Addressing Mental Health Services Disparities for Ethnically Diverse Children

描述(由申请人提供)： 这项拟议的研究是对题为《通过翻译研究消除健康差异(R18)》的项目公告的回应。这项研究的目的是使循证干预措施适用于拥有大量低收入拉丁裔学生的城市学校。这些干预措施将在一个以家庭为中心的系统内提供，以便为儿童提供心理健康服务，该系统有可能随着时间的推移而自我维持。这些干预措施基于SW-PBS方法，将解决儿童在学校和家里经历的一系列行为障碍和伴随的同伴困难。这项研究将在两所公立学校(K到5和K到8)进行，这些学校位于低收入拉丁裔家庭高度集中的城市地区。将同时收集该项目正在进行的三个方面的数据：(A)开发数据收集系统；(B)改进主要学校系统；(C)修改和执行议定书。这项拟议的研究旨在惠及所有参加参与学校的儿童。这项研究的目的是：(1)开发一个有用、高效和可接受的短波PBS数据收集系统；(2)建设学校系统支持实施短波PBS的能力；(3)确定需要适应的短波PBS小学和中学干预措施的组成部分；(4)确定在两所资源不足的学校实施短波PBS干预措施的可行性；(5)评估第一级和第二级干预措施(摄取)的可接受性；以及(6)评估与实施短波PBS方案相关的健康后果。将根据焦点小组、后续访谈和对93名家长和60名教师的简短调查，确定和修改循证干预方案。第一级干预措施将首先在1027名学生中实施。对第1级干预无效的儿童将被分配到第2级干预的一个或多个干预中，或者将他们评估并转介到社区接受治疗。预计将有154名儿童在学校接受二级干预，63名二级儿童的父母将在社区中心接受父母技能培训。这项拟议的研究是研究人员、全校积极行为支持(SW-PBS)专家、教职员工、学校管理人员、家长/照顾者和社区精神卫生工作者合作的结果。这项研究涉及2010年健康人的一个具体目标--减少或消除不同种族儿童之间的心理健康服务差距。这项研究可能有助于发展一种高效率和有效的系统，为低收入、市中心的儿童和家庭提供精神健康服务。为这项研究获得的数据可能有助于更好地理解促进在资源不足的城市学校适应和实施循证干预措施的因素。这项建议中所述的经过调整的循证干预措施可能有助于减少城市族裔儿童之间的精神卫生服务差距。该提案还可能增加对全校积极行为支持(SW-PBS)干预在资源不足的城市学校中的有效性的研究兴趣。

DESCRIPTION (provided by applicant): The proposed study is in response to a Program Announcement entitled, Elimination of Health Disparities through Translation Research (R18). The purpose of the study is to adapt evidence-based interventions for use in urban schools with large numbers of low-income Latino students. The interventions will be delivered within a family-centered system for the delivery of mental health services for children that has the potential to be self- sustaining over time. The interventions, which are based on SW-PBS methodology, would address a range of behavioral disorders and concomitant peer difficulties experienced by children at school and at home. The study will take place in two public schools (K through 5th and K through 8th) in an urban area with high concentrations of low-income Latino families. Data will be collected simultaneously on three ongoing aspects of the project: (a) Development of a data collection system; (b) Improvement of key school systems; (c) Protocol modification and implementation. The proposed study is designed to reach all children attending the participating schools. Aims of the study are: (1) To develop a data collection system for SW-PBS that is useful, efficient, and acceptable; (2) To build the capacity of the school system to support the implementation of SW-PBS; (3) To identify components of SW-PBS primary and secondary tier interventions that need adaptation; (4) To determine the feasibility of implementing SW-PBS interventions in two under-resourced schools; (5) To assess acceptability of Tier 1 and Tier 2 interventions (uptake); and (6) To estimate the health outcome associated with the implementation of the SW-PBS package. Evidence-based intervention packages will be identified and modified based on focus groups, follow-up interviews and brief surveys with 93 parents and 60 teachers. Tier 1 interventions will be implemented first on 1,027 students. Children who do not respond to Tier 1 interventions will be assigned to one or more interventions for Tier 2 or they will be assessed and referred for treatment in the community. It is expected that 154 children will receive Tier 2 interventions in the school and that 63 parents of children in Tier 2 will receive parental skills training at a community center. The proposed study is the result of a partnership between researchers, experts in school-wide positive behavior support (SW-PBS), teaching staff, school administrators, parents/caregivers and community mental health workers. The study addresses a specific goal of Healthy People 2010--reducing or eliminating mental health services disparities among ethnically diverse children. The study may contribute to the development of an efficient and effective system for the delivery of mental health services to low-income, inner-city children and families. Data obtained for this study may contribute to a better understanding of factors that facilitate the adaptation and implementation of evidence-based interventions in under-resourced urban schools. The adapted evidence-based interventions described in this proposal are likely to contribute to a reduction in mental health services disparities among urban ethnically-diverse children. The proposal may also increase research interest in the effectiveness of school-wide positive behavior support (SW-PBS) interventions in under-resourced urban schools.