Resettled Refugee Families for Healing (RRF4H): A Study of the Intergenerational Impact of War Trauma and Resilience

重新安置难民家庭康复（RRF4H）：战争创伤和复原力的代际影响研究

• 批准号: 10740686
• 负责人: Nhial Timothy Tutlam
• 金额: $ 17.94万
• 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: 2023-08-10 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740686
• 关键词: 2 arm randomized control trial; Acculturation; Address; Affect; Age; Aggressive behavior; Anxiety; Area; Behavioral; Biological; Cambodian; Child; Collection; Communities; Complex; Conflict (Psychology); Country; Data; Development; Diagnostic; Discrimination; Emotional; Emotional disorder; Exploration, Preparation, Implementation, and Sustainment; Family; Generations; Goals; Grant; Health; High Prevalence; Holocaust survivor; Homicide; Imprisonment; Income; Interdisciplinary Study; Intervention; Knowledge; Literature; Longevity; Mental Depression; Mental Health; Mental Health Associations; Mental association; Mental disorders; Mentors; Methods; Modeling; Outcome; Parents; Participant; Peer Group; Population; Post-Traumatic Stress Disorders; Poverty; Problem behavior; Public Health; Randomized, Controlled Trials; Refugees; Research; Risk; School Drop-Outs; Student Dropouts; Suicide; Symptoms; System; Systems Theory; Teenagers; Testing; Torture; Training; Trauma; Veterans; Violence; War; Youth; acceptability and feasibility; antisocial behavior; arm; effectiveness testing; effectiveness/implementation trial; efficacy testing; evidence base; experience; gang; group intervention; healing; implementation determinants; implementation science; implementation strategy; improved; intergenerational; peer; peer coaching; post intervention; programs; racism; recruit; resilience; skills; social; substance use; theories; therapy design; trauma exposure; usual care arm; virtual; virtual environment; virtual group; vulnerable community; youth violence

PROJECT SUMMARY/ABSTRACT Youth from resettled refugee families are at elevated risk of developing serious mental health challenges compared to their U.S. native peers. Studies have found that refugee youth living in high income countries have high prevalence of trauma-associated mental disorders like PTSD, (19% to 54%) and depression (3% to 30%). Additionally, youth belonging to these vulnerable communities have high rates of substance use, school dropout, incarcerations, violence including gang-related homicides, with suicides emerging as a serious public health threats. The purpose of this K01 is to provide the candidate with formal training and mentoring in: (1) systematically adapting and implementing community-based interventions; (2) collection, management, and analysis of qualitative and mixed methods data; and (3) advanced implementation science research, including the application of theories and frameworks, methods for identifying and prioritizing implementation determinants, and systematic approaches to developing and testing implementation strategies. This training will prepare the candidate for independent research conducting multidisciplinary research that develops and tests community- based interventions aimed at addressing the myriad of mental health challenges among youth in resettled refugee communities. Accordingly, the candidate will conduct a type 1hybrid effectiveness-implementation trial to test a combination intervention designed to improve intergenerational trauma-related mental health symptoms among second generation refugee children (SGRC). Guided by Social Action and Family Systems theories, and applying them to the ITT framework, the proposed combination intervention consists of: family strengthening (FS) model delivered through multiple family groups (MFG) + peer mentoring program called TeenAge Health Consultants (TAHC) adapted for delivery in virtual environment (Virtual TAHC). The intervention will have the following specific aims: (1) systematically adapt an evidence-based family strengthening (FS) model delivered through multiple family groups (MFG) combined with a peer mentoring program (Virtual TAHC) (Goal 1); (2) assess preliminary short- and long-term impact of the combination intervention (MFG + Virtual TAHC) on behavioral emotional disorders (aggressive behavior, antisocial behaviors, anxiety, depression, and PTSD) related to intergenerational trauma among SGRC in the trial (Goal 2); and (3) utilizing mixed methods and applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, examine implementation strategies, facilitators, and barriers of the RRF4H intervention (Goal 3). Given the transdiagnostic application of the intervention, this study is significant because it has potential to advance our understanding on how to mitigate the intergenerational impact of war trauma among children who have not directly experienced war trauma.

项目概要/摘要 来自重新安置的难民家庭的青少年面临严重心理健康挑战的风险较高 与美国本土同行相比。研究发现，生活在高收入国家的难民青年 与创伤相关的精神障碍，如创伤后应激障碍 (PTSD)（19% 至 54%）和抑郁症（3% 至 30%）的患病率很高。 此外，属于这些弱势社区的青少年吸毒、辍学、 监禁、暴力，包括与帮派有关的凶杀，自杀已成为严重的公共卫生问题 威胁。 K01 的目的是为候选人提供以下方面的正式培训和指导：(1) 系统地调整和实施基于社区的干预措施； （二）收集、管理、 定性和混合方法数据分析； (3) 先进的实施科学研究，包括 理论和框架的应用，确定实施决定因素并确定优先顺序的方法， 以及制定和测试实施策略的系统方法。本次培训将准备 独立研究候选人进行多学科研究，开发和测试社区- 旨在解决重新安置青年中的无数心理健康挑战的干预措施 难民社区。因此，候选人将进行类型 1 混合有效性实施 测试旨在改善代际创伤相关心理健康的组合干预措施的试验 第二代难民儿童（SGRC）的症状。以社会行动和家庭系统为指导 理论，并将其应用到 ITT 框架中，建议的组合干预包括： 通过多个家庭团体 (MFG) + 同伴指导计划提供强化 (FS) 模式 青少年健康顾问 (TAHC) 适合在虚拟环境 (虚拟 TAHC) 中提供服务。干预 将有以下具体目标：（1）系统地采用基于证据的家庭强化（FS）模型 通过多个家庭小组 (MFG) 结合同伴指导计划（虚拟 TAHC）提供（目标 1）； (2) 评估联合干预（MFG + 虚拟 TAHC）对患者的初步短期和长期影响 行为情绪障碍（攻击行为、反社会行为、焦虑、抑郁和创伤后应激障碍） 与试验中 SGRC 中的代际创伤有关（目标 2）； (3) 采用混合方法 应用探索、准备、实施、维持 (EPIS) 框架，检查实施情况 RRF4H 干预的策略、促进因素和障碍（目标 3）。鉴于跨诊断应用 这项研究意义重大，因为它有可能增进我们对如何减轻影响的理解 战争创伤对没有直接经历战争创伤的儿童的代际影响。