Adaptation of virtual group interventions to promote resilience among English and Spanish speaking parents of children with Learning and Attentional Disabilities (LAD)

采用虚拟团体干预措施，以提高学习和注意力障碍（LAD）儿童的英语和西班牙语家长的适应力

• 批准号: 10848137
• 负责人: KAREN A KUHLTHAU
• 金额: $ 57.86万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-14 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10848137
• 关键词: Address; Anxiety; Area; Attention; Behavior; Behavioral Model; Black, Indigenous, People of Color; Breathing; COVID-19 pandemic; Child; Child Rearing; Clinical; Collaborations; Communities; Control Groups; Data; Development; Dissemination and Implementation; Dose; Eligibility Determination; Emotional; Enrollment; Face; Fatigue; Feedback; Financial Hardship; Focus Groups; Group Interviews; Guided imagery; Hair; Health education; Hour; Hydrocortisone; Intervention; Language; Latinx; Leadership; Learning; Low income; Massachusetts; Measures; Meditation; Mental Depression; Mental Health; Mental disorders; Mind-Body Intervention; Modeling; Modification; Movement; Muscle relaxation phase; National Center for Complementary and Integrative Health; Outcome; Parents; Personal Satisfaction; Phase; Population; Posttraumatic growth; Process; Protocols documentation; Recommendation; Relaxation; Relaxation Therapy; Research; Resources; Running; Rural; Sampling; Self Care; Social isolation; Stress; Stress and Coping; Techniques; Time; Translating; Underserved Population; Work; disability; emotional distress; evidence base; expectation; experience; group intervention; improved; intervention delivery; meetings; mind/body; mindfulness; pandemic disease; physical conditioning; physical process; pilot test; pilot trial; programs; progressive relaxation therapy; promote resilience; psychologic; randomized trial; randomized, clinical trials; recruit; remote delivery; remote group; remote intervention; resilience; response; satisfaction; skills; skills training; social; stress management; therapy development; tool; virtual group

Parents of children with learning and attentional disabilities (LAD) face ongoing stress that leads to deleterious mental and physical health outcomes. Specifically, parents of children with LAD experience higher levels of stress compared to parents of neurotypically developing children, have high rates of mental health disorders, experience social isolation, financial distress, and are likely to forego self-care needs. Accessible remote interventions are critically needed for these vulnerable parents. Thus, we propose in this R56 to develop and pilot a fully remote mind-body resiliency group intervention that is targeted to the needs of these parents with an expectation that we will then move to a full randomized clinical trial. We developed an evidence-based mind-body resiliency intervention (Stress Management and Relaxation Training: Relaxation Response Resiliency Program; SMART-3RP), which uses a combination of mind and body approaches to enhance resiliency and adapted it to the needs of parents of children with LAD (SMART-LAD). Pilot trial findings supported the feasibility of the Zoom-delivered group format, remote delivery, and dose; acceptability of the intervention skills; and clinical benefit for improving resiliency and its psychological and physical processes, including stress coping, mental health, physical health, and healthy behaviors. Partnering with the Federation for Children with Special Needs (FCSN) we will further adapt the SMART-LAD intervention in this R56 and the Health Education Program (HEP) attention matched control intervention with diverse parents (or guardians as parents) throughout Massachusetts, including BIPOC (Black, Indigenous, and People Of Color), Latinx, and low-income, rural, and other underserved groups. The aims are: A1: To conduct focus groups to elicit feedback on recruitment plan and tool, intervention delivery (proposed co-facilitator model) and timing, intervention content (SMART-LAD and HEP), and cultural and Spanish language modifications. Five live video-based focus groups will be run: 1 professional group, 2 English speaking parent groups (1 SMART-LAD and 1 HEP), and 2 Spanish speaking parent groups (1 SMART-LAD and 1 HEP). A2: To integrate focus group findings to develop adapted and translated treatments. A3: To conduct 4 pilot groups (SMART-LAD and HEP in English and Spanish) and finalize adapted and translated treatments. Outcomes will be Feasibility (% eligible parents who enroll, % sessions completed, % returned hair cortisol) and Acceptability (rating and open-ended questions of satisfaction, needs met, helpfulness and recommendations). The final adaptation step will be a meeting with our community partner, FCSN, leadership. This work is critical in assuring that these interventions are adapted to and useful to diverse English and Spanish speaking parent populations. The next phase would be a full RCT which would be built upon strong preliminary data and a sustainable collaboration with community partners which would facilitate widespread implementation and dissemination of a remote group mind-body intervention to promote psychological resilience of vulnerable parents of children with LAD.

学习和注意障碍儿童的父母（LAD）面临持续的压力，导致了有害的身心健康。具体来说，与神经型发育的儿童的父母相比，患有LAD的孩子的父母经历了更高的压力，精神健康障碍率很高，经历了社会隔离，经济困扰，并且可能会放弃自我保健需求。这些脆弱的父母至关重要的远程干预措施是必需的。因此，我们建议在此R56中开发和驾驶完全遥远的身心弹性群体干预措施，该干预措施针对这些父母的需求，并期望我们将进行全面的随机临床试验。我们开发了一种基于证据的思维弹性干预措施（压力管理和放松训练：放松响应弹性计划； SMART-3RP），该计划结合了思维和身体方法来提高弹性，并将其适应了与LAD（Smart-Lad）的孩子的父母的需求。试点试验结果支持缩放分组格式，远程交付和剂量的可行性；干预技能的可接受性；以及提高弹性及其心理和身体过程的临床利益，包括压力应对，心理健康，身体健康和健康行为。与有特殊需要的儿童联合会合作（FCSN），我们将进一步适应此R56的智能LAD干预措施，健康教育计划（HEP）注意与整个马萨诸塞州的多元化父母（或父母）相匹配，包括Bipoc（包括Bipoc（包括黑人，原住民），色彩和低含量），拉丁裔和低含量群体和其他群众和其他群众和其他群众，以及其他群众和其他群众。目的是：A1：进行焦点小组以引起对招聘计划和工具的反馈，干预交付（拟议的共同模型模型）以及时间安排，干预内容（Smart-LAD和HEP）以及文化和西班牙语的修改。将运行五个基于视频的焦点小组：1个专业小组，2个英语的父母小组（1个智能LAD和1个HEP）以及2个讲西班牙语的家长组（1个智能LAD和1个HEP）。 A2：整合焦点小组的发现以开发适应和翻译的治疗方法。 A3：进行4个飞行员小组（用英语和西班牙语的智能LAD和HEP），并最终改编和翻译的治疗方法。结果将是可行性的（有资格的父母，参加的百分比，完成的百分比皮质醇）和可接受性（评分和开放式的满意问题，需求满足，有帮助和建议）。最终的改编步骤将是与我们的社区合作伙伴FCSN领导的会议。这项工作对于确保这些干预措施适应并适用于多样化的英语和西班牙语的家长人群至关重要。下一阶段将是一个完整的RCT，它将建立在强大的初步数据基础上，并与社区合作伙伴进行可持续的合作，这将促进广泛的实施和传播远程团体思维方式干预措施，以促进LAD儿童脆弱父母的心理韧性。