Testing Relevance and Efficacy in a Culturally Adapted Parenting Program

测试文化适应育儿计划的相关性和有效性

• 批准号: 7991799
• 负责人: Jose Ruben Parra-Cardona
• 金额: $ 28.78万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7991799
• 关键词: Address; African American; American; Applications Grants; Categories; Child; Cities; Classification; Data; Development; Educational Curriculum; Ensure; Equilibrium; Evidence based intervention; Family; Funding; Future; Generations; Goals; Health Services Research; Immigrant; Intervention; Investigation; Latino; Life; Life Experience; Linguistics; Low income; Measures; Mental Health; Mental disorders; Michigan; Modeling; Muslim population group; NIH Program Announcements; National Institute of Mental Health; Oregon; Outcome; Parenting behavior; Parents; Participant; Pilot Projects; Population; Population Heterogeneity; Preventive Intervention; Procedures; Qualitative Methods; Randomized Controlled Trials; Research; Research Design; Research Priority; Research Project Grants; Risk; Scholarship; Science; Services; Stress; System; Target Populations; Testing; Time; Training; Translating; Treatment Efficacy; United States; United States National Institutes of Health; Vulnerable Populations; base; cultural competence; cultural values; effectiveness research; ethnic minority population; evidence base; expectation; experience; externalizing behavior; falls; health disparity; high risk; improved; novel strategies; programs; public health relevance; skills; stressor; therapy development

DESCRIPTION (provided by applicant): The dissemination of evidence-based interventions constitutes a key strategy to reduce the disproportionate burden of mental illness experienced by ethnic minority populations in the United States. Current scientific debate exists regarding the need to culturally adapt evidence-based preventive interventions prior to dissemination among at-risk ethnic minorities. This debate is known as the adaptation/balance fidelity debate. However, this debate is restricted by the limited number of rigorous empirical studies on cultural adaptation. The goal of this R34 exploratory study is to contribute to the scholarship on cultural adaptation services research by determining the minimum adaptation requirements that are necessary to integrate a culturally adapted parenting intervention characterized by high feasibility, efficacy, and cultural acceptability. The original evidence-based parenting intervention was developed with low-income and at-risk Euro-American families and it is known as Parent Management Training Oregon (PMTO). Funding for its development was provided by the National Institute of Mental Health (NIMH). The first culturally adapted intervention to be tested in this study is a Spanish version of the PMTO intervention (TO), which was translated according to a rigorous model of cultural adaptation in order to ensure cultural appropriateness of materials and intervention delivery. The second intervention integrates all the components of the TO intervention, as well as culture-specific sessions and engagement strategies aimed at enhancing the cultural relevance of the intervention (culturally adapted: CA). The target population for this exploratory study will be low-income, first generation Latino immigrant families because children in these families are likely to be exposed to intense contextual stressors. The following specific aims will guide this research: (a) Implement a pilot study aimed at refining intervention curricula and study procedures of the two differentially culturally adapted parenting interventions, (b) implement a small randomized control trial with the two differentially culturally adapted interventions, (c) utilize observation-based rating systems to measure fidelity to core PMTO components, as well as cultural competence in the delivery of both adapted interventions, and (d) systematically examine differential rates of engagement, retention, and cultural acceptability (i.e., TO vs. CA). Differential treatment efficacy will be analyzed by evaluating changes in parenting skills, levels of internalizing and externalizing behaviors in children, and parental stress. Quantitative and qualitative methods will be used to measure the impact of both interventions. This application addresses the need identified by NIMH to promote research focused on evaluating the feasibility and efficacy of novel approaches aimed at improving the mental health of vulnerable populations by bridging science to service. PUBLIC HEALTH RELEVANCE: This proposal is responsive to NIMH research priorities on health disparities as the primary goal of the study is to identify the minimum adaptation requirements that are required to culturally adapt an efficacious parenting intervention while also ensuring high feasibility, cultural relevance, and efficacy. The participants in this study will be low income and at-risk Latino families. This study constitutes the first step of a program of research aimed at duplicating the most useful model of cultural adaptation with additional at-risk diverse populations.

说明(申请人提供)：传播以证据为基础的干预措施是减少美国少数民族人口经历的不成比例的精神疾病负担的关键战略。目前存在的科学争论是，在高危少数民族中传播之前，是否需要在文化上适应循证预防干预措施。这场辩论被称为适应/平衡保真度辩论。然而，关于文化适应的严格实证研究数量有限，限制了这场辩论。这项R34探索性研究的目的是通过确定整合具有高可行性、有效性和文化可接受性的文化适应父母干预所需的最低适应要求，为文化适应服务研究的学术做出贡献。最初的循证育儿干预是在低收入和高风险的欧美家庭中开发的，被称为父母管理培训俄勒冈州(PMTO)。国家精神卫生研究所(NIMH)为其发展提供了资金。本研究测试的第一个文化适应干预措施是西班牙版的PMTO干预措施(TO)，它是根据严格的文化适应模式翻译的，目的是确保材料和干预措施的文化适当性。第二次干预结合了干预的所有组成部分，以及旨在加强干预的文化相关性的特定文化会议和参与战略(文化适应：CA)。这项探索性研究的目标人群将是低收入的第一代拉美裔移民家庭，因为这些家庭的孩子可能会暴露在强烈的背景压力之下。以下具体目标将指导这项研究：(A)实施一项试点研究，旨在完善两种不同文化适应的育儿干预措施的干预课程和研究程序，(B)对两种不同文化适应的干预措施实施小型随机对照试验，(C)利用基于观察的评级系统来衡量对PMTO核心组成部分的忠诚度，以及在提供两种适应的干预措施方面的文化能力，以及(D)系统地检查参与度、保留率和文化可接受性(即对CA)。不同的治疗效果将通过评估父母养育技能、儿童内化和外化行为水平以及父母压力的变化来分析。将使用定量和定性方法来衡量这两种干预措施的影响。这项申请解决了NIMH确定的促进研究的需要，这些研究侧重于评估旨在通过将科学与服务联系起来改善弱势群体心理健康的新方法的可行性和有效性。 公共卫生相关性：这项建议回应了NIMH关于健康差距的研究优先事项，因为该研究的主要目标是确定在文化上适应有效的育儿干预措施所需的最低适应要求，同时确保高度的可行性、文化相关性和有效性。这项研究的参与者将是低收入和高危的拉丁裔家庭。这项研究是一项研究计划的第一步，该计划旨在复制最有用的文化适应模式，增加处于危险中的不同人群。