying the consequences of children’s trauma exposure and developing and testing innovative parenting-based interventions for victims of trauma and their families. This K99/R00 mechanism is a critical step to obtaining the experience and independence necessary to obtain this goal.

项目摘要 超过三分之二的儿童经历了创伤事件，例如儿童虐待，暴力或突然或 暴力损失。这些孩子中的许多人都具有重大的情感和发育困难，包括创伤 症状，侵略性和自杀性。从理论上讲，照顾者的情感支持是针对的 创伤的影响；但是，许多照顾者缺乏自我效能和技能，无法有效地抚养孩子，或者 在创伤后的压力很大的时期内努力运用这些技能。不幸的是，为专为 儿童创伤后的护理人员很少。现有干预措施是漫长的（持续8-20次）和结果 在家庭中的家庭中。该建议断言儿童创伤的不利影响可能会中断 尽管简短的干预措施（该项目支持积极的育儿模块）可以增强支持性育儿 - 通过远程医疗交付给家庭候补名单以进行创伤的服务。候选人收集的试点数据 建议该干预可以由专业人士提供，改善育儿自我效能和情感 支持，并增加以创伤为重点的治疗。但是，提供商特征（例如 知识，经验）以及内在（例如组织支持）和外部（例如，患者需求，参加） 影响家庭对创伤服务候补名单上的短暂干预措施吸收的情境因素是 未知。目标1和2包括K99指导的研究阶段，目标3包括R00独立 研究阶段。具体目的包括：1）考试障碍和促进者通过 具有n = 20名护理人员的远程医疗，n = 10个治疗提供者； 2）检查可行性和可接受性 在混合方法证明试点试验中，通过远程医疗的项目支持，n = 30个家庭等待 以创伤为中心的服务和n = 4个治疗提供者； 3）评估项目的初步效率 在n = 100个家庭中的随机对照试验中的支持（项目支持与治疗）等待 用于创伤的服务。拟议的研究活动与将支持的培训一致 候选人向独立调查员的过渡。在K99阶段，候选人将通过 课程，讲习班和咨询：（1）实施科学框架和传播 策略，（2）定性和混合方法，以及（3）授予技巧和科学交流。 来自儿童创伤，照顾者与孩子关系，实施科学专家的指导和咨询 定性方法和统计分析将确保实现培训目标。该建议将支持 候选人的长期职业目标是成为一名独立资助的任期教师 儿童创伤研究领域通过研究儿童的创伤和发展和发展和 测试基于创新的育儿干预措施，以侵犯创伤及其家人。此K99/R00 机制是获得获得此目标所必需的经验和独立性的关键步骤。