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.

项目摘要/摘要 重新安置难民家庭的年轻人面临严重心理健康挑战的风险较高 与他们的美国本地同龄人相比。研究发现，居住在高收入国家的难民青年有 诸如PTSD（19％至54％）和抑郁症（3％至30％）等创伤相关的精神疾病的高患病率。 此外，属于这些脆弱社区的青年具有很高的药物使用率，学校辍学的率， 监禁，包括帮派相关凶杀在内的暴力行为，自杀是一种严重的公共卫生 威胁。该K01的目的是为候选人提供正规培训和指导：（1） 系统地适应和实施基于社区的干预措施； （2）收集，管理和 分析定性和混合方法数据； （3）高级实施科学研究，包括 理论和框架的应用，识别和优先确定实施确定因素的方法， 以及制定和测试实施策略的系统方法。这项培训将为 独立研究的候选人进行多学科研究，开发和测试社区 - 基于干预措施旨在应对青年人在重新安置的青年中众多的心理健康挑战 难民社区。因此，候选人将进行1型杂化有效性实施 试验以测试旨在改善代际创伤相关心理健康的组合干预措施 第二代难民儿童（SGRC）的症状。在社会行动和家庭系统的指导下 理论，并将它们应用于ITT框架，拟议的组合干预措施包括：家庭 通过多个家庭群体（MFG） +同行指导计划提供的加强（FS）模型称为 青少年健康顾问（TAHC）适用于虚拟环境（虚拟TAHC）。干预 将具有以下具体目标：（1）系统地适应基于证据的家庭加强（FS）模型 通过多个家庭团体（MFG）与同行指导计划（Virtual TAHC）交付（目标 1）; （2）评估组合干预（MFG +虚拟TAHC）的初步短期和长期影响 行为情绪障碍（侵略性行为，反社会行为，焦虑，抑郁和PTSD） 在试验中，与SGRC之间的代际创伤有关（目标2）； （3）使用混合方法和 应用探索，准备，实施，维持（EPIS）框架，检查实施 RRF4H干预的策略，促进者和障碍（目标3）。给定经诊断的应用 干预措施，这项研究很重要，因为它有可能提高我们对如何减轻的理解 战争创伤对没有直接遭受战争创伤的儿童的代际影响。