Organizational Context and Children's Mental Health in Urban After School Program

城市课后项目的组织背景和儿童心理健康

• 批准号: 8015633
• 负责人: Marc Steven Atkins
• 金额: $ 46.25万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-05 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8015633
• 关键词: Age; Behavior; Chicago; Child; Child Behavior; Child Mental Health; Clinical Trials; Communities; Consultations; Data; Development; Effectiveness; Funding; Goals; Intervention; Life; Link; Literature; Manuals; Measures; Mental Health; Mission; Modeling; National Institute of Mental Health; Outcome; Parents; Patient Self-Report; Perception; Poverty; Process; Provider; Psyche structure; Randomized; Reporting; Research; Resources; Risk; Services; Site; Social Environment; Structure; Testing; Training; Work; after-school program; child mental health service; experience; health practice; improved; meetings; programs; public health relevance; response; satisfaction; social; theories; therapy development

DESCRIPTION (provided by applicant): This application extends a program of research that examines the capacity of publicly-funded after-school programs to promote children's mental health in urban, poor communities, where the risks for mental health difficulties are extremely high and the resources available to meet those needs are severely limited. The proposed study will be conducted at the Chicago Park District's Park Kids program, one of the largest providers of publicly-funded after school programs for children and youth in Chicago. We recently completed the first study in this program of research (NIMH R34-MH070637; PI: Frazier; see Preliminary Studies Project NAFASI) examining the feasibility of mental health consultation to after school program staff around academic enrichment, coaching behaviors, activity engagement and behavior management. Those findings reveal strong evidence for the feasibility of intervention, high staff satisfaction, and encouraging though modest improvements in children's adaptive functioning. The current application will expand the NAFASI intervention to reflect a growing literature in children's mental health services linking organizational social context with service quality and outcomes, which suggests that effective and sustainable change at a program level will require more concentrated intervention at an organizational level. Hence, we propose to examine in Years 1-3 via mixed-effects regression models how social context (by direct observation and staff perceptions) operates in after school programs in relation to child and parent reported program quality and children's mental health outcomes (staff and self report) for 12 randomly selected children ages 8 to 16 in each of the 84 Park Kids programs throughout Chicago (n=357 staff, 1,008 children). These data will be used to (1) provide norms for after school programs on a measure of organizational social context, (2) estimate the variance component structures associated with site that will be used to power a subsequent clinical trial, and (3) inform the expansion in Year 4 of organizational-level intervention components for the NAFASI intervention. The proposed study will contribute to the overall goal of this research to develop new models of community mental health practice focused on supporting the mission, improving the quality, and enhancing the capacity of after- school programs to promote mental health and adaptive functioning for children living in urban poverty. PUBLIC HEALTH RELEVANCE: The proposed study will examine relationships among organizational features of after school programs, child and parent reports of program experiences, and children's behavior toward the further development of an intervention to impact on the ability of after school programs to promote children's adaptive functioning. The study will be conducted at 84 organized after school programs directed by the Chicago Park District. This application is the next step in a program of research that examines the capacity of publicly-funded after-school programs to promote children's mental health in urban, poor communities.

描述(由申请人提供)：本申请扩展了一项研究计划，该计划审查公共资助的课后计划在城市贫困社区促进儿童心理健康的能力，在这些社区，精神健康困难的风险极高，可用于满足这些需求的资源严重有限。这项拟议的研究将在芝加哥公园区的公园儿童计划中进行，该计划是芝加哥最大的公共资助的儿童和青少年课外计划提供商之一。我们最近完成了这个研究项目(NIMH R34-MH070637；PI：Frazier；参见初步研究项目Nafasi)的第一项研究，考察了向课外项目工作人员提供围绕学业充实、辅导行为、活动参与和行为管理的心理健康咨询的可行性。这些调查结果显示了干预的可行性、工作人员的高度满意度以及令人鼓舞的、尽管幅度不大的儿童适应功能改善的有力证据。目前的应用将扩大Nafasi干预措施，以反映儿童心理健康服务中越来越多的文献将组织社会背景与服务质量和结果联系起来，这表明在计划层面上的有效和可持续的变化将需要在组织层面上进行更集中的干预。因此，我们建议在1-3年级通过混合效应回归模型检验社会背景(通过直接观察和工作人员感知)如何在课外计划中运作，与儿童和家长报告的计划质量和儿童心理健康结果(工作人员和自我报告)有关，这些儿童在芝加哥各地的84个公园儿童计划(n=357名工作人员，1008名儿童)中随机选择了12名8至16岁的儿童。这些数据将被用来(1)为课后计划提供衡量组织社会背景的标准，(2)估计与将被用来为随后的临床试验提供动力的现场相关的差异成分结构，以及(3)为Nafasi干预措施的组织级干预成分在第4年的扩展提供信息。这项拟议的研究将有助于本研究的总体目标，即开发新的社区心理健康实践模式，专注于支持使命，提高质量，并增强课外计划的能力，以促进城市贫困儿童的心理健康和适应功能。 公共卫生相关性：拟议的研究将检查课后计划的组织特征、儿童和家长对计划经验的报告以及儿童行为与进一步发展干预措施的关系，以影响课后计划促进儿童适应功能的能力。这项研究将在84个由芝加哥公园地区指导的课外项目中进行。这项申请是一项研究项目的下一步，该项目旨在考察公共资助的课外项目在城市贫困社区促进儿童心理健康的能力。