Building and testing feasibility of EMPOWER, a skill-based psychosocial intervention for parents of critically ill children

建立并测试 EMPOWER 的可行性，这是一种针对危重儿童家长的基于技能的心理社会干预措施

• 批准号: 10662959
• 负责人: Lauren Yagiela
• 金额: $ 16.98万
• 依托单位: CENTRAL MICHIGAN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-23 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662959
• 关键词: Academy; Address; Adherence; Admission activity; Adolescent; Adoption; Adult; Affect; African American; Award; Behavior Therapy; Caregivers; Child; Child Health; Childhood; Collaborations; Communication; Competence; Conduct Clinical Trials; Critical Care; Critically ill children; Data; Distress; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Event; Evidence based intervention; Exercise; Failure; Focus Groups; Foundations; Funding; Future; Gender; Goals; Health Personnel; Intervention; Interview; Lead; Learning; Life; Maintenance; Manuals; Measures; Medical; Medicine; Mental Health; Mentored Clinical Scientist Development Program; Mentors; Methods; Mission; Modeling; Morbidity - disease rate; National Institute of Child Health and Human Development; Outcome; Parents; Participant; Pediatric Intensive Care Units; Perception; Phase; Program Development; Race; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Recovery; Research; Research Personnel; Resources; Risk; Role playing therapy; Safety; Scientist; Self Efficacy; Social support; Standardization; Stress and Coping; Structure; Testing; Training; Trauma; Work; career; caucasian American; coping; cost; design; eHealth; efficacious intervention; efficacy testing; emotion regulation; empowerment; evidence base; experience; feasibility testing; feasibility trial; implementation barriers; implementation determinants; improved; improved outcome; intervention delivery; intervention refinement; parental role; physical conditioning; post-traumatic symptoms; psychosocial; psychosocial resources; racial diversity; response; skills; symposium; systematic review; theories; tool

PROJECT SUMMARY Surviving a serious, life-threatening illness in the pediatric intensive care unit (PICU) often comes at the cost of new child morbidity and detriments to child and parent mental health. Parents are integral in a child’s PICU recovery. Yet, parent mental health and caregiver self-efficacy can be significantly and negatively impacted by the trauma associated with a child’s PICU admission, affecting parents’ ability to help their child optimally recover. Recognizing the key role of parents in child health, the National Academy of Medicine has identified a crucial need for psychosocial interventions for parents in vulnerable situations, such as PICU admission. However, a recent systematic review found a paucity of parent interventions in the PICU. Thus, a critical need exists for an effective psychosocial intervention for PICU parents that reduces PTSS and enhances caregiver self-efficacy after discharge. The overall objective of this proposal is to gain the skills to build and test the feasibility of a theory-driven and evidence-based parent psychosocial intervention through three specific aims: Aim 1) Build EMPOWER, an intervention for parents whose children are admitted to a PICU. Dr. Yagiela will collaborate with PICU stakeholders and use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework to integrate and adapt evidence-based components from existing parent interventions to create EMPOWER. Aim 2) Develop and test a training curriculum to prepare parent mentors to deliver the EMPOWER intervention. Principles of adult learning, didactics, role-playing exercises, and delivery of the intervention in standardized scenarios will be used to train and test the readiness of parent mentors to deliver the intervention. Aim 3) Determine the feasibility, acceptability, and implementation factors of the EMPOWER intervention. Parent mentors will deliver the intervention to PICU parents in a feasibility trial. The expected outcome of these aims is a feasible theory-driven and evidence-based intervention called EMPOWER, that helps parents gain skills to reduce immediate distress, which my conceptual model posits can reduce future PTSS and enhance caregiver self-efficacy. This is expected to have a positive impact by improving parents’ ability to support their child’s recovery, thereby increasing the potential for improved PICU child outcomes. This K23 proposal also includes a four-year training plan. With the support of an expert team of mentors and advisors, Dr. Yagiela will gain training in developing behavioral interventions, designing and conducting clinical trials, and qualitative and mixed methods, and develop professionally. The training goals will be accomplished through frequent interaction with mentors / advisors, didactic coursework, mentored study, seminars, and conferences. This K23-supported data and training will provide a foundation for a future R01-funded randomized controlled trial of the EMPOWER intervention and enable Dr. Yagiela to achieve her long-term goal of becoming an independent clinician-researcher who develops, tests, and implements psychosocial interventions that improve mental and physical health outcomes in parents and critically ill children.

项目概要 在儿科重症监护病房 (PICU) 中幸存严重的、危及生命的疾病通常要付出以下代价： 新的儿童发病率以及对儿童和父母心理健康的损害。父母是儿童 PICU 中不可或缺的一部分 恢复。然而，父母的心理健康和照顾者的自我效能感可能会受到以下因素的显着和负面影响： 与孩子入住 PICU 相关的创伤，影响父母以最佳方式帮助孩子的能力 恢复。认识到父母在儿童健康中的关键作用，美国国家医学院确定了一个 处于弱势处境的父母迫切需要进行心理社会干预，例如入住儿科重症监护病房(PICU)。 然而，最近的一项系统回顾发现，儿科重症监护病房 (PICU) 缺乏家长干预。因此，迫切需要 为 PICU 家长提供有效的社会心理干预，以减少 PTSS 并增强护理人员的能力 出院后的自我效能感。该提案的总体目标是获得构建和测试 通过三个具体目标进行理论驱动和基于证据的家长心理社会干预的可行性： 目标 1) 建立 EMPOWER，这是一项针对孩子入住 PICU 的家长的干预措施。亚吉拉博士将 与 PICU 利益相关者合作并使用 RE-AIM（覆盖范围、有效性、采用、实施和 维护）框架，以整合和调整现有家长干预措施中基于证据的组成部分 创造赋权。目标 2) 开发并测试培训课程，让家长导师做好准备，以提供 授权干预。成人学习、教学、角色扮演练习和交付的原则 标准化场景的干预将用于培训和测试家长导师是否准备好交付 的干预。目标 3) 确定 EMPOWER 的可行性、可接受性和实施因素 干涉。家长导师将在可行性试验中向 PICU 家长提供干预措施。预期的 这些目标的结果是一种可行的理论驱动和基于证据的干预措施，称为 EMPOWER， 帮助父母获得减少眼前痛苦的技能，我的概念模型认为这可以减少未来的痛苦 PTSS 并提高护理人员的自我效能。预计这将通过改善家长的 支持孩子康复的能力，从而增加改善 PICU 儿童预后的潜力。这 K23提案还包括一个四年的培训计划。在导师专家团队的支持下 作为顾问，Yagiela 博士将接受开发行为干预、设计和进行临床的培训 试验、定性和混合方法，并专业发展。培训目标一定会实现 通过与导师/顾问的频繁互动、教学课程、指导学习、研讨会和 会议。 K23 支持的数据和培训将为未来 R01 资助的项目奠定基础 EMPOWER 干预的随机对照试验使 Yagiela 博士实现了长期目标 成为一名独立的临床医生研究员，开发、测试和实施社会心理治疗的目标 改善父母和危重儿童心理和身体健康结果的干预措施。