Leveraging Implementation Science and Design Methods to Sustain Community-Based Mental Health Services for Refugees

利用实施科学和设计方法为难民维持基于社区的心理健康服务

基本信息

批准号：
10525624
负责人：
Mary Bunn
金额：
$ 18.69万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
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：
2022-09-08 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10525624
关键词：
Address Adopted Adoption Adult Affect Area Attention Caring Characteristics Chicago Child Child Mental Health Coffee Collaborations Communities Community Practice Community Services Complex Conflict (Psychology)Country Coupled Data Education Effectiveness Effectiveness of Interventions Evidence based intervention Family Family Relationship Focus Groups Foundations Funding Future Goals Health Resources Health Services Accessibility Home Hybrids Improve Access Income Individual Intervention Knowledge Life Experience Mediating Mental Health Mental Health Services Mental disorders Mentored Research Scientist Development Award Mentors Methods Modeling National Institute of Mental Health Outcome Partnership Practice Personal Satisfaction Pilot Projects Population Prevention Process Provider Randomized Refugee Camp Refugees Research Research Personnel Research Priority Research Project Grants Resources Risk Risk Factors Service setting Services Social Network Stress and Coping Structure Syria System Testing Time Training Trauma Universities War Well in self Woman Work base care systems career clinical practice community organizations community partnership community setting coping design effectiveness implementation design effectiveness implementation study evidence base experience group intervention health disparity help-seeking behavior human centered design implementation design implementation evaluation implementation science low and middle-income countries men migration military family multidisciplinary peer practice setting preference prevention service preventive intervention programs psychosocial research study scale up service organization skills social social relationships stressor tool trauma exposure trial design uptake urban area violence exposure

项目摘要

There has been an unprecedented increase in the number of refugees worldwide, with approximately 26 million men, women and children forcibly displaced from their homes at the end of 2019. More than half of the world’s refugees live in dense urban areas or refugee camps in low- and middle-income countries. A smaller percentage are permanently resettled in high-income countries. Across these contexts, refugees have elevated rates of common mental disorders. War and forced migration also contribute to systematic disruptions in social relationships including family separation, tension and conflict, and losses of social networks. There is an emerging evidence base of models regarding refugees’ mental health and psychosocial needs, but major gaps exist regarding how to adapt evidence-based interventions (EBIs) to refugee populations and sustain them in community settings. To address these gaps, my career goal is to establish an independent research program focused on the implementation of community-based mental health services for refugee communities across the displacement continuum. In collaboration with community partners, I aim to examine methods for integrating EBIs into non-traditional service settings to enable refugees’ access to prevention and care interventions that promote positive mental health outcomes. A central concern my research seeks to address is how to best mobilize social and family resources to enhance coping and wellbeing. These research priorities are shaped by my more than fifteen years of clinical practice experience working with war-affected populations in the U.S and globally, doctoral training at the University of Chicago and early research experiences. This K01 application is structured to build upon my strengths and develop new knowledge and skills in key areas needed to achieve my long-term goals. My training aims focus on 1) implementation science methods to adapt, scale up and sustain EBIs in community settings; 2) the application of human-centered design to community-based refugee mental health services; and 3) community-based trial design and analysis. With support from an accomplished multidisciplinary team of mentors, I will apply these skills to a research project that focuses on implementing a peer-led multiple family group (MFG) prevention intervention called CAFES in two community-based organizations in Chicago to promote uptake and meet the multi-level needs of refugee families. Using a pilot randomized type 1 hybrid implementation-effectiveness design, the research aims include: 1) Adapting the multiple family CAFES model for Syrian refugee families and delivery by peer providers in community-based organizations using the ADAPT-ITT framework and human-centered design methods; 2) Piloting the adapted CAFES model to assess implementation science domains; and 3) Exploring changes in mental health outcomes and family and community support and mechanisms of change. Drawing on the new knowledge and skills and pilot study data obtained from this K01, I will prepare an R01 proposal to further test the model implementation and effectiveness.

全球难民数量有前所未有的增加，约有26个 2019年底，有百万的男人，女人和儿童被强行从家中流离失所。世界难民生活在茂密的城市地区或低收入国家的难民营。较小百分比在高收入国家永久安置。在这些情况下，难民提升了常见的精神障碍率。战争和强迫迁移也有助于社会系统中断关系包括家庭分离，紧张和冲突以及社交网络的损失。有一个有关难民心理健康和社会心理需求的模型的新兴证据基础，但主要差距存在如何适应基于证据的干预措施（EBI）来难民人口并维持他们社区设置。为了解决这些差距，我的职业目标是建立一个独立的研究计划专注于为各个跨越难民社区实施社区心理健康服务位移连续体。与社区合作伙伴合作，我旨在研究整合的方法 EBIS进入非传统服务设置，以使难民获得预防和护理干预措施促进积极的心理健康结果。我的研究试图解决的核心问题是如何做到最好动员社会和家庭资源以增强应对和福祉。这些研究的重点是由我有十五年以上的临床实践经验在美国与受战争影响的人群一起工作在全球范围内，芝加哥大学和早期研究经验的博士培训。此K01应用程序是结构旨在基于我的优势，并在实现需要的关键领域发展新的知识和技能我的长期目标。我的培训旨在关注1）实施科学方法以适应，扩展和在社区环境中维持EBI； 2）以人为中心的设计在社区难民中的应用心理健康服务； 3）基于社区的试验设计和分析。在成就的支持下多学科导师团队，我将把这些技能应用于一个研究项目，该研究重点是实施在两个基于社区的咖啡馆中，由同伴领导的多个家庭组（MFG）预防干预措施称为咖啡馆芝加哥的组织促进吸收并满足难民家庭的多层次需求。使用飞行员随机类型1混合实施效应设计，研究目的包括：1）适应叙利亚难民家庭的多个家庭咖啡馆模式和同伴提供者在基于社区的供应商的交付使用Adapt-ITT框架和以人为本的设计方法的组织； 2）驾驶改编评估实施科学领域的咖啡馆模型； 3）探索心理健康的变化结果，家庭以及社区的支持和变革机制。利用新知识和从该K01获得的技能和试点研究数据，我将准备R01提案以进一步测试模型实施和有效性。