Jump Start+:COVID Support to improve resiliency and mitigate risks in childcare centers serving children from low-income ethnic minority backgrounds.

快速启动：新冠疫情支持，旨在提高为低收入少数族裔背景的儿童提供服务的托儿中心的弹性并降低风险。

• 批准号: 10605262
• 负责人: JASON F JENT
• 金额: $ 64.55万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-07 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10605262
• 关键词: Address; Adult; Affect; Anger; Anxiety; Area; Attitude; Behavior; Belief; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Child; Child Behavior; Child Care; Child Development; Child Health; Child Support; Chronic; Cluster randomized trial; Communication; Communities; Community Networks; Consultations; Control Groups; County; Data; Development; Disasters; Distress; Education; Educational process of instructing; Emotional; Environment; Environmental Risk Factor; Evaluation; Exhibits; Family; Family Characteristics; Future; Goals; Guidelines; HIV; Hurricane; Individual; Intervention; Link; Long-Term Effects; Low income; Measures; Mediating; Mental Depression; Mental Health; Methods; Minority; Modeling; National Institute of Child Health and Human Development; Needs Assessment; Nursery Schools; Occupations; Outcome; Parents; Personal Satisfaction; Policies; Poverty; Problem behavior; Program Effectiveness; Psychosocial Assessment and Care; Public Health; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Recovery; Research; Research Priority; Resources; Risk; Robot; Role; Safety; Self Care; Self Efficacy; Social isolation; Societies; Stress; Support System; System; Testing; Time; Toddler; Trauma; UNICEF; Uncertainty; Well in self; ZIKA; attentional control; care systems; contextual factors; coping; coronavirus disease; early childhood; effectiveness evaluation; effectiveness study; effectiveness testing; effectiveness/implementation hybrid; effectiveness/implementation trial; ethnic diversity; ethnic minority; executive function; experience; follow-up; group intervention; high risk; hybrid type 1 design; implementation barriers; implementation evaluation; implementation/effectiveness; improved; innovation; minority communities; obesity prevention; pandemic disease; pandemic impact; preventive intervention; primary outcome; programs; promote resilience; psychologic; psychosocial; psychosocial development; public health intervention; racial diversity; resilience; risk mitigation; scale up; social factors; teacher; teleconsultation; telepresence; uptake; vaccine acceptance; virtual

Background. This is a Type 1 hybrid effectiveness-implementation trial studying the role of a community- based, childcare center-support system in improving resilience and mitigating the long-term impacts of the pandemic on child development. Public health disasters have disproportionate and long-term impacts on poor, disenfranchised communities. Miami-Dade County has one of the US's highest rates of chronic poverty, is minority majority, and has been an epicenter of the pandemic. COVID-19 is having psychosocial impacts on children that is producing anxiety, irritability, anger, and depression. Teachers in childcare centers continue to be overwhelmed by changing guidelines and how to address the downstream psychological effects children are experiencing. While numerous resources exist that can help childcare centers with disaster recovery, the information can be overwhelming and difficult to navigate, and research is yet to show the actual benefits of the resources. Approach. We will leverage our existing community-based intervention, Jump Start, with its extensive reach in Miami-Dade County, to childcare centers participating in the County’s Quality Improvement System. This system prioritizes children living in poverty who are at highest risk for problems. This study will be modeled on a successful Early Childhood Mental Health Consultation (ECMHC) intervention which utilizes mental health consultants to deliver a Jump Start+: COVID Support virtual toolkit to childcare centers via a Kubi robot. The toolkit is comprised of four strength-based strategies likely to be effective in improving resiliency following disasters: Safety Planning, Effective Communication, Adult Self-Care, and Trauma-Informed Behavior Support. We will use Reach, Effectiveness-Adoption, Implementation, Maintenance (RE-AIM) framework to guide the evaluation of our Type 1 hybrid design. Our first aim will utilize a cluster randomized trial to examine the effectiveness of Jump Start+: COVID Support on improving the psychosocial functioning of young children, as compared to an obesity-prevention intervention control group. Child development is the primary outcome, with children followed at 6, 12,18, and 24 months. The second aim will examine the mechanisms that contribute to effective teachers’ uptake of Jump Start+: COVID Support strategies on child outcomes. The third aim will explore implementation barriers/facilitators as well as potential societal contextual factors (e.g., vaccine uptake) to help centers serving disproportionately affected minority communities recover from and prepare for future crises. Impact. These aims meet a high-priority research area for NICHD because they address the social and environmental factors that can enhance children’s resilience. Employing a Type 1 hybrid design will inform the refinement and scaling of Jump Start+: COVID Support and generalize impacts to other childcare center interventions in the context of disasters. We have the potential to influence long-term trajectories of childcare center practices and child development which, in turn, can chart a course for future child health and well-being in the face of crises.

背景这是一项 1 类混合有效性实施试验，研究基于社区的作用。 托儿中心支持系统，以提高抵御能力并减轻大流行病对儿童的长期影响 公共卫生灾难对贫困、被剥夺权利的人产生不成比例的长期影响。 迈阿密戴德县是美国长期贫困率最高的社区之一，少数民族人口占多数。 COVID-19 一直是大流行的中心，对正在生产的儿童产生了心理社会影响。 托儿所的老师们仍然面临着焦虑、烦躁、愤怒和抑郁的困扰。 改变指导方针以及如何解决儿童正在经历的下游心理影响。 存在许多可以帮助托儿中心进行灾难恢复的资源，这些信息可以 势不可挡且难以驾驭，研究尚未显示这些资源的实际好处。 我们将利用现有的基于社区的干预措施“Jump Start”及其广泛的影响力。 迈阿密戴德县，要求儿童保育中心参与该县的质量改进系统。 这项研究将优先考虑面临问题风险最高的贫困儿童。 成功利用心理健康的幼儿心理健康咨询（ECMHC）干预 顾问通过 Kubi 机器人向儿童保育中心提供 Jump Start+：COVID 支持虚拟工具包。 工具包由四种基于力量的策略组成，这些策略可能有效地提高跟随能力 灾难：安全规划、有效沟通、成人自我护理和创伤知情行为支持。 我们将使用影响力、有效性-采用、实施、维护 (RE-AIM) 框架来指导 我们的第一个目标是利用整群随机试验来评估我们的 1 型混合设计。 Jump Start+ 的有效性：新冠肺炎支持改善幼儿的心理社会功能，如 与肥胖预防干预对照组相比，儿童发育是主要结果。 第二个目标是研究导致 6、12、18 和 24 个月大的儿童的机制。 教师有效采用 Jump Start+：针对儿童成果的新冠病毒支持策略。 探索实施障碍/促进因素以及潜在的社会背景因素（例如疫苗接种） 帮助为受影响尤其严重的少数群体社区提供服务的中心从灾后恢复并为未来做好准备 这些目标符合 NICHD 的高度优先研究领域，因为它们涉及社会和影响。 采用 1 型混合设计可以增强儿童的适应能力。 Jump Start+ 的细化和扩展：新冠疫情支持并推广对其他托儿中心的影响 我们有潜力影响儿童保育的长期轨迹。 中心实践和儿童发展，进而可以为未来儿童的健康和福祉制定路线 面对危机。