Scaling a Parenting EBI for Latinx Youth Mental Health in Primary Care

扩大初级保健中拉丁裔青少年心理健康的育儿 EBI

• 批准号: 10684435
• 负责人: C. HENDRICKS BROWN
• 金额: $ 77.29万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10684435
• 关键词: 17 year old; Adolescence; Adolescent; Adoption; Adult; Affect; Age; Anxiety; Behavior Therapy; Child; Child Rearing; Childhood; Chronic; Clinic; Communication; Development; Disease; Drug usage; Early Intervention; Education; Employment; Engineering; Family; Feeling suicidal; Goals; Health; Health Insurance; Hispanic; Impairment; Interruption; Intervention; Knowledge; Latinx; Mediating; Medicine; Mental Depression; Mental Health; Mental disorders; Mental health promotion; Not Hispanic or Latino; Outcome; Participant; Pathway interactions; Prevention; Prevention program; Primary Care; Provider; Psyche structure; Randomized; Recording of previous events; Reporting; Research; Resources; Risk Factors; Schools; Severities; Sexually Transmitted Diseases; Substance Use Disorder; Suicide attempt; Symptoms; System; Testing; Time; United States National Academy of Sciences; Youth; adolescent health; anxiety symptoms; communication behavior; cost effective; depressive symptoms; design; disparity reduction; drug abuse prevention; drug misuse; drug use behavior; eHealth; effectiveness evaluation; emerging adult; ethnic minority; evidence base; experience; externalizing behavior; health disparity; hybrid type 1 trial; ideation; implementation process; implementation/effectiveness; improved; intervention delivery; intervention effect; maladaptive behavior; minority children; peer; prevent; preventive intervention; primary care setting; programs; protective factors; reduce symptoms; reducing suicide; single episode major depressive disorder; social; socioeconomic disadvantage; standard of care; statistics; suicidal behavior; theories; therapy design

Project Summary The prevention of adolescent mental health disorders is an underused but scientifically justified approach to improving the public’s mental health. Youth with mental health disorders before the age of 18 have poorer outcomes in education, social, employment, and health compared with youth without mental health or substance use disorders. Hispanic youth report higher rates of depressive and anxiety symptoms, drug use, suicide ideation and attempts, compared to their non-Hispanic White peers. Interventions designed to interrupt the sequelae of mental health disorders and other poor outcomes are imperative for maximizing health among Hispanic youth. Familias Unidas, which was highlighted in the National Academies of Sciences, Engineering, and Medicine prevention report, has been found to be efficacious and effective in the reduction and/or prevention of adolescent health problems. Familas Unidas has had crossover effects on internalizing symptoms for youth who report low family communication, the intervention’s primary mediational pathway. It has also reduced suicide ideation rates for youth reporting this same mediational pathway of poor family communication. The online adaptation of Familias Unidas, eHealth Familias Unidas, has also been found to reduce adolescent health problems. However, to date, evidence-based preventive interventions such as Familias Unidas and eHealth Familias Unidas have largely been tested in schools and delivered mostly by research staff. Evaluating these interventions in real world studies of primary care and understanding the implementation processes that facilitate or impede the integration of interventions in systems is key to improving mental health and reducing disparities in the U.S. The goal of the proposed application is to evaluate in an effectiveness-implementation type I hybrid trial, an enhanced version of eHealth Familias Unidas for reducing depressive and anxious symptoms as well as suicide behavior in Hispanic youth. Using a randomized rollout design of 18 clinics, the study’s aims are: AIM 1: Evaluate the effectiveness of eHealth Familias Unidas for Mental Health in preventing/reducing depressive, anxiety symptoms, suicide ideation and behavior, and drug misuse among those screened as having poor family communication or elevated levels of depressive or anxiety symptoms, or a history of suicide behavior (ideation or attempts); AIM 2: Determine whether intervention effects are partially mediated by family communication and externalizing behaviors, including drug misuse, and moderated by parental depression; and Exploratory AIM 3: Intervention impact on mental health and drug misuse as well as sustainment will vary by quality of implementation at the levels of clinic and clinician. Participants will be assed at baseline, 3, 6, and 18-months post baseline.

项目摘要 预防青少年心理健康障碍是一种未充分利用但科学上合理的方法 改善公众的心理健康。 18岁以前精神疾病的青年患有较差 与没有心理健康的青年相比，教育，社会，就业和健康的成果或 物质使用障碍。西班牙裔青年报告的抑郁症状和动画症状率更高，吸毒， 与非西班牙裔白人同龄人相比，自杀的想法和尝试。旨在中断的干预措施 精神健康障碍和其他不良结果的后遗症对于最大化健康至关重要 西班牙裔青年。 Familias Unidas，在美国国家科学学院，工程学学院强调 和医学预防报告已被发现在减少和/或 预防青少年健康问题。 Familas Unidas对内在化产生了跨界影响 报告家庭交流低下的年轻人的症状，这是干预措施的主要中介途径。 还降低了自杀率的想法率，以报告贫穷家庭的同样中介途径 沟通。还发现Familias Unidas的在线改编，Ehealth Familias Unidas，也已被发现 减少青少年健康问题。但是，迄今为止，基于证据的预防干预措施，例如 Familias Unidas和Ehealth Familias unidas在学校很大程度上进行了测试，主要由 研究人员。评估这些干预措施在现实世界中的初级保健研究和理解 促进或阻碍系统中干预措施集成的实施过程是 改善心理健康并减少美国的差异，拟议申请的目标是评估 在I型I型混合试验中 减少西班牙裔青年的抑郁和焦虑症状以及自杀行为。使用随机 这项研究的推出设计是：AIM 1：评估eHealth famias unidas的有效性 为了防止/减轻抑郁症，焦虑症状，自杀的想法和行为以及 在被筛查的那些毒品遗嘱中，家庭交流或抑郁水平较高或 动画符号或自杀行为的历史（构想或尝试）；目标2：确定是否 干预效应部分是由家庭交流和外在行为（包括药物）介导的 小姐，并由父母抑郁症主持；和探索目的3：干预对心理健康的影响 滥用毒品以及维持的情况会因诊所水平的实施质量而异 临床。参与者将在基线后的基线，3、6和18个月的基线时进行评估。

项目成果

eHealth Familias Unidas Mental Health: Protocol for an effectiveness-implementation hybrid Type 1 trial to scale a mental health preventive intervention for Hispanic youth in primary care settings.

• DOI: 10.1371/journal.pone.0283987
• 发表时间: 2023
• 期刊: PloS one
• 影响因子: 3.7

Measurement Invariance of Family Functioning Among Latina/o/x Sexual Minority Youth and Heterosexual Latina/o/x Youth.

拉丁/o/x 性少数青少年和异性恋拉丁/o/x 青少年家庭功能的测量不变性。

• DOI: 10.1080/27703371.2023.2217096
• 发表时间: 2023
• 期刊: LGBTQ+ family : an interdisciplinary journal
• 作者: Lozano,Alyssa;Ocasio,ManuelA;Boga,DevinaJ;Fernandez,Alejandra;Hodge,Shanelle;Estrada,Yannine;Cano,MiguelÁngel;Prado,Guillermo
• 通讯作者: Prado,Guillermo