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.

全球难民人数空前增加，约有 26 人截至 2019 年底，有 100 亿男性、女性和儿童被迫流离失所。其中一半以上世界上的难民居住在人口稠密的城市地区或中低收入国家的难民营中。在这些背景下，难民永久定居在高收入国家的比例有所上升。战争和强迫移民也会导致社会系统性混乱。关系，包括家庭分离、紧张和冲突以及社交网络的丧失。关于难民心理健康和心理社会需求的模型的新兴证据基础，但存在重大差距关于如何针对难民群体采取基于证据的干预措施（EBI）并维持这些措施为了解决这些差距，我的职业目标是建立一个独立的研究计划。重点是为全国各地的难民社区提供以社区为基础的心理健康服务我的目标是与社区合作伙伴合作，研究整合方法。将 EBI 纳入非传统服务环境，使难民能够获得预防和护理干预措施，我的研究寻求解决的一个核心问题是如何最好地促进积极的心理健康结果。调动社会和家庭资源来增强应对能力和福祉。我在美国与受战争影响的人群一起工作超过十五年的临床实践经验在全球范围内，芝加哥大学的博士培训和早期的研究经历是这个K01申请的重点。旨在发挥我的优势并在实现目标所需的关键领域发展新的知识和技能我的长期目标集中在 1) 实施科学方法来适应、扩大规模和在社区环境中维持 EBI；2) 将以人为本的设计应用于基于社区的难民心理健康服务；3) 基于社区的试验设计和分析。多学科的导师团队，我将把这些技能应用到一个研究项目中，该项目的重点是实施在两个基于社区的社区中，由同伴主导的多家庭群体 (MFG) 预防干预措施（称为 CAFES）芝加哥的组织通过试点促进吸收并满足难民家庭的多层次需求。随机1型混合实施-有效性设计，研究目标包括：1）适应为叙利亚难民家庭提供多家庭咖啡馆模式，并由基于社区的同行提供者提供服务使用 ADAPT-ITT 框架和以人为本的设计方法的组织 2) 试点适应性；用于评估科学实施领域的 CAFES 模型；以及 3) 探索心理健康的变化利用新知识和变革的成果以及家庭和社区的支持和机制。从这个K01获得的技能和试点研究数据，我将准备一个R01提案来进一步测试模型实施和有效性。