Exploring PTSD Symptoms, Barriers and Facilitators to Mindfulness-based Stress Reduction for Justice-Involved Black/African American Female Adolescents and Parents/Caregivers

探索创伤后应激障碍 (PTSD) 症状、障碍和促进因素，为涉及正义的黑人/非裔美国女性青少年和父母/照顾者进行基于正念的减压

• 批准号: 10593806
• 负责人: Camille R. Quinn
• 金额: $ 24.89万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-14 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10593806
• 关键词: Address; Adolescent; African American; Age; Behavior; Behavioral; Biological; Biological Markers; Black race; Caregivers; Child Abuse; Child Rearing; Chronic stress; Clinical; Communities; Conflict (Psychology); County; Crime; Data; Development; Diversion Program; Dreams; Drops; Emotional; Enrollment; Exposure to; Family; Feedback; Female Adolescents; Focus Groups; Fostering; Future; Goals; Health; Hearing; Home; Hostility; Hydrocortisone; Individual; Inflammation; Institution; Intervention; Interview; Investigation; Justice; Knowledge; Life Experience; Link; Literature; Manuals; Mental Health; Methods; Modeling; National Institute on Minority Health and Health Disparities; Nature; Outcome; Outcome Study; Parent-Child Relations; Parents; Participant; Patient Self-Report; Personal Satisfaction; Phase; Physiological; Population; Post-Traumatic Stress Disorders; Prevention; Psychopathology; Reduce health disparities; Reporting; Research; Residential Treatment; Risk; Secure; Social support; Stress; Stress and Coping; Surveys; Symptoms; Testing; Theoretical Domains framework; Trauma; Underserved Population; United States; Violence; Youth; barrier to care; behavior change; biological adaptation to stress; boys; chronic pain; clinically significant; court; design; experience; girls; healing; health disparity; health equity; health equity promotion; hypothalamic-pituitary-adrenal axis; implementation evaluation; improved; innovation; interdisciplinary approach; intersectionality; iterative design; juvenile justice system; life history; male; maltreatment; mindfulness; mindfulness-based stress reduction; multimodality; novel strategies; perceived stress; physical conditioning; pilot test; preventive intervention; primary outcome; probation; procedure safety; psychosocial; racial identity; recidivism; recruit; response; secondary outcome; social culture; stress reduction; theories; therapy design; therapy development; trauma exposure

PROJECT SUMMARY/ABSTRACT High rates of trauma and post-traumatic stress disorder (PTSD) associated with delinquency (and recidivism) persist for justice-involved individuals. This enduring problem denotes a significant gap in our treatment approach. PTSD, the primary outcome of the proposed study about healing informed mindfulness-based stress reduction (MBSR), combines stress-inflammation/cortisol reactivity, recidivism, personal agency, racial identity, and parent-child relationships (secondary outcomes), which contribute to the overall health equity and well-being of justice-involved Black/African American female adolescents (JI BAFAs). The proposed study will investigate the barriers and facilitators to the MBSR intervention with JI BAFAs and their P/Cs. MBSR has been successfully implemented as a treatment for PTSD and is a promising new approach for healing to reduce health disparities among both JI BAFAs and their P/Cs. We will use a healing-informed MBSR approach based on an intersectional trauma-responsive (ITR) framework: Intersectionality theory, Healing Centered Engagement (HCE), and Theoretical Domains Framework (TDF). HCE is based on healing justice, a strengths-based framework to re- center culture and improve and nurture well-being that involves transforming institutions and relationships that cause harm to collectively heal and foster hope. TDF comprises 7 stages to assess implementation problems and supports intervention design as a solution to the theory-practice gap as it helps identify theoretically driven targets for interventions based on content-specific information about the behavior targeted to change, i.e., PTSD symptoms. For this study, we expect to enroll (35 JI BAFAs and P/C dyads) in Franklin County, OH. This two- phase study follows a multimodal mixed methods design, comprising two phases. Phase I includes collecting qualitative interview data about their past barriers to treatment and interventions and use this information as well as self-report survey results to culturally adapt until we reach saturation. Participants will complete study assessments with psychosocial and biological (biomarker) data (n = 10 JI BAFAs-P/Cs dyads) (Aim 1). Phase II consists of conducting a nonrandomized pilot test of the adapted intervention adapted healing intervention to assess the feasibility of recruitment, acceptability, and preliminary effects of the adapted intervention on the study outcomes. Dyads will complete assessments, and psychosocial and biological data at baseline, immediately after the final intervention session (~ 3 months post baseline) and again 6-months post-baseline. Clinically meaningful improvements in PTSD symptoms (primary outcome) and stress/cortisol reactivity, recidivism, agency, racial identity, parent-child relationships (secondary outcomes) will be examined. (n = 25 JI BAFAs-P/Cs dyads) (Aim 2). We will also promote healing of the dyads’ relationship dynamic via the intervention to create a corrective outcome for P/Cs and JI BAFAs, including the use of safety procedures (Exploratory Aim). We will hold two separate focus groups with 6 dyads who completed the MBSR intervention to elicit feedback on the initial qualitative findings. The study findings will be integrated based on the two types of data.

