Resilient Families (R-FAM): A dyadic resiliency intervention for parents of babies in neonatal intensive care

弹性家庭（R-FAM）：针对新生儿重症监护室婴儿父母的二元弹性干预

• 批准号: 10570750
• 负责人: Victoria Ann Grunberg
• 金额: $ 16.92万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570750
• 关键词: Acute; Address; Admission activity; Anxiety; Awareness; Benchmarking; Birth; Caregivers; Child; Child Development; Child Health; Child Rearing; Childbirth; Chronic; Clinical; Clinical Investigator; Cognitive; Collaborations; Communication; Complex; Couples; Cultural Backgrounds; Development; Distress; Education; Emotions; Enrollment; Ensure; Environment; Event; Family; Family Relationship; Fathers; Focus Groups; Fright; Funding; Future; Goals; Health; Healthcare; High-Risk Pregnancy; Home; Hospital Costs; Hospitalization; Hybrids; Impairment; Individual; Institution; Intervention; Interview; Life; Link; Maternal Health; Medical; Medicine; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Modeling; Morbidity - disease rate; Mothers; National Institute of Child Health and Human Development; Neonatal; Neonatal Intensive Care; Neonatal Intensive Care Units; Newborn Infant; Nurses; Outcome; Pamphlets; Parent-Child Relations; Parents; Patient Care; Perinatal; Physicians; Prognosis; Psychologist; Psychosocial Assessment and Care; Publications; Qualitative Methods; Research; Research Design; Research Personnel; Resources; Risk; Same-sex; Self Efficacy; Single Parent; Single-Parent Family; Social Workers; Social support; Strategic Planning; Stress; Structure; Surgeon; Testing; Time; Training; Training Programs; Transact; Trauma; Uncertainty; United States National Institutes of Health; Woman; Work; acceptability and feasibility; arm; burnout; career; career development; clinical care; coping; cost outcomes; cultural health; effectiveness trial; emotional distress; emotional experience; experience; family management; feasibility testing; follow up assessment; hospital utilization; implementation trial; improved; improved outcome; innovation; medical schools; meetings; mid-career faculty; mindfulness; multidisciplinary; neonatal health; neonatal period; novel; parental role; post-traumatic stress; prevent; programs; promote resilience; psychosocial; randomized, clinical trials; reproductive; resilience; satisfaction; skills; social; standard of care; stress management; success; theories; therapy design; treatment as usual; virtual; virtual delivery

PROJECT SUMMARY This K23 proposal details a 5-year training program that will help launch my career as an independent clinical investigator who develops, tests, adapts, and implements resiliency interventions for families managing stressful reproductive life events. I propose an innovative and clinically meaningful research and training plan consistent with my career development goals. Background: With 400,000 U.S. newborns admitted to Neonatal Intensive Care Units (NICU) annually, up to 50% of their parents experience emotional distress (depression, anxiety, posttraumatic stress) during and after hospitalization. Emotional distress can negatively impact couple and family adjustment, and in turn, child health and development. Building resiliency in parents early during the NICU journey is key to improve family and child outcomes. Specific aims and research design: My goal is to develop, refine, and test the feasibility and acceptability of an innovative, resiliency intervention (“Resilient Families;” R-FAM) for parental dyads (couples) with babies in the NICU. To achieve this goal, my aims are three-fold: (1) develop R-FAM using stakeholder input from interviews with parent dyads (N=20) and focus groups with NICU staff (N=4); (2) optimize R-FAM through an open pilot (N=5 dyads) with pre/post assessments and exit interviews; and (3) test R-FAM for feasibility and acceptability (N=50 dyads) through a pilot randomized clinical trial of R-FAM compared with a minimally enhanced usual control (MEUC). Findings will inform a subsequent R01 hybrid efficacy-effectiveness trial (R-FAM versus MEUC) and future R01 mechanistic, adaptation, and implementation trials. Training and mentoring: My research aims are supported by three training goals: (1) qualitative methods, including longitudinal, dyadic interviews and focus groups; (2) intervention design and optimization using mixed methods; and (3) conduct dyadic randomized clinical trials. My research and training goals are supported by: (1) expert mentors (Vranceanu & Lerou) and advisors (Patterson, Kaimal, & Parker); (2) a rich and supportive institutional environment; and (3) targeted coursework, scientific meetings, trainings, and planned publications. Relevance to NICHD. This K23 directly aligns with NICHD’s funding priorities to improve treatment and wellness of women and families who experience high-risk pregnancy-related morbidities (Strategic Plan 3). Impact: This K23 award will provide me with the research experience, collaborations, mentorship, and training I need to become an independent and successful clinical investigator in perinatal-neonatal health. I hope to develop, adapt, test, and implement resiliency interventions that aim to improve emotional distress and relationships in families during the perinatal-neonatal period. If successful, this work can help inform future adaptations of R-FAM (R01s) that meet the unique needs of different families, such as single parents, parents coping with loss, non-romantic dyads, and families from diverse cultural backgrounds. R-FAM has the potential to set a new standard of NICU psychosocial care—therefore improving the outcomes and culture of these healthcare units across the globe.

