Targeting School Climate and Children's Behavioral Health in Urban Schools

针对城市学校的学校氛围和儿童行为健康

基本信息

批准号：
8976782
负责人：
Ricardo B Eiraldi
金额：
$ 60.39万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-01-01 至 2017-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8976782
关键词：
Address Adoption African American Anxiety Anxiety Disorders Award Behavior Behavior Disorders Behavioral Centers for Disease Control and Prevention (U.S.)Child Climate Clinic Clinical Clinical effectiveness Cognitive Therapy Conduct Disorder Contracts Coping Skills Cost Analysis Development Diagnostic Discipline Disease Education Emotional Emotional disorder Evaluable Disease Evidence based intervention Generalized Anxiety Disorder Goals Grant Health Health Personnel Health Services Human Resources Impairment Improve Access Intervention Latino Lead Leadership Learning Low income Mental Health Mental Health Services Minority Mission National Institute of Child Health and Human Development Oppositional Defiant Disorder Outcome Participant Perception Philadelphia Population Prevention Productivity Professional counselor Program Development Provider Randomized Reading Research Infrastructure Research Support Resources Risk Safety School Health Services Schools Secondary to Separation Anxiety Disorder Services Severities Social Phobia Source Strategic Planning Students Supervision Support Groups Support System Symptoms Training Training Support Work academic preparation behavioral health child mental health service cohort cost cost effective cost effectiveness design disorder prevention ethnic minority population externalizing behavior health disparity high risk improved member minority children programs racial and ethnic school district social stigma success urban children

项目摘要

DESCRIPTION (provided by applicant): Unmet need for mental health services is extraordinarily high among urban children of diverse racial/ethnic backgrounds. As overall need continues to rise, schools are fast becoming the main source of mental health services for children. Externalizing behavior disorders and anxiety disorders are highly prevalent in low-income urban children. Unfortunately, evidence-based interventions (EBI) for those disorders are seldom employed in urban schools. School-Wide Positive Behavior Support (SWPBS), a multi-level services delivery strategy that combines universal and targeted interventions, has been found to be effective in improving school climate, perceived school safety, and student reading scores. Targeted group cognitive behavioral therapy (GCBT) can be provided to at-risk and high-risk students as part of the SWPBS system. Unfortunately, SWPBS and GCBT are seldom employed in under-resourced urban schools, in part, because school districts do not have enough resources to contract outside providers with expertise in EBIs for behavioral health problems. Also, widespread deployment of EBIs to "real world" settings has been hampered by problems such as inadequate training of service providers and poor implementation fidelity. The creation of mechanisms for the training and support of counselors and other school personnel that focus on maintaining high implementation fidelity and integrity can facilitate a significant increase in the use of EBIs in urban schools and contribute to lowering behavioral health disparities. The overall purpose of this project is to determine whether school personnel implementing a two-tier SWPBS program for typically developing children and children with, or at risk for, externalizing or anxiety disorders, can implement the components of the program with the same level of fidelity and integrity and clinical effectiveness when they receive a Low Level of Support (LLS) from their coaches and supervisors as compared to a High Level of Support (HLS). We also want to determine whether school personnel who receive HLS for two years could continue to implement the components of the program with a similar level of fidelity and integrity and clinical effectiveness while receiving LLS during the following two years. We will calculate the total costs and net costs associated with the development and implementation of the SWPBS program. The study uses a cohort-sequential design and follows 6 separate K-8 schools in the Philadelphia School District, yielding approximately 48 leadership team members, 180 school personnel, and 3,900 students in Tier 1, and 12 counselors, 84 groups of 4-5 children with, or at risk for, oppositional defiant disorder or conduct disorder in each CBT group, and 3-4 children with, or at risk for, generalized anxiety disorder, separation anxiety disorder, o social phobia in each CBT group, for a total of 306 evaluable child participants. Schools will be randomly assigned to receive either HLS or LLS from project staff. The proposed study is consistent with the current strategic plan of the National Institute of Child Health and Human Development (NICHD), particularly the commitment to support research that addresses barriers to school readiness and academic success for minority and low-income children.

描述（由申请人提供）：不同种族/民族背景的城市儿童对心理健康服务的未满足需求非常高。随着总体需求持续上升，学校正迅速成为儿童心理健康服务的主要来源。外化行为障碍和焦虑症在低收入城市儿童中非常普遍。不幸的是，城市学校很少采用针对这些疾病的循证干预措施（EBI）。全校积极行为支持 (SWPBS) 是一种结合了普遍性和针对性干预措施的多层次服务提供策略，已被发现可有效改善学校氛围、学校安全意识和学生阅读成绩。作为 SWPBS 系统的一部分，可以向高危和高危学生提供目标群体认知行为治疗 (GCBT)。不幸的是，SWPBS 和 GCBT 很少在资源贫乏的城市学校中使用，部分原因是学区没有足够的资源来与具有行为健康问题 EBI 专业知识的外部提供商签约。此外，EBI 在“现实世界”环境中的广泛部署也受到服务提供商培训不足和实施保真度差等问题的阻碍。建立对辅导员和其他学校工作人员进行培训和支持的机制，重点是保持高度的实施忠诚度和完整性，可以促进城市学校 EBI 的使用大幅增加，并有助于降低行为健康差异。该项目的总体目的是确定为典型发育儿童和患有外化障碍或焦虑症或有风险的儿童实施两层 SWPBS 计划的学校工作人员是否能够以相同的保真度实施该计划的各个组成部分与高水平支持 (HLS) 相比，当他们从教练和主管那里获得低水平支持 (LLS) 时，他们会表现出诚信和临床有效性。我们还想确定接受 HLS 两年的学校人员在接下来的两年内接受 LLS 时是否可以继续以类似的保真度、完整性和临床有效性水平实施该计划的组成部分。我们将计算与 SWPBS 计划的开发和实施相关的总成本和净成本。该研究采用队列序贯设计，跟踪费城学区 6 所独立的 K-8 学校，得出约 48 名领导团队成员、180 名学校工作人员和 3,900 名 1 级学生以及 12 名辅导员、84 个 4-5 人小组每个 CBT 组中患有对立违抗障碍或行为障碍或有风险的儿童，每个 CBT 组中有 3-4 名患有广泛性焦虑症、分离焦虑症或社交恐惧症或有患广泛性焦虑症、分离焦虑症或社交恐惧症风险的儿童，总共 306 名可评估儿童参与者。学校将被随机分配接受项目工作人员提供的 HLS 或 LLS。拟议的研究符合国家儿童健康和人类发展研究所（NICHD）当前的战略计划，特别是承诺支持解决少数民族和低收入儿童入学准备和学业成功障碍的研究。