A Brief Intervention to Enhance Supportive Parenting and Treatment Engagement Among Families Waiting for Trauma-Focused Services

项目摘要 超过三分之二的儿童经历过创伤性事件，如儿童虐待，暴力，或突然或 暴力的损失这些儿童中的许多人承受着严重的情感和发展困难，包括创伤 症状攻击性和自杀倾向从理论上讲，来自护理者的情感支持可以缓冲 创伤的影响;然而，许多照顾者缺乏有效支持孩子的自我效能和技能，或者 在创伤后的紧张时期努力运用这些技能。不幸的是， 儿童创伤后的护理人员很少。现有的干预措施时间很长（持续8-20次会议）， 排在长长的等待名单上的家庭。该提案声称，儿童创伤的不良影响可以被中断， 通过一个简短的干预（项目支持积极育儿模块）， - 通过远程保健向等待接受以创伤为重点的服务的家庭提供。候选人收集的试点数据 建议这种干预可以由辅助专业人员提供，提高育儿自我效能和情绪 支持，并增加以后的创伤为重点的治疗出席。然而，提供者特征（例如， 知识，经验），以及内部（例如，组织支持）和外部（例如，患者的需求、态度） 影响创伤服务等待名单上的家庭接受简短干预的背景因素是 未知目标1和2包括K99指导研究阶段，目标3包括R 00独立研究阶段。 研究阶段。具体目标包括：1）通过以下方式检查提供项目支持的障碍和促进因素： 远程保健，n = 20名护理人员和n = 10名治疗提供者; 2）检查 在一项混合方法概念验证试点试验中通过远程医疗提供项目支持，其中n = 30个家庭等待 创伤为重点的服务和n = 4治疗提供者;和3）评估项目的初步疗效 在n = 100个等待的家庭中进行的随机对照试验（项目支持与常规治疗）中的支持 提供创伤治疗服务拟议的研究活动与培训活动同时进行， 候选人向独立调查员的过渡。在K99阶段，候选人将通过以下方式接受培训 课程、讲习班和咨询：（1）实施科学框架和传播 战略，（2）定性和混合方法，和（3）granitarian和科学的沟通。 指导和咨询专家在儿童创伤，儿童关系，实施科学， 定性方法和统计分析将确保实现培训目标。该提案将支持 候选人的长期职业目标是成为一个独立资助的终身教职教师， 儿童创伤研究领域，通过研究儿童创伤暴露的后果， 为创伤受害者及其家庭测试创新的基于父母的干预措施。K99/R00 这一机制是获得实现这一目标所需的经验和独立性的关键步骤。

PROJECT SUMMARY Over two-thirds of children experience traumatic events such as child maltreatment, violence, or sudden or violent loss. Many of these children sustain significant emotional and developmental difficulties including trauma symptoms, aggression, and suicidality. Emotional support from a caregiver is theorized to buffer against the effects of trauma; however, many caregivers lack the self-efficacy and skills to effectively support their child, or struggle to apply these skills during the stressful time following trauma. Unfortunately, programs designed for caregivers following child trauma are scarce. Existing interventions are lengthy (lasting 8-20 sessions) and result in families placed on long waitlists. This proposal asserts the adverse effects of child trauma can be interrupted though a brief intervention (the Project Support Positive Parenting Module) that enhances supportive parenting – delivered via telehealth to families on waitlists for trauma-focused services. Pilot data collected by the candidate suggests this intervention can be delivered by paraprofessionals, improve parenting self-efficacy and emotional support, and increase later trauma-focused treatment attendance. However, the provider characteristics (e.g., knowledge, experiences), as well as inner (e.g., organizational support) and outer (e.g., patient needs, attitudes) contextual factors that influence uptake of a brief intervention for families on the waitlist for trauma services is unknown. Aims 1 and 2 comprise the K99 Mentored Research Phase and Aim 3 comprises the R00 Independent Research Phase. Specific Aims include: 1) examine barriers and facilitators to delivering Project Support via telehealth with n = 20 caregivers and n = 10 treatment providers; 2) examine the feasibility and acceptability of Project Support via telehealth in a mixed-methods proof-of-concept pilot trial with n = 30 families waiting for trauma-focused services and n = 4 treatment providers; and 3) evaluate the preliminary efficacy of Project Support in a randomized controlled trial (Project Support vs. treatment as usual) among n = 100 families waiting for trauma-focused services. The proposed research activities coincide with training that will support the candidate’s transition to an independent investigator. In the K99 phase the candidate will receive training via coursework, workshops, and consultation in: (1) implementation science frameworks and dissemination strategies, (2) qualitative and mixed methodology, and (3) grantsmanship and scientific communication. Mentorship and consultation from experts in child trauma, caregiver-child relationships, implementation science, qualitative methods, and statistical analyses will ensure training goals are met. This proposal will support the candidate’s long-term career goal to become an independently funded tenure track faculty who advances the field of child trauma research by studying the consequences of children’s trauma exposure and developing and testing innovative parenting-based interventions for victims of trauma and their families. This K99/R00 mechanism is a critical step to obtaining the experience and independence necessary to obtain this goal.