Wa'Kan Ye'Zah: Enhancing caregivers' and children's well-being through an evidence-based and culturally informed prevention intervention

WaKan YeZah：通过基于证据和文化背景的预防干预措施提高护理人员和儿童的福祉

• 批准号: 10113419
• 负责人: Teresa Brockie
• 金额: $ 102.99万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10113419
• 关键词: 5 year old; Address; Adolescence; Adolescent; Adverse event; Affect; Age; Behavior; Behavioral; Caregivers; Child; Child Development; Child Rearing; Child Welfare; Cognitive Therapy; Communities; