Pragmatic RCT of a multi-level mechanistically informed community intervention to prevent the onset of behavioral health symptoms among socioeconomically disadvantaged pandemic affected children

多层次、机械化的社区干预的务实随机对照试验，以防止受大流行影响的社会经济弱势儿童出现行为健康症状

• 批准号: 10310851
• 负责人: Tara Leytham-Powell
• 金额: $ 77.69万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10310851
• 关键词: Address; Affect; Alabama; Anxiety; Attenuated; Behavior; COVID-19; COVID-19 impact; COVID-19 pandemic; Caregivers; Child; Childhood; Climate; Communities; Consolidated Framework for Implementation Research; Control Groups; Coping Behavior; Coping Skills; Coupled; Diagnosis; Disadvantaged minority; Disasters; Distress; Elements; Exposure to; Family; Future; Goals; Hurricane; Individual; Intervention; Life; Link; Mediating; Mental Depression; Mental Health; Mental disorders; Modeling; Morbidity - disease rate; National Institute on Minority Health and Health Disparities; New Zealand; Oklahoma; Outcome; Parents; Poverty; Poverty Areas; Prevention; Prevention program; Professional counselor; Randomized; Randomized Controlled Trials; Research; Resources; Risk; SARS-CoV-2 exposure; Safety; Schools; Security; Self Efficacy; Social Well-Being; Symptoms; Time; United States; Well in self; Wildfire; arm; attentional control; base; behavioral health; behavioral health intervention; behavioral outcome; community intervention; coping; design; effective intervention; efficacy evaluation; eighth grade; emotional distress; ethnic minority; experience; follow up assessment; health disparity; healthy lifestyle; high risk; implementation barriers; intervention effect; minority children; mortality; neighborhood disadvantage; pandemic disease; pediatric trauma; peer; peer support; physical health service; poor communities; post intervention; preservation; prevent; preventive intervention; prospective; protective factors; public health emergency; racial minority; skills; social; social determinants; socioeconomic disadvantage; stressor; therapy design

PROJECT SUMMARY/ABSTRACT The COVID-19 pandemic is having a profound impact on children globally, jeopardizing their sense of safety, security, and behavioral health. In addition to COVID-19, millions of children are still recovering from recent hurricanes that struck the southern the United States. Children exposed to climate-induced disasters (e.g. hurricanes) are at a significant risk for mental and behavioral health challenges. Coupled with an enduring pandemic, many of these children are disproportionately at risk for escalating mental health problems. Racial and ethnic minority children who live in socio-economically disadvantaged neighborhoods are among the most vulnerable during and after large-scale disasters. They are more likely experience high levels of social and material losses, displacement, and lack of access to mental and physical health services. Thus, there is a critical need for these children to received accessible, empirically supported preventative interventions to mitigate the onset of mental illness and behavioral health issues. Most post-disaster behavioral health interventions are designed to treat rather than prevent mental health conditions and are often inaccessible to racial and ethnic minority children living in socio-economically disadvantaged communities. The present study, therefore, seeks to examine the implementation and efficacy of the COVID-19 adaptation of a disaster focused empirically supported prevention intervention, the Journey of Hope (JoH), distributed by Save the Children, a humanitarian organization serving socio-economically disadvantaged and racial and ethnic minority children in communities dually impacted by COVID-19 and recent hurricanes that struck the Southern United States. The long-term goals of this study are to: (1) respond to the critical need of accessible behavioral health interventions designed to prevent and/or reduce COVID-19 related distress; and (2) provide an understanding on how a COVID-19 tailored prevention intervention mitigates behavioral health disparities among racial and ethnic minority children in high poverty settings who have been exposed to multiple large scale disasters. In a pragmatic randomized control trial with 800 children between 3-8th grade, we seek to: Aim 1: Evaluate the efficacy of the COVID-19 adapted JoH (JoH-C19) in preventing behavioral health and interpersonal problems among socio-economically disadvantaged and racial and ethnic minority children who have been exposed to multiple large-scale disasters relative to a healthy life-style attention control condition. Aim 2: Examine if hypothesized mechanisms of change variables (social connectedness, adaptive coping, self-efficacy) mediate intervention effects (JoH-C19 vs attention control) on child individual behavioral health and interpersonal outcomes. Aim 3: Assess the moderating impact of COVID-19 related stressors on behavioral health outcomes among children who participate in JoH-C19 versus the control condition. Aim 4: Explore implementation barriers, facilitators, and acceptability of the JoH-C19 within school and afterschool settings and delivered by community and school-based counselors.

项目总结/文摘