Multiple Family Groups and Child Welfare Involved Families

多个家庭群体和涉及儿童福利的家庭

• 批准号: 8063664
• 负责人: Geetha Gopalan
• 金额: $ 2.24万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2011-09-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8063664
• 关键词: Activities of Daily Living; Address; Adult; Applications Grants; Area; Attenuated; Behavior; Behavioral; Calculi; Caregivers; Characteristics; Child; Child Mental Health; Child Welfare; Childhood; Clinic; Clinical Research; Clinical effectiveness; Communication; Communities; Consultations; Data; Data Analyses; Data Set; Disruptive Behavior Disorder; Effectiveness; Family; Family Caregiver; Family Study; Fellowship; Funding; Goals; Grant; Health Services Accessibility; Health Services Research; Healthy People 2010; Home environment; Individual; Intervention; Investigation; Knowledge; Lead; Literature; Low income; Manuscripts; Mediation; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methodology; Methods; Minority; Modeling; Modification; Motivation; National Institute of Mental Health; National Research Service Awards; Neighborhoods; Outcome; Outpatients; Parent-Child Relations; Parenting behavior; Parents; Perception; Population Heterogeneity; Preparation; Process; Provider; Psychiatry; Qualitative Methods; Qualitative Research; Quality of life; Randomized Clinical Trials; Reading; Recommendation; Relative (related person); Research; Research Activity; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Training; Sampling; Schools; Science; Services; Site; Social Work; Staging; Stress; Study Section; System; Techniques; Testing; Time; Training; Universities; Vulnerable Populations; Work; Youth; base; career; child mental health service; coping; design; effectiveness research; forging; foster care; group intervention; improved; inner city; innovation; medical schools; meetings; member; programs; psychosocial; public health relevance; response; service intervention; skills; theories; treatment effect

DESCRIPTION (provided by applicant): Close to half of all children who remain at home with their permanent caregivers following a child welfare investigation (i.e., not placed into foster care) manifest high rates of mental health need, yet few engage or remain in mental health treatment (Burns et al., 2004; Lau & Weisz, 2003).This is particularly concerning as children from these child welfare involved families (CWIFs) manifest disproportionately high rates of behavioral difficulties (ACF, 2005; Burns et al., 2004). Lack of available child mental health service providers in inner-city communities (Asen, 2002) creates even greater obstacles to accessing treatment. The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders (DBDs; Franco et al., 2008; Gopalan & Franco, 2009; McKay, et al., 1995; 1999; 2002; Stone, McKay, & Stoops, 1996) is currently being tested in an NIMH-funded effectiveness study. This model may be beneficial for CWIFs as an innovative, engaging mental health intervention that addresses inner-city service capacity limitations. Although preliminary data indicate that CWIFs manifest high engagement rates in MFGs, CWIFs have substantial needs (e.g., parental depression) which may exceed the MFG model's current capacities. As a result, the MFG model may require adaptation for CWIFs. Consequently, the goals of the proposed fellowship include (1) increasing the applicant's theoretical knowledge and methodological expertise in child mental health service and intervention science; (2) increasing theoretical knowledge in services for CWIFs and family-based treatment of childhood DBDs; and (3) preparing the applicant to develop and pilot a family-based mental health intervention for CWIFs to reduce childhood DBDs. The specific aims of the current application are met through two studies examining CWIF caregiver responses to the MFG model and identifying where modifications, if any, may be necessary. Using qualitative methods, Study #1 will identify CWIF caregiver perceptions of factors that influence service delivery (i.e., engagement, program helpfulness, relevance, and ability to stimulate motivation to make family- level changes), and recommendations for improvement. Study #2 involves quantitative, secondary data analyses to assess if CWIF status moderates the MFG treatment effect over time regarding (1) engagement and process characteristics of service delivery (i.e., relationship with service provider, relationships between MFG members, parental and youth motivation to address treatment goals, perceived barriers to treatment), (2) family-level outcomes and parent characteristics (i.e., parenting skills, family communication, within family support, and parent/child interaction, parent stress, parent depression, parent coping), and (3) youth-level outcomes (i.e., externalizing behavioral difficulties and functional capacities). Those outcomes where the MFG treatment effect is attenuated can be targeted for further revision when adapting the MFG model. Both studies will provide preliminary data used to develop and pilot a family-based mental health intervention to reduce child DBD's for CWIFs. Thus, mental health treatment may be improved for a diverse and vulnerable population. PUBLIC HEALTH RELEVANCE: The current application proposes two studies which examine how families with child welfare services contact (i.e., open child welfare case without foster care placement, prior child welfare services contact) respond to the Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders (DBDs; Franco et al., 2008; Gopalan & Franco, 2009; McKay, et al., 1995; 1999; 2002; Stone, McKay, & Stoops, 1996) regarding engagement, service delivery characteristics, as well as family- and youth-level outcomes. Qualitative and quantitative techniques will be utilized to identify where modifications, if any, may be necessary in order to adapt the MFG intervention for these child welfare involved families (CWIFs). Given that CWIFs often do not engage or remain in child mental health services (Burns et al., 2004; Lau & Weisz, 2003) despite high rates of child behavioral difficulties (ACF, 2005; Burns et al., 2004), developing an effective, engaging, and innovative mental health service will help children from CWIFs access and benefit from needed treatment.

