Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees

基于社区的多层次心理健康干预措施，以解决结构性不平等以及 COVID-19 疫情对拉丁裔移民和非洲难民造成的不同不利后果

• 批准号: 10676776
• 负责人: JESSICA R GOODKIND
• 金额: $ 62.26万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10676776
• 关键词: Address; Advocacy; Affect; African; Awareness; Black Populations; Black race; COVID-19; COVID-19 pandemic effects; Collaborations; Communities; Complex; Control Groups; Data; Disasters; Discrimination; Disparate; Disparity; Economics; Education; Effectiveness of Interventions; Enrollment; Essential worker; Exposure to; Family; Goals; Grief reaction; Health; Health Insurance; Housing; Immigrant; Immigration; Incidence; Individual; Inequity; Insurance Coverage; Intervention; Interview; Language; Latinx; Latinx population; Learning; Legal; Low income; Mediating; Mental Health; Mental Health Services; Methods; Modeling; Occupations; Participant; Pathway interactions; Personal Satisfaction; Persons; Policies; Probability Samples; Prognosis; Randomized; Refugees; Research; Research Design; Resources; Sampling; Science; Site; Social Change; Social support; Stress; System; Testing; Time; United States; Waiting Lists; Work; Youth; adverse outcome; barrier to care; behavioral economics; community based participatory research; community organizations; comparison group; comparison intervention; cultural health; design; disparity reduction; economic impact; effectiveness testing; experience; food insecurity; health care availability; health disparity; health economics; health service use; improved; innovation; intervention effect; marginalized population; mutual learning; outcome disparities; pandemic disease; pandemic impact; peer; physical conditioning; primary outcome; protective factors; psychological distress; recruit; research study; response; secondary outcome; social; social determinants; socioeconomics; stressor; trauma exposure; treatment as usual; university student

PROJECT SUMMARY The goal of this study is to test a multilevel approach to reduce adverse consequences of the COVID-19 pandemic with disparate impacts on Latinx and Black immigrants and refugees by observing and implementing three nested levels of intervention: 1) an efficacious 6-month peer advocacy and mutual learning model (Refugee and Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes expected to be enacted in response to the pandemic, such as a state disaster relief proposal for mixed status Latinx families and expanded statewide health insurance coverage. This community-based participatory research (CBPR) study builds on a long-standing collaboration with five community-based organizations (CBOs) that focus on mental health, education, legal issues, and system change efforts to improve the well-being of Latinx immigrants and African refugees. By including 240 Latinx immigrants and 60 African refugees recruited from CBO partners who are randomly assigned to treatment-as- usual CBO involvement or the RIWP intervention and a random sample comparison group of 300 Latinx immigrants, this mixed methods longitudinal waitlist control group design study with seven time points over 36 months will test the effectiveness of the RIWP intervention and engagement with CBOs to reduce psychological distress, daily stressors, and economic precarity and increase protective factors (social support, critical awareness of/access to resources, English proficiency, cultural connectedness, and mental health service use). This study will also test the ability of the RIWP intervention and engagement with CBOs to increase access to the direct benefits of structural interventions (local/state relief-related policies) for Latinx and Black immigrants and refugees. Mechanisms of intervention effectiveness will be explored by testing mediating relationships between primary outcomes and protective factors. We will also track local/state policy changes and obtain preliminary quantitative estimates of effects of these structural interventions on psychological distress, stressors, and economic precarity using propensity score matching. Qualitative interview data from a purposive subsample of participants and CBO staff will enable additional exploration of mechanisms of change, the effects of policy interventions on individuals, how CBOs contribute to enacting policies and helping people benefit from them, and the context of RIWP implementation at each site. This research is innovative and significant because it employs cutting-edge research design and intervention strategies to advance the science of multilevel mental health interventions that aim to understand and address underlying structural inequities and resulting mental health disparities that have been highlighted and exacerbated by the pandemic. Thus, this study will contribute not only to reducing the disparate adverse mental health, behavioral, and socioeconomic consequences of the COVID-19 pandemic but also to our ability to eliminate mental health disparities among Latinx and Black populations.

项目摘要 这项研究的目的是测试一种多层次的方法来减少COVID-19的不良后果 通过观察和实施，大流行对拉丁裔和黑人移民和难民产生不同的影响 三个嵌套的干预水平：1）有效的6个月同伴倡导和相互学习模型 （RIWP难民和移民福祉项目）； 2）与社区组织的互动 （CBO）; 3）预计将根据大流行而制定的结构性政策变化，例如 灾害救援提案，关于拉丁裔家庭的混合状态，并扩大了全州范围内的健康保险范围。 这项基于社区的参与性研究（CBPR）研究以与五个的长期合作为基础 集中于心理健康，教育，法律问题和系统的社区组织（CBO） 改变努力，以改善拉丁裔移民和非洲难民的福祉。通过包括240个拉丁裔 从CBO伙伴招募的移民和60名非洲难民，他们被随机分配给治疗 通常的CBO参与或RIWP干预和300个拉丁裔的随机样本比较组 移民，这种混合方法纵向候补对照组设计研究，七个时间点超过36 几个月将测试RIWP干预和与CBO的互动的有效性以减少 心理困扰，日常压力源和经济不稳定并增加保护因素（社会支持， 对资源，英语水平，文化联系和心理健康的批判意识 服务使用）。这项研究还将测试RIWP干预和与CBO的参与的能力 增加对拉丁裔的结构干预措施的直接益处（本地/州救济相关的政策） 和黑人移民和难民。通过测试将探索干预效率的机制 介导主要结果和保护因素之间的关系。我们还将跟踪本地/国家政策 改变并获得这些结构干预效果的初步定量估计 使用倾向得分匹配的心理困扰，压力源和经济不稳定。定性 来自参与者和CBO工作人员的有目的子样本的访谈数据将促进对 变革机制，政策干预对个人的影响，CBO如何促进制定 政策和帮助人们从中受益，以及每个站点实施RIWP的背景。这 研究具有创新性和意义，因为它采用了尖端的研究设计和干预 推进旨在理解和解决多层次心理健康干预措施科学的策略 基本的结构不平等和由此产生的心理健康差异已得到强调，并且 大流行而加剧。因此，这项研究不仅将有助于减少不同的不利 19009年大流行的心理健康，行为和社会经济后果，也符合我们的能力 消除拉丁人和黑人人群之间的心理健康差异。