项目概要 这份 K23 提案详细介绍了一项为期 5 年的培训计划，该计划将有助于开启我作为独立临床研究者的职业生涯 谁为管理生殖生活压力事件的家庭制定、测试、调整和实施弹性干预措施。 我提出了一个与我的职业发展目标相一致的创新且具有临床意义的研究和培训计划。 背景：美国每年有 400,000 名新生儿入住新生儿重症监护病房 (NICU)，其中高达 50% 住院期间和住院后，父母会经历情绪困扰（抑郁、焦虑、创伤后压力）。 痛苦会对夫妻和家庭的适应产生负面影响，进而影响儿童的健康和发展。 在新生儿重症监护病房 (NICU) 旅程的早期阶段对父母进行干预是改善家庭和儿童结局的关键 具体目标和研究设计： 我的目标是开发、完善和测试创新的弹性干预措施的可行性和可接受性（“弹性干预措施”） 家庭；”R-FAM）针对新生儿重症监护病房的父母（夫妇）。为了实现这一目标，我的目标有三个：（1） 使用利益相关者从对家长二人组 (N = 20) 和新生儿重症监护病房工作人员 (N = 4) 焦点小组访谈中提供的意见来制定 R-FAM； (2) 通过开放试点（N=5 组）以及前/后评估和退出访谈来优化 R-FAM；以及 (3) 测试 R-FAM； 通过 R-FAM 的试点随机临床试验与最低限度的比较来确定可行性和可接受性（N=50） 增强常规控制 (MEUC) 的结果将为随后的 R01 混合功效-效果试验（R-FAM 与 R-FAM 对比）提供信息。 MEUC）和未来的 R01 机制、适应和实施试验 培训和指导：我的研究目标。 由三个培训目标支持：（1）定性方法，包括纵向访谈、二元访谈和焦点小组； (2) 使用混合方法进行干预设计和优化；(3) 进行二元随机临床试验。 研究和培训目标由以下人员支持：(1) 专家导师（Vranceanu 和 Lerou）和顾问（Patterson、Kaimal 和 Parker）；（2）丰富且支持性的制度环境；以及（3）有针对性的课程、科学会议、培训和 与 NICHD 的相关性 本 K23 与 NICHD 改善治疗的资助优先事项直接一致。 以及患有高风险妊娠相关疾病的妇女和家庭的健康（战略计划 3）。 这个 K23 奖项将为我提供成为一名科学家所需的研究经验、合作、指导和培训。 我希望能够开发、调整、测试和实施围产期新生儿健康方面的独立且成功的临床研究者。 旨在改善围产期-新生儿期间的情绪困扰和家庭关系的弹性干预措施 如果成功，这项工作可以帮助为 R-FAM (R01s) 的未来调整提供信息，以满足不同人群的独特需求。 家庭，例如单亲父母、应对失去亲人的父母、非浪漫的夫妻以及来自不同文化的家庭 R-FAM 有潜力为 NICU 心理社会护理制定新标准，从而改善治疗结果。 全球这些医疗保健单位的文化和文化。