Developing an engagement intervention for Black and Latinx caregivers to improve children’s receipt of mental health services after sexual abuse

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PROJECT SUMMARY This application for a K23 Mentored Patient-Oriented Research Career Development Award aims to support the career development of Dr. Hiu-fai Fong, a child abuse pediatrician at Boston Children’s Hospital and Harvard Medical School, in becoming an independent investigator whose work improves mental health care and outcomes for families affected by child abuse. Dr. Fong proposes to develop and pilot test a novel engagement intervention for Black and Latinx caregivers of sexually abused children to address the significant burden of unmet mental health need for these children. Engagement interventions, in which child-serving professionals (e.g., social workers) work with caregivers to increase children’s receipt of MH services, represent a promising approach to address unmet mental health need but have not been well studied with Black and Latinx caregivers of sexually abused children. This K23 project seeks to develop a novel engagement intervention for this new population of caregivers that integrates components from two evidence- based interventions (McKay’s engagement intervention and the DECIDE intervention). The research will use principles of community based participatory research and a systematic process of cultural adaptation to develop the engagement intervention over three Aims. Aim 1 will use in-depth interviews with Black and Latinx caregivers of sexually abused children to identify sociocultural perceptions about child sexual abuse and mental health care seeking. Aim 2 will use focus groups to elicit feedback from social workers that serve Black and Latinx caregivers of sexually abused children and input from a community advisory board to culturally and contextually adapt intervention components. Aim 3 will pilot test the new engagement intervention for feasibility and acceptability with Black and Latinx caregivers of sexually abused children. This research will lead to the development of a new engagement intervention ready for large-scale testing as a strategy to reduce racial and ethnic disparities in mental health care after sexual abuse. Dr. Fong has assembled a highly experienced mentorship team, including Dr. Margarita Alegria (intervention development for multicultural populations), Dr. Megan Bair-Merritt (trauma-focused research), and Dr. Michael Lindsey (treatment engagement for minority families) to guide her through a rigorous training plan to gain expertise in: 1) intervention development for culturally diverse populations; 2) sociocultural and ethical issues in trauma-focused research with minority groups; and 3) clinical trial methodology for behavioral interventions. Dr. Fong will leverage the unique resources available at Boston Children’s Hospital (a leading pediatric healthcare and research institution, and a specialty referral center for child sexual abuse) and the broader Harvard community (Harvard Medical School, Harvard T.H. Chan School of Public Health, Harvard Catalyst) to carry out her research and career development plan. The K23 award will prepare Dr. Fong to tackle the substantial challenges of inadequate and inequitable mental health care for abused children and their families as a future independent researcher.