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

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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.