Cultural Pride Reinforcement for Early School Readiness: Pilot Randomized Controlled Trial of a Clinic-Based Intervention for Young African American Children

强化文化自豪感，为早期入学做好准备：对非裔美国幼儿进行临床干预的随机对照试验

• 批准号: 10664763
• 负责人: Ashaunta Tumblin Anderson
• 金额: $ 17.2万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-21 至 2028-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10664763
• 关键词: 4 year old; Address; Adherence; Affect; African American; African American population; Age; Area; Automobile Driving; Behavior; Books; Buffers; Child; Child Care; Child Development; Child Rearing; Childhood; Chronic; Clinic; Clinical Trials; Communities; Complement; Development; Distal; Early Intervention; Enrollment; Equation; Evaluation; Exclusion; Exhibits; Failure; Family; Federally Qualified Health Center; Goals; Health; Healthcare; Implementation readiness; Inequity; Intervention; Interview; K-Series Research Career Programs; Language Development; Latino; Latino Population; Leadership; Learning; Life Cycle Stages; Los Angeles; Mediating; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Modeling; Outcome; Parents; Pathway interactions; Patient Recruitments; Pediatric Hospitals; Physicians; Policies; Population; Process; Provider; Psychological reinforcement; Race; Randomized, Controlled Trials; Readiness; Reporting; Research; Research Personnel; Review Literature; Sampling; Schools; Social Development; Socialization; Societies; Stress; Supervision; System; Testing; Training; United States; Visit; Work; acceptability and feasibility; adverse childhood events; behavioral health; career; design; dissemination science; early childhood; evidence base; experience; externalizing behavior; feasibility trial; follow-up; implementation science; improved; improved outcome; intervention refinement; literacy; minority children; minority health; minority health disparity; pilot test; primary care clinic; primary outcome; programs; racial bias; racism; recruit; secondary outcome; skill acquisition; skills; statistics

PROJECT SUMMARY/ABSTRACT This career development award will establish Dr. Ashaunta Anderson, MD, MPH, MSHS, as an independent investigator with a focus on the development, implementation, and dissemination of evidence-based racial socialization interventions for young African American children, using experimental and mixed-method approaches. This K23 award will provide her with the support she needs to develop expertise in 4 areas: 1) randomized controlled trials, 2) structural equation modeling, 3) mixed methods in dissemination and implementation science, and 4) leadership and professional development. African American children disproportionately experience racism, which is associated with behavioral health problems and school failure. Behavioral health problems impede learning and are more likely to be chronic, severe, disabling, and untreated in African Americans compared to Whites. Clinic-based interventions that boost cultural pride may improve outcomes related to behavioral health in young African American children. However, little is known about cultural pride interventions in this population. It is important to understand these processes in young children because early childhood is a period during which racial bias may develop and stymie behavioral health and learning, and cultural pride may support it. This project will recruit patients from AltaMed primary care clinics affiliated with Children’s Hospital Los Angeles. AltaMed is the United States’ largest system of Federally Qualified Health Centers. The project will pilot a cultural pride intervention (Cultural Pride Reinforcement for Early School Readiness (CPR4ESR)) in young African American children using experimental and mixed methods. CPR4ESR provides culturally themed children’s books and advice at health supervision visits of children enrolled at ages 2-4 years. It is based on a well-established national program called Reach Out and Read (ROR). ROR provides children’s books and book-sharing advice at health supervision visits with reports of increased book-sharing behaviors and literacy. The specific aims of the proposed project are to: 1) assess the feasibility and acceptability of CPR4ESR implementation among parents and providers, 2) evaluate the capacity of CPR4ESR to improve cultural pride reinforcement and book-sharing behaviors in parents of young African American children, and 3) evaluate the capacity of CPR4ESR to improve behavioral health and literacy in young African American children. The interviews conducted in Aim 1 will guide refinement of the intervention tested in Aims 2 and 3. The qualitative assessment will be complemented by quantitative trial statistics (e.g., recruitment rate) that inform trial feasibility and acceptability. Finally, the mechanism by which CPR4ESR impacts the primary outcome, behavioral health, and the secondary outcome, literacy, will be evaluated by structural equation modeling. This project will inform the development and implementation of early childhood interventions that address the deleterious health-related effects of racism among African Americans.

项目总结/摘要 这个职业发展奖将建立博士Ashaunta安德森，医学博士，公共卫生硕士，MSHS，作为一个独立的 调查员，重点是发展，实施和传播基于证据的种族歧视 对年轻的非洲裔美国儿童的社会化干预，使用实验和混合方法 接近。这个K23奖项将为她提供所需的支持，以发展4个领域的专业知识：1） 随机对照试验，2）结构方程模型，3）混合传播方法， 实施科学，以及4）领导力和专业发展。非裔美国儿童 不成比例地经历种族主义，这与行为健康问题和学校失败有关。 行为健康问题会妨碍学习，并且更有可能是慢性的、严重的、致残的和未经治疗的 非洲裔美国人与白人相比。以诊所为基础的干预措施可以提高文化自豪感 与非洲裔美国儿童行为健康相关的结果。然而，人们对 对这一群体的文化自豪感进行干预。理解幼儿的这些过程是很重要的 因为幼儿期是种族偏见可能发展并阻碍行为健康的时期， 学习和文化自豪感可能会支持它。该项目将招募来自AltaMed初级保健诊所的患者 隶属于洛杉矶儿童医院。AltaMed是美国最大的联邦医疗系统， 合格的保健中心。该项目将试行一项文化自豪感干预措施（加强文化自豪感， 早期入学准备（CPR 4 ESR））在年轻的非洲裔美国儿童使用实验和混合 方法. CPR 4 ESR提供文化主题的儿童书籍和建议， 2-4岁的儿童入学。它基于一个名为“伸出援手”的完善的国家方案， 读取（ROR）。ROR在卫生监督访问时提供儿童书籍和书籍分享建议，并提供报告 分享书籍的行为和读写能力的增加。拟议项目的具体目标是：1）评估 CPR 4 ESR在家长和供应商中实施的可行性和可接受性，2）评估 CPR 4 ESR的能力，以提高文化自豪感的加强和图书分享行为的父母年轻 非裔美国儿童，3）评估CPR 4 ESR改善行为健康和识字能力的能力 年轻的非裔美国儿童。目标1中进行的访谈将指导干预措施的完善 在目标2和3中进行了测试。定量试验统计将补充定性评估（例如， 招募率），告知试验的可行性和可接受性。最后，CPR 4 ESR的机制 影响主要结果，行为健康，和次要结果，识字，将评估 结构方程建模。该项目将为幼儿教育的发展和实施提供信息， 采取干预措施，解决种族主义对非裔美国人健康的有害影响。