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

项目总结 本次申请K23以患者为导向的研究职业发展奖旨在支持 波士顿儿童医院儿童虐待儿科医生方晓辉博士的职业发展 哈佛医学院成为一名独立调查者，其工作改善了精神卫生保健 以及受虐待儿童影响的家庭的结果。方博士建议开发和试行一部小说 对性虐待儿童的黑人和拉丁裔照顾者进行参与干预，以解决重大问题 这些儿童的心理健康需求未得到满足的负担。参与干预，在其中为儿童提供服务 专业人员(例如，社会工作者)与照顾者合作，增加儿童接受保健服务的机会， 代表了一种解决未得到满足的心理健康需求的有希望的方法，但尚未得到很好的研究 性虐待儿童的黑人和拉丁裔照顾者。这个K23项目旨在开发一部小说 针对这一新的照顾者群体的敬业度干预，整合了来自两个证据的组成部分- 基于干预措施(McKay‘s Engagement干预和Decision干预)。这项研究将使用 以社区为基础的参与性研究的原则和系统的文化适应过程 围绕三个目标开展敬业度干预。Aim 1将使用对Black和Latinx的深度采访 性虐待儿童的照顾者，以确定社会文化对儿童性虐待的看法和 寻求心理健康护理。目标2将利用焦点小组从为黑人服务的社会工作者那里获得反馈 以及性虐待儿童的拉丁裔照顾者和社区顾问委员会的意见，以文化和 根据上下文调整干预组件。目标3将对新的交战干预进行试点测试，以确定其可行性 性虐待儿童的黑人和拉丁裔照顾者的接受度。这项研究将导致 开发一种新的参与干预措施，准备进行大规模测试，作为减少种族和 性虐待后精神卫生保健方面的种族差异。方博士组建了一支经验丰富的 导师团队，包括Margarita Aregria博士(多元文化人群干预发展)，Dr。 Megan Bair-Merritt(专注于创伤的研究)和Michael Lindsey博士(针对少数族裔的治疗参与 家庭)指导她完成严格的培训计划，以获得以下方面的专业知识：1)制定干预措施 文化多样性人群；2)少数群体创伤研究中的社会文化和伦理问题 3)行为干预的临床试验方法学。方博士将利用独特的 波士顿儿童医院(一家领先的儿科保健和研究机构，以及 儿童性虐待专业转介中心)和更广泛的哈佛社区(哈佛医学院， 哈佛大学公共卫生学院，哈佛大学催化剂)进行她的研究和职业生涯 发展规划。K23奖项将使方博士做好准备，以应对不充分和 作为未来的独立研究人员，为受虐待儿童及其家人提供不公平的心理健康护理。

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.