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，该计划旨在研究公共资助的课后计划促进城市贫困社区儿童心理健康的能力，这些社区的心理健康困难风险极高，可用于满足这些需求的资源严重有限。这项拟议中的研究将在芝加哥公园区的公园儿童项目中进行，该项目是芝加哥最大的公共资助儿童和青少年课后项目提供者之一。我们最近完成了这项研究计划中的第一项研究（NIMH R34-MH 070637; PI：Frazier;见初步研究项目NAFASI），研究了心理健康咨询的可行性，以围绕学术充实，教练行为，活动参与和行为管理的课后计划工作人员。这些研究结果揭示了强有力的证据，干预的可行性，高工作人员的满意度，以及令人鼓舞的，但在儿童的适应功能的适度改善。目前的应用程序将扩大NAFASI干预，以反映越来越多的文献在儿童的心理健康服务联系组织的社会背景与服务质量和成果，这表明，有效的和可持续的变化，在程序层面将需要更集中的干预，在组织层面。因此，我们认为，我们建议在1-3年级通过混合效应回归模型来研究社会背景如何（通过直接观察和工作人员的看法）在课后计划中与儿童和家长报告的计划质量和儿童的心理健康结果有关在整个芝加哥的84个公园儿童项目中，随机选择12名8至16岁的儿童（n=357名工作人员，1,008名儿童）。这些数据将用于（1）提供关于组织社会背景测量的课后计划规范，（2）估计与将用于为后续临床试验提供动力的研究中心相关的方差分量结构，以及（3）为NAFASI干预的组织级干预分量在第4年的扩展提供信息。拟议的研究将有助于本研究的总体目标，即开发社区心理健康实践的新模式，重点是支持使命，提高质量，增强课后计划的能力，以促进城市贫困儿童的心理健康和适应功能。 公共卫生关系：拟议的研究将探讨组织功能的课后计划，儿童和家长的报告程序的经验，和儿童的行为对进一步发展的干预影响能力的课后计划，以促进儿童的适应功能之间的关系。这项研究将在芝加哥公园区指导的84个课后项目中进行。这项申请是一项研究计划的下一步，该计划旨在研究公共资助的课后计划促进城市贫困社区儿童心理健康的能力。