描述（由申请人提供）：在儿童福利调查（即，没有被寄养的人）表现出很高的心理健康需求率，但很少有人从事或保持心理健康治疗（Burns等人，二○ ○四年;这尤其令人担忧，因为来自这些儿童福利参与家庭（CWIF）的儿童表现出不成比例的高行为困难率（ACF，2005; Burns等人，2004年）。市中心社区缺乏儿童心理健康服务提供者（阿森，2002年），这对获得治疗造成了更大的障碍。减少儿童破坏性行为障碍的多家庭小组（MFG）服务提供模式（DBD; Franco等人，2008; Gopalan & Franco，2009; McKay等人，1995; 1999; 2002; Stone，McKay，& Stoops，1996）目前正在NIMH资助的有效性研究中进行测试。这种模式可能是有益的CWIF作为一种创新的，从事心理健康干预，解决内城服务能力的限制。虽然初步数据表明，化学品妇女投资基金在制造业中的参与率很高，但化学品妇女投资基金有大量的需求（例如，父母抑郁症），这可能超过MFG模型的当前容量。因此，MFG模型可能需要针对CWIF进行调整。因此，建议的研究金的目的包括（1）增加申请人在儿童精神健康服务和干预科学方面的理论知识和方法学专业知识;（2）增加对社区工作者健康基金服务和以家庭为基础治疗儿童DBD的理论知识;以及（3）准备申请人为社区工作者健康基金开发和试点以家庭为基础的精神健康干预，以减少儿童DBD。通过两项研究来满足当前申请的具体目标，这两项研究检查了CWIF护理人员对MFG模型的反应，并确定了可能需要进行修改的地方。使用定性方法，研究#1将确定CWIF照顾者对影响服务提供的因素的看法（即，参与度、计划的有益性、相关性和激发动机进行家庭层面改变的能力），以及改进建议。研究#2涉及定量的二次数据分析，以评估CWIF状态是否随着时间的推移缓和了MFG治疗效果，涉及（1）服务交付的参与和过程特征（即，与服务提供者的关系，MFG成员之间的关系，父母和青少年解决治疗目标的动机，感知的治疗障碍），（2）家庭水平的结果和父母特征（即，养育技巧、家庭沟通、家庭内支持、父母/子女互动、父母压力、父母抑郁、父母应对），以及（3）青年水平的结果（即，外化行为困难和功能能力）。当调整MFG模型时，MFG治疗效果减弱的那些结局可以作为进一步修订的目标。这两项研究将提供用于开发和试点基于家庭的心理健康干预以减少儿童DBD的CWIF的初步数据。因此，可以为多样化和弱势群体改善心理健康治疗。 公共卫生相关性：目前的申请提出了两项研究，研究儿童福利服务的家庭如何联系（即，没有寄养安置的开放式儿童福利案例，先前的儿童福利服务联系人）响应多家庭组（MFG）服务提供模式，以减少儿童破坏性行为障碍（DBD; Franco等人，2008; Gopalan & Franco，2009; McKay等人，1995; 1999; 2002; Stone，McKay和Stoops，1996）关于参与，服务提供特征以及家庭和青年层面的结果。定性和定量技术将被用来确定修改，如果有的话，可能是必要的，以适应这些涉及儿童福利的家庭（CWIF）的MFG干预。鉴于CWIF往往不参与或留在儿童心理健康服务（伯恩斯等人，2004; Lau & Weisz，2003），尽管儿童行为困难的发生率很高（ACF，2005; Burns等人，2004年），开发一个有效的，吸引人的，创新的心理健康服务将帮助来自CWIF的儿童获得并受益于所需的治疗。