Pragmatic RCT of a multi-level mechanistically informed community intervention to prevent the onset of behavioral health symptoms among socioeconomically disadvantaged pandemic affected children

多层次、机械化的社区干预的务实随机对照试验，以预防受大流行影响的社会经济弱势儿童出现行为健康症状

• 批准号: 10670793
• 负责人: Tara Leytham-Powell
• 金额: $ 64.09万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10670793
• 关键词: Address; Affect; Alabama; Anxiety; Attenuated; Behavior; COVID-19; COVID-19 impact; COVID-19 pandemic; Caregivers; Child; Childhood; Climate; Communities; Consolidated Framework for Implementation Research; Control Groups; Coping Behavior; Coping Skills; Coupled; Diagnosis; Disasters; Distress; Education; Elements; Exposure to; Family; Future; Goals; Hurricane; Individual; Intervention; Life Cycle Stages; Link; Mediating; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Modeling; Morbidity - disease rate; National Institute on Minority Health and Health Disparities; New Zealand; Oklahoma; Outcome; Parents; Poverty; Poverty Areas; Prevention; Prevention program; Professional counselor; Randomized; Randomized, Controlled Trials; Research; Resources; Risk; SARS-CoV-2 exposure; Safety; Schools; Security; Self Efficacy; Symptoms; Time; United States; Well in self; Wildfire; arm; attentional control; behavioral health; behavioral health intervention; community intervention; community organizations; coping; design; effective intervention; efficacy evaluation; eighth grade; emotional distress; ethnic minority; experience; follow up assessment; future pandemic; health disparity; healthy lifestyle; high risk; implementation barriers; improved; intervention effect; minority children; mortality; neighborhood disadvantage; pandemic disease; pandemic impact; pediatric trauma; peer; peer support; physical health service; poor communities; post intervention; preservation; prevent; preventive intervention; prospective; protective factors; public health emergency; racial minority; skills; social; social health determinants; socioeconomic disadvantage; stressor; therapy design

PROJECT SUMMARY/ABSTRACT The COVID-19 pandemic is having a profound impact on children globally, jeopardizing their sense of safety, security, and behavioral health. In addition to COVID-19, millions of children are still recovering from recent hurricanes that struck the southern the United States. Children exposed to climate-induced disasters (e.g. hurricanes) are at a significant risk for mental and behavioral health challenges. Coupled with an enduring pandemic, many of these children are disproportionately at risk for escalating mental health problems. Racial and ethnic minority children who live in socio-economically disadvantaged neighborhoods are among the most vulnerable during and after large-scale disasters. They are more likely experience high levels of social and material losses, displacement, and lack of access to mental and physical health services. Thus, there is a critical need for these children to received accessible, empirically supported preventative interventions to mitigate the onset of mental illness and behavioral health issues. Most post-disaster behavioral health interventions are designed to treat rather than prevent mental health conditions and are often inaccessible to racial and ethnic minority children living in socio-economically disadvantaged communities. The present study, therefore, seeks to examine the implementation and efficacy of the COVID-19 adaptation of a disaster focused empirically supported prevention intervention, the Journey of Hope (JoH), distributed by Save the Children, a humanitarian organization serving socio-economically disadvantaged and racial and ethnic minority children in communities dually impacted by COVID-19 and recent hurricanes that struck the Southern United States. The long-term goals of this study are to: (1) respond to the critical need of accessible behavioral health interventions designed to prevent and/or reduce COVID-19 related distress; and (2) provide an understanding on how a COVID-19 tailored prevention intervention mitigates behavioral health disparities among racial and ethnic minority children in high poverty settings who have been exposed to multiple large scale disasters. In a pragmatic randomized control trial with 800 children between 3-8th grade, we seek to: Aim 1: Evaluate the efficacy of the COVID-19 adapted JoH (JoH-C19) in preventing behavioral health and interpersonal problems among socio-economically disadvantaged and racial and ethnic minority children who have been exposed to multiple large-scale disasters relative to a healthy life-style attention control condition. Aim 2: Examine if hypothesized mechanisms of change variables (social connectedness, adaptive coping, self-efficacy) mediate intervention effects (JoH-C19 vs attention control) on child individual behavioral health and interpersonal outcomes. Aim 3: Assess the moderating impact of COVID-19 related stressors on behavioral health outcomes among children who participate in JoH-C19 versus the control condition. Aim 4: Explore implementation barriers, facilitators, and acceptability of the JoH-C19 within school and afterschool settings and delivered by community and school-based counselors.

项目摘要/摘要 COVID-19的大流行对全球儿童产生了深远的影响，危害他们的安全感， 安全和行为健康。除199年的Covid-19外，数以百万计的儿童仍在从最近的 袭击美国南部的飓风。暴露于气候引起的灾难的儿童（例如 飓风）面临精神和行为健康挑战的重大风险。加上持久的 大流行，其中许多孩子在不成比例的心理健康问题上有不成比例的风险。种族 和生活在社会经济处境不利的社区的少数民族儿童是最大的 在大规模灾难期间和之后脆弱。他们更有可能经历高水平的社交和 物质损失，流离失所以及无法获得身心健康服务。因此，有一个 这些孩子的临界需求是可访问的，经验支持的预防干预措施 减轻精神疾病和行为健康问题的发作。大多数灾后行为健康 干预措施旨在治疗而不是防止心理健康状况，并且通常无法访问 生活在社会经济处境不利的社区中的种族和少数民族儿童。本研究， 因此，试图研究COVID-19改编的灾难的实施和功效 经验支持的预防干预，希望之旅（JOH），由拯救孩子们分发 人道主义组织在社会经济上为处于弱势群体和种族和少数民族儿童服务 社区受到19日和最近袭击美国南部的飓风的双重影响。这 这项研究的长期目标是：（1）应对可访问行为健康的迫切需要 旨在预防和/或减少共同遇难的干预措施； （2）提供理解 关于共同19量量身定制的预防干预措施如何减轻种族和 在高贫困环境中遭受多次大规模灾难的少数民族儿童。在 务实的随机对照试验，有800名3至8年级的儿童，我们寻求：AIM 1：评估 COVID-19改编的Joh（JOH-C19）的功效在防止行为健康和人际问题上 在社会经济上处于不利地位，种族和少数民族的儿童中 相对于健康的生活风格控制条件，多次大规模灾难。目标2：检查是否 变化变量的假设机制（社会联系，自适应应对，自我效能）调解 干预效果（JOH-C19与注意力控制）对儿童个人行为健康和人际关系 结果。 AIM 3：评估Covid-19相关压力源对行为健康的调节影响 参加JOH-C19与控制状况的儿童的结果。目标4：探索 JOH-C19在学校和课后设置中的JOH-C19的实施障碍，促进者和可接受性 并由社区和学校辅导员提供。