Advancing Health Equity through Park Afterschool Programs

摘要 被系统边缘化的社区的年轻人有不成比例的高心理健康需求和 服务利用率低[1，2]。课外计划(ASP)促进积极的青年发展轨迹 受系统性不平等影响的社区。[39]高质量的ASP依赖于青年与成人的关系和良好的 有组织的例行公事来培养社交情绪技能[44-46]，通常是循证预防的目标 程序。几十年来，调查人员一直试图通过传统的方式将校本课程带到ASP[51，52] 以结构化课程形式提供的手工课程教师培训。这有两个问题 ASP的模式：1.教职员工和年轻人不喜欢学校式的大型、复杂的课程；还有，ASP中的孩子 迟到早退，错过只在特定的有组织的时间内提供的指导；2.常见 一站式的教师专业发展研讨会不能很好地转移到ASP提供商， 而一刀切的做法忽视了他们不同的教育、培训和经验。频繁 在ASP中不断变化的时间表、优先级和资源使其严格遵守自动化程序 不太可能，也是不可持续的。专业技术人员的专业发展必须：(1)提供差异化的指导和 基于文化和背景的知识应用；(2)包括对知识行动的持续支持；和(3) 对组织和提供者层面对知识、行动和结果的影响作出反应。本R01 应用程序扩展了与国家顾问委员会和三个大型城市县公园区(洛杉矶， 芝加哥，迈阿密)，并提出了一种混合方法、多地点、可移植性研究设计来检验 组织和提供者层面的促进者和知识行动的障碍。ASP提供商(n=180，~55% 女性，40%白人，45%黑人/非裔美国人，5%亚裔美国人，10%多种族，30%西班牙裔/拉丁裔) 将接受专业发展，强调工具和与情感洞察力相关的可教时刻 和监管。参与者将自行选择持续支持的形式和频率 ASP课程(约3-4个月)：(A)持续在线培训；(B)通过短信“催促”； 以及(C)在每月的Zoom咖啡时间促进与专家或同行的讨论。调查前和调查后， 以及每周的签到，将评估提供者的知识、自我效能、态度、学习内容的灌输 ASP编程和福祉。随机挑选的提供者(每个公园区15名)将参加 在约1小时的测试后面试中。量化分析将测试知识之间的预测关联 消费、知识行动、提供者福祉和与青年的关系。混合方法分析 我将研究组织和提供者级别的促进者以及使用和灌输社交情绪的障碍 技能融入自然的ASP套路，并对技能输入量和质量产生积极影响 提供关于幸福和与青年关系的报告。

Abstract Youth in systemically marginalized communities have disproportionately high rates of mental health need and low rates of service utilization [1,2]. Afterschool programs (ASPs) promote positive youth trajectories in communities impacted by systemic inequities.[39] High quality ASPs rely on youth-adult relationships and well- organized routines to build social-emotional skills[44-46] commonly targeted in evidence-based prevention programs. For decades, investigators have tried to bring school-based programs to ASPs[51,52] via traditional teacher training for manualized curriculum delivered in structured lessons. There are two problems with this model for ASP: 1. Staff and youth dislike the school-like format of big, complex curriculum; also, kids in ASPs arrive late and leave early, and miss instruction that’s offered only during specific structured time; 2. Common one-and-done in-person teacher professional development workshops do not transfer well to ASP providers, and the one-size-fits-all approach neglects their diverse education, training, and experience. Frequently changing schedules, priorities, and resources among ASP make rigid adherence to manualized programs unlikely and unsustainable. Professional Development in ASPs must: (1) provide differentiated instruction and culture- and context-based application of knowledge; (2) include ongoing support for knowledge action; and (3) be responsive to organizational- and provider-level influences on knowledge action and outcomes. This R01 application extends collaboration with a national advisory board and three large urban county park districts (LA, Chicago, Miami), and proposes a mixed method, multi-site, transportability research design to examine organizational- and provider-level facilitators and barriers to knowledge action. ASP providers (n=180, ~55% female, 40% White, 45% Black/African American, 5% Asian American, 10% multiracial, 30% Hispanic/LatinX) will receive professional development emphasizing tools and teachable moments related to emotional insight and regulation. Participants will self-select the formats and frequency of ongoing support for the duration of an ASP session (~3-4 months) from: (a) ongoing access to online training; (b) “nudges” via SMS text messages; and (c) facilitated discussion with expert or peers during monthly Zoom coffee hours. Pre- and post- surveys, and weekly check-ins, will assess provider knowledge, self-efficacy, attitudes, infusion of learned content into ASP programming and well-being. Randomly selected providers (n=15 from each park district) will participate in ~1-hour post-test interviews. Quantitative analyses will test predicted associations among knowledge consumption, knowledge action, and provider well-being and relationships with youth. Mixed method analyses will examine organizational- and provider-level facilitators and barriers to using and infusing social-emotional skills into natural ASP routines, and the quantity and quality of skills infusion necessary to positively influence provider reports of well-being and relationships with youth.