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

项目摘要/摘要 这一职业发展奖将确立Ashaunta Anderson博士，医学博士，公共卫生硕士，MSHS的独立 调查员，重点是制定、实施和传播以证据为基础的种族 采用实验法和混合法对非洲裔美国儿童进行社会化干预 接近了。这项K23奖项将为她提供在4个领域发展专业知识所需的支持：1) 随机对照试验，2)结构方程模型，3)传播和分析的混合方法 实施科学，以及4)领导力和专业发展。非洲裔美国儿童 不成比例地经历种族主义，这与行为健康问题和学业失败有关。 行为健康问题阻碍学习，更有可能是慢性的、严重的、致残的和未经治疗的 在非裔美国人和白人中。提高文化自豪感的基于临床的干预措施可能会有所改善 结果与非洲裔美国儿童的行为健康有关。然而，人们对此知之甚少。 文化自豪感在这一人群中的干预。了解幼儿的这些过程是很重要的 因为早期儿童是种族偏见可能发展并阻碍行为健康和 学习和文化自豪感可能会支持它。该项目将从AltaMed初级保健诊所招募患者 附属于洛杉矶儿童医院。AltaMed是美国最大的联邦医疗系统 合格的健康中心。该项目将试行一项文化自豪感干预(针对 非洲裔美国儿童早期入学准备(CPR4ESR)的研究 方法：研究方法。CPR4ESR在卫生监督访问中提供以文化为主题的儿童书籍和建议 2-4岁的儿童入学。它是基于一项久负盛名的国家计划，名为接触和 读取(RoR)。ROR在卫生监督访问中提供儿童书籍和书籍分享建议，并提供报告 分享书籍的行为和识字能力的提高。拟议项目的具体目标是：1)评估 在家长和提供者中实施CPR4ESR的可行性和可接受性，2)评估 CPR4ESR改善幼儿父母文化自豪感强化和图书分享行为的能力 3)评估CPR4ESR改善行为健康和识字的能力 在年轻的非裔美国儿童中。在目标1中进行的访谈将指导干预措施的改进 在目标2和目标3中进行了测试。定性评估将得到定量试验统计数据的补充(例如， 招聘率)，以告知试验的可行性和可接受性。最后，CPR4ESR的作用机制 影响主要结果，行为健康，和次要结果，识字，将由 结构方程建模。该项目将为幼儿的发展和实施提供信息 针对非裔美国人中种族主义对健康的有害影响的干预措施。

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.