Improving Evidence-Based Trauma Care in Schools Through Community Partnerships

描述(由申请人提供)：这项拟议的导师研究科学家发展奖(K01)的总体目标是让候选人，一名儿童临床心理学家，成为一名独立的调查员，进行旨在改善少数族裔儿童和家庭的校本心理健康服务的研究。候选人在少数民族人群中研究发展精神病理学方面有很强的背景，正在寻求这一奖项，以获得精神健康服务研究和社区合作研究方法方面的基本技能。为了实现这些目标，候选人的直接职业发展计划包括以实施研究为重点的课程作业和指导，社区合作研究方法，学校组织和政策，以及精神健康服务研究的混合方法。主要导师包括哥伦比亚大学的金伯利·霍格伍德博士和加州大学洛杉矶分校卫生服务研究中心的珍妮·米兰达博士。该研究计划旨在通过与学校利益攸关方合作，加强创伤后应激障碍(PTSD)的循证治疗(EBT)与城市学校环境之间的兼容性。尽管学校一直被吹捧为接触服务不足的少数民族青年的理想环境，但EBTS的实施极其有限。执行率低的一个原因是，学校发现很难将资源投入到超出其教育使命的项目上。这项研究的目的是开发一个模型，以增加创伤相关创伤后应激障碍症状的循证治疗与学校利益相关者(例如，家长、教师、行政人员、学校临床医生)的目标和优先事项之间的契合度。这包括审查学校系统采取干预措施时作出的适应，使心理健康干预措施的实施与学校可以用来支持学生学习的有效做法相一致，并确保处理和评估心理健康结果和与学校相关的功能结果(例如，课堂/家庭行为、出勤率、学校表现、社交能力)。其目的是：1)使用与学校社区合作的社区研究模式，更有效地使创伤后应激障碍的EBT与学校-社区优先事项和结构相一致；2)与学校教职员工和家长一起记录和探索使用社区合作研究方法的效用；以及3)为遭受暴力的青少年试行心理健康服务提供模式，以改善创伤后应激障碍和学校优先事项的EBT之间的“契合度”。这项研究对于为遭受社区暴力、获得护理机会有限的青年提供服务具有重要意义。它还将介绍EBT是如何发展和传播到非专业精神卫生环境中的，如学校。 与公共卫生有关：儿童对心理卫生保健的需求很高，而学校是儿童和青少年心理卫生服务的最常见来源。然而，循证治疗(EBT)在学校的应用一直受到限制。这一应用程序将利用社区伙伴关系方法产生一个框架，以加强创伤后应激障碍的循证治疗与学校利益攸关方优先事项之间的兼容性，最终促进学校采用和实施EBTS。

DESCRIPTION (provided by applicant): The overall goal of this proposed Mentored Research Scientist Development Award (K01) is for the candidate, a child clinical psychologist, to become an independent investigator who conducts research designed to improve school-based mental health services for ethnic minority children and families. The candidate has a strong background in studying developmental psychopathology in ethnic minority populations, and is seeking this award in order to gain essential skills in mental health services research and community-partnered research methods. To accomplish these goals, the candidate's immediate career development plan consists of coursework and mentorship focused on implementation research, community partnered research methods, school organization and policy, and mixed methods in mental health services research. Key mentors include Dr. Kimberly Hoagwood at Columbia University and Dr. Jeanne Miranda at the UCLA Health Services Research Center. The research plan is designed to enhance the compatibility between evidence-based treatment (EBT) for Post-traumatic Stress Disorder (PTSD) and urban school settings by partnering with school stakeholders. Although schools have been touted as ideal settings to reach underserved, ethnic minority youth, implementation of EBTs has been extremely limited. One reason for the low rates of implementation is that schools find it difficult to devote resources to programs that stretch beyond their educational mission. The purpose of this research is to develop a model for increasing the fit between an evidence based treatment for trauma-related PTSD symptoms and the goals and priorities of school stakeholders (e.g., parents, teacher, administrators, school clinicians). This involves examining adaptations that are made when an intervention is adopted by a school system, aligning mental health intervention implementation with effective practices schools can use to support students' learning, and ensuring that both mental health outcomes and school- relevant functioning outcomes (e.g., classroom/home behavior, attendance, school performance, social competence) are addressed and assessed. The aims are to: 1) Use a community partnered research model with the school community to more effectively align EBT for PTSD with school-community priorities and structures, 2) Document and explore the utility of using a community partnered research approach with school staff and parents, and 3) Pilot a mental health service delivery model for adolescents exposed to violence that improves the "fit" between and EBT for PTSD and school priorities. This research has important implications for serving youth exposed to community violence with limited access to care. It will also inform how EBTs are developed and disseminated into non-specialty mental health settings, like schools. PUBLIC HEALTH RELEVANCE: There is a high level of unmet need for mental health care among children, and schools are the most common source of mental health services among children and adolescents. However, uptake of evidence-based treatments (EBTs) in schools has been limited. This application will produce a framework, using community partnership methods, for enhancing the compatibility between an evidence-based treatment for Post Traumatic Stress Disorder and the priorities of school stakeholders, ultimately promoting the adoption and implementation of EBTs in schools.