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/摘要 COVID-19大流行正在对全球儿童产生深远影响，危及他们的安全感， 安全和行为健康。除了COVID-19，数百万儿童仍在从最近的疾病中恢复。 袭击美国南部的飓风。受气候灾害影响的儿童（例如： 飓风）对心理和行为健康挑战构成重大风险。再加上一个持久的 由于这一大流行病，这些儿童中的许多人面临着不成比例的不断升级的心理健康问题的风险。种族 生活在社会经济弱势社区的少数民族儿童是最受欢迎的儿童之一。 在大规模灾害发生期间和之后，他们更有可能经历高水平的社会和 物质损失、流离失所和缺乏身心健康服务。由此可见，有一 这些儿童迫切需要获得可获得的、有经验支持的预防性干预措施， 减轻精神疾病和行为健康问题的发作。大多数灾后行为健康 干预措施旨在治疗而不是预防心理健康状况， 生活在社会经济处境不利社区的少数种族和族裔儿童。本研究， 因此，旨在研究COVID-19适应灾害的实施和有效性， 经验支持的预防干预措施，希望之旅（JoH），由拯救儿童组织分发， 为社会经济处境不利儿童以及少数种族和族裔儿童提供服务的人道主义组织 受COVID-19和最近袭击美国南部的飓风双重影响的社区。的 本研究的长期目标是：（1）响应可及行为健康的迫切需求 旨在预防和/或减少COVID-19相关痛苦的干预措施;以及（2）提供理解 关于COVID-19量身定制的预防干预如何减轻种族和性别之间的行为健康差异， 高度贫困环境中的少数民族儿童，他们曾遭受多次大规模灾害。中 我们对800名3 - 8年级的儿童进行了一项实用的随机对照试验，目的1：评估 COVID-19适应性JoH（JoH-C19）在预防行为健康和人际关系问题方面的有效性 在社会经济上处于不利地位的儿童以及少数种族和族裔儿童中， 多个大规模的灾难相对于一个健康的生活方式的注意力控制条件。目标2：检查是否 假设的变化变量机制（社会联系，适应性应对，自我效能）介导 JoH-C19与注意控制对儿童个体行为健康和人际关系的干预效果 结果。目标3：评估COVID-19相关压力源对行为健康的调节作用 参加JoH-C19的儿童与对照条件的结果。目标4：探索 在学校和课后环境中实施JoH-C19的障碍、促进者和可接受性 并由社区和学校辅导员提供。