项目概要/摘要 与犯罪（和累犯）相关的创伤和创伤后应激障碍（PTSD）发病率很高 对于涉及正义的个人来说，这一持久的问题表明我们的待遇存在重大差距。 创伤后应激障碍（PTSD），该研究的主要结果是关于治愈基于正念的压力。 减少（MBSR），结合了压力炎症/皮质醇反应性、累犯、个人代理、种族认同、 以及亲子平等关系（次要结果），这有助于整体健康和福祉 拟议的研究将调查涉及正义的黑人/非裔美国女性青少年 (JI BAFA)。 JI BAFA 及其 P/C 的 MBSR 干预的 MBSR 障碍和促进因素已经成功。 作为创伤后应激障碍 (PTSD) 的治疗方法，是一种有前途的新治疗方法，可减少健康差异 在 JI BAFA 及其 P/C 之间，我们将使用基于交叉的治疗知情 MBSR 方法。 创伤响应 (ITR) 框架：交叉理论、以治疗为中心的参与 (HCE) 和 理论领域框架 (TDF) 以治愈正义为基础，这是一个基于优势的框架，用于重新定义。 中心文化并改善和培养福祉，其中包括转变机构和关系， 从造成伤害到集体治愈并培育希望 TDF 包括 7 个阶段来评估实施问题。 并支持干预设计作为理论与实践差距的解决方案，因为它有助于识别理论驱动的 基于有关要改变的行为（即 PTSD）的特定内容信息的干预目标 对于这项研究，我们希望在俄亥俄州富兰克林县招募（35 名 JI BAFA 和 P/C 双人组）。 阶段研究遵循多模式混合方法设计，包括两个阶段：收集。 关于他们过去治疗和干预障碍的定性访谈数据，并使用这些信息 作为自我报告的调查结果，以适应文化，直到我们达到饱和为止。 使用社会心理和生物（生物标志物）数据进行评估（n = 10 JI BAFA-P/Cs 二元组）（目标 1）。 II 包括对适应的干预措施进行非随机试点测试，适应康复干预措施 评估招募的可行性、可接受性以及调整后的干预措施对患者的初步影响 研究结果将完成评估以及基线的心理和生物数据， 最后一次干预后（基线后约 3 个月）立即进行，并在基线后 6 个月再次进行。 PTSD 症状（主要结果）和压力/皮质醇反应性的临床有意义的改善， 将审查累犯、代理、种族身份、亲子关系（次要结果）（n = 25 JI）。 BAFA-P/Cs 双人组）（目标 2）我们还将通过干预促进双人组关系的修复。 为 P/C 和 JI BAFA 创建纠正结果，包括使用安全程序（探索性 目标）我们将举行两个单独的焦点小组，由 6 名完成 MBSR 干预的人组成。 对初步定性研究结果的反馈将根据两种类型的数据进行整合。