Promoting Emotional Development Among Young Children Facing Adversity: An Effectiveness Implementation Study in St. Louis Schools

促进面临逆境的幼儿的情绪发展：圣路易斯学校的有效性实施研究

• 批准号: 10725495
• 负责人: Patricia Lynn Kohl
• 金额: $ 77.65万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10725495
• 关键词: 6 year old; Adherence; Aftercare; Behavioral; COVID-19 pandemic; Caregivers; Characteristics; Child; Child Behavior; Child Rearing; Clinical; Code; Cognitive; Communities; Complex; Consolidated Framework for Implementation Research; Cost Analysis; Cost Measures; County; Development; Early Intervention; Education; Emotional; Emotions; Family; Health Services Accessibility; Home; Hybrids; Intervention; Length; Life; Measures; Mediating; Mental Depression; Mental Health; Methods; Outcome; Outcome Measure; Outcome Study; Parent-Child Relations; Parenting Education; Parents; Population; Poverty; Prevention; Professional counselor; Psychopathology; Public Health; Quality of Care; Randomized; Resources; Risk; Schools; Social Functioning; Stress; Supportive care; System; Testing; Training; aged; caregiving; comparison intervention; cost; cost effective; cost effectiveness; depressive symptoms; effectiveness study; effectiveness testing; effectiveness/implementation design; effectiveness/implementation study; emotional functioning; experience; functional near infrared spectroscopy; high risk; implementation barriers; implementation context; implementation cost; implementation outcomes; implementation strategy; improved; improved outcome; inclusion criteria; innovation; intervention delivery; meetings; neural; optimism; post intervention; prevent; preventive intervention; primary caregiver; programs; response; school district; service delivery; symposium

Project Summary Children facing adversity are at high risk for poor socio-emotional and cognitive outcomes and later psychopathology. However, there is increasing evidence that these negative developmental trajectories can be significantly improved by enhancing nurturing caregiving early in development. Despite numerous empirically supported early interventions, these programs are not readily accessible to the majority of US children most in need. Based on this, there is an urgent need to make these interventions feasible and readily available to these communities. To do this we propose to test the effectiveness of a brief 6 session parent-child preventive intervention conducted by video conference in the family's home and study two implementation methods within 3 high-risk school districts. The intervention, entitled “THRIVE,” is a previously tested early parent child intervention piloted in a St. Louis county district which proved feasible, acceptable and appeared effective. Caregiver-child dyads aged 4.0-6.11 meeting inclusion criteria will be randomized to a THRIVE condition or an established online parenting education of comparable length. Although the use of schools as a service delivery platform will increase accessibility, this system presents unique and complex challenges for implementation of a mental health prevention. Therefore, we will use a hybrid effectiveness-implementation design to test the effectiveness of THRIVE compared to Parenting Wisely, while also assessing the impact of two forms of implementation (coaching vs. no coaching) on study outcomes. Assessments of key outcome measures, including child behavior, social, and emotional functioning, child psychopathology, parenting stress, optimism, and depressive symptoms, and changes in parenting and the parent-child dyadic relationship (observational and neural using functional near infrared spectroscopy' fNIRS) will be measured at baseline, post-treatment (P1), and 12-weeks post-treatment (P2). We will also test how the preventive intervention mechanistically targets the quality of the caregiver-child relationship by enhancing caregiver responsiveness and sensitivity via baseline, mid-treatment and post-treatment (P1) assessments. This project provides the first test of a brief parent-child early prevention accessed through schools and delivered in home by video conference with minimal therapist training to enhance access to care. It further examines the cost-effectiveness of therapist coaching as a means to improve implementation and clinical outcomes.

项目摘要 面对广告的儿童面临着社会情感和认知结果不良的高风险 后来的心理病理学。但是，有越来越多的证据表明这些负面发展 通过在开发早期增强养育护理，可以显着改善轨迹。 尽管有许多经验支持的早期干预措施，但这些程序并不容易 我们大多数最有需要的儿童都可以使用。基于此，迫切需要 使这些干预措施可行，并容易为这些社区提供。为此，我们 提议测试简短的6会长的父母预防性干预的有效性 由家庭家庭中的视频会议进行，并研究了两种实施方法 3个高风险学区。干预措施为“壮成长”，是先前测试的早期父母 在圣路易斯县区试行的儿童干预措施，该区被证明是可行的，可接受的 看起来有效。 4.0-6.11的护理人员 - 儿童二元组将参加纳入标准 随机分配到繁荣状态或已建立的在线育儿教育 长度。尽管将学校用作服务交付平台将增加可访问性，但这 系统提出了实施心理健康的独特而复杂的挑战 预防。因此，我们将使用混合有效性 - 实现设计来测试 与明智的育儿相比，成长的有效性，同时还评估了两个的影响 实施形式（教练与无教练）在学习成果上。关键的评估 结果措施，包括儿童行为，社交和情感功能，儿童 心理病理学，育儿压力，乐观和抑郁症状以及变化 育儿和亲子二聚体关系（观察和神经使用功能附近 红外光谱'FNIRS）将在基线，治疗后（P1）和12周进行测量 治疗后（P2）。我们还将测试预防干预如何将 通过增强护理人员的响应能力和敏感性，照顾者与孩子关系的质量 通过基线，治疗和治疗后（P1）评估。该项目提供了第一个 测试一个简短的亲子早期预防的早期预防，并通过学校访问并在家中送达 视频会议和最少的治疗师培训，以增强获得护理的机会。它进一步检查 治疗师教练的成本效益作为改善实施和临床的一种手段 结果。