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

一项简短的干预措施，以加强等待创伤重点服务的家庭的支持性养育和治疗参与

• 批准号: 10644434
• 负责人: Caitlin Rancher
• 金额: $ 12.86万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-14 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644434
• 关键词: Address; Adverse effects; Affect; Aggressive behavior; Applied Skills; Area; Attitude; Award; Benchmarking; Buffers; COVID-19 pandemic; Caregiver support; Caregivers; Caring; Characteristics; Child; Child Abuse and Neglect; Child Development; Child Rearing; Communication; Consolidated Framework for Implementation Research; Consultations; Data; Development; Disadvantaged; Educational process of instructing; Educational workshop; Emotional; Ensure; Epidemic; Faculty; Family; Funding; Future; Goals; Health Personnel; Hybrids; Instruction; Interruption; Intervention; Interview; Knowledge; Literature; Mediator; Mental Health; Mentors; Mentorship; Methodology; Methods; Modeling; Patients; Persons; Phase; Provider; Public Health; Qualitative Methods; Randomized, Controlled Trials; Research; Research Activity; Research Personnel; Rural; Self Efficacy; Services; Statistical Data Interpretation; Suspensions; Technology; Testing; Time; Training; Transportation; Trauma; Underserved Population; Videoconferencing; Violence; Waiting Lists; Work; acceptability and feasibility; barrier to care; brief intervention; career; caregiver interventions; child services; contextual factors; design; dissemination strategy; effective intervention; effectiveness testing; experience; health disparity; implementation framework; implementation science; improved; innovation; pediatric trauma; pilot trial; programs; recruit; research study; response; satisfaction; scale up; service delivery; skills; suicidal; telehealth; tenure track; theories; therapy design; trauma exposure; trauma symptom; traumatic event; traumatized children; treatment as usual; trend; uptake

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.

项目概要 超过三分之二的儿童经历过创伤事件，例如虐待儿童、暴力、或突然或 剧烈的损失。其中许多儿童患有严重的情感和发育困难，包括创伤 症状、攻击性和自杀倾向。从理论上讲，护理人员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 在创伤后的压力时期努力运用这些技能。不幸的是，设计的程序 儿童创伤后的护理人员很少。现有的干预措施时间较长（持续 8-20 次）且效果不佳 在排在很长的候补名单上的家庭中。该提案声称可以中断儿童创伤的不利影响 通过简短的干预（项目支持积极养育模块）来增强支持性养育 – 通过远程医疗向等待创伤重点服务的家庭提供服务。候选人收集的试点数据 建议这种干预措施可以由辅助专业人员进行，提高育儿自我效能感和情绪 支持，并增加以后以创伤为重点的治疗就诊率。然而，提供者的特征（例如， 知识、经验），以及内部（例如组织支持）和外部（例如患者需求、态度） 影响创伤服务候补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 R00 独立研究阶段 研究阶段。具体目标包括： 1) 检查通过以下方式提供项目支持的障碍和促进因素： n = 20 名护理人员和 n = 10 名治疗提供者的远程医疗； 2）审查可行性和可接受性 在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，n = 30 个家庭正在等待 以创伤为重点的服务和 n = 4 名治疗提供者； 3）评估项目的初步效果 在 n = 100 个等待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 以创伤为重点的服务。拟议的研究活动与支持培训相一致 候选人转变为独立调查员。在 K99 阶段，候选人将通过以下方式接受培训 课程作业、研讨会和咨询：(1) 实施科学框架和传播 策略，(2) 定性和混合方法，以及 (3) 资助和科学传播。 来自儿童创伤、照顾者与儿童关系、实施科学、 定性方法和统计分析将确保培训目标的实现。该提案将支持 候选人的长期职业目标是成为一名独立资助的终身教员，推动 儿童创伤研究领域，通过研究儿童创伤暴露的后果以及发展和 针对创伤受害者及其家人测试基于育儿的创新干预措施。这款K99/R00 机制是获得实现这一目标所需的经验和独立性的关键一步。