Adaptation of post-disaster mental health training for black communities

适应和采用基于证据的心理健康策略对于那些与受自然灾害后果影响不成比例的亚群一起工作的人来说是一项挑战，可能会导致在获得心理健康服务，诊断和治疗心理健康状况方面出现越来越大的种族差异。外部援助团队面临着对工具的巨大需求，这些工具要考虑到心理健康状况的文化和种族背景，并促进采取权宜之计和具有成本效益的措施来减轻灾难对心理健康的影响。我们提出的灾后心理健康干预培训工具将有助于应对这些挑战，并有望为需要支持的人提供有效的干预措施，因为它将通过与在东南部和海湾地区工作的卫生服务提供者和黑人社区领导人的迭代合作方法来开发。我们首先将在沿海和北卡罗来纳州东部进行彻底的需求评估，并继续通过对斯坦·库彻博士开发的材料进行实施测试，将满足受众学习需求的材料纳入其中。该模式基于世界卫生组织和NIMH推荐的灾后心理健康实践。新的培训方案还将包括能力和社会资本建设技术，并通过培训培训员组成部分进行扩展。这项形成性研究的结果将被编织成一个新的灾害干预培训计划，可以连续量身定制的高风险地区的其他少数群体。培训教材的原型将包括：1）核心知识/护理能力手册; 2）临床提供者和社区领导培训生工具包（针对1项已完成的核心能力进行可测试的合作学习练习，提供实用精神健康转诊和治疗方法的资源清单，并进行培训前和培训后测试评估，一个样本光盘，用于测试未来远程学习的接受程度，使用基于网络的培训组件格式）;以及3）一个培训人员促进手册，其中包括幻灯片集和用于实施培训人员计划的可测试说明。我们将制定一项多中心田间评价试验计划。在第二阶段，我们将进一步开发培训组件，包括远程学习光盘和基于网络的教学的基础上，第一阶段的概念证据证明。公共卫生相关性：我们建议开发的灾难心理健康培训工具将促进适当的和具有成本效益的反应，以满足卫生服务提供者和黑人社区领导人应对灾难造成的不利心理健康后果的需要。通过反复调整教材，使之适应有色人种社区的文化背景，我们将拥有一个有用的工具来解决在提供心理健康服务方面挑战外人的文化障碍。扩展到其他形式的远程学习不同的培训内容，并为其他弱势社区量身定制，将使当地的第一反应者获得可持续的技能。

DESCRIPTION (provided by applicant): Adaptation and adoption of evidence based mental health strategies has been challenging for those working with subpopulations disproportionately affected by the aftermath of natural disasters and may contribute to the growing racial disparities seen in access to mental health services, diagnosis, and treatment of mental health conditions. Outside assistance teams have faced overwhelming demands for tools that take into account the cultural and ethnic context of mental health conditions and facilitate expedient and cost effective measure to mitigate the mental health effects of disasters. Our proposed post disaster mental health intervention training tool will assist in addressing these challenges and holds promise for delivering effective interventions to those in need of support because it will be developed through an iterative collaborative approach with health providers and black community leaders working in areas in the Southeastern and Gulf states that have experienced the greatest impact of recent hurricanes. We first will conduct thorough needs assessment in coastal and eastern North Carolina and continue to incorporate materials that respond to audience learning needs through implementation testing of materials developed by Dr. Stan Kutcher. This model is based on World Health Organization and NIMH recommended post disaster mental health practices. The novel training program will also include capacity and social capital building techniques and expansion through a train the trainer component. The results of this formative research will be woven into a novel disaster intervention training program that can be successively tailored to other minority groups in high risk areas. The prototype training package will consists of 1) a core knowledge/care competencies manual; 2) clinical provider and community leader trainee toolkits (with testable cooperative learning exercises for 1 completed core competency, a list of resources for practical mental health referral and treatment approaches, and training evaluation pre and post tests, a sample CD rom to test the acceptance of future distance learning using web based format for training components); and 3) a trainer facilitation manual with slide sets and testable instructions for implementing a train the trainer program. We will elaborate a plan for conducting a multi site field evaluation trial. In Phase II we will further develop the training components, including distance learning CD rom and web based instruction based on the Phase I proof of concept evidence. PUBLIC HEALTH RELEVANCE: The disaster mental health training tool that we propose to develop will promote an appropriate and cost effective response to the need to prepare health providers and black community leaders for addressing the adverse mental health consequences to disasters. Through the iterative adaptation of teaching materials to the cultural context of communities of color, we will have a useful tool to address cultural barriers that challenge outsiders in providing mental health services. Expansion to other formats for distance learning of different training components and tailoring for other vulnerable communities will allow local first responders to gain the sustainable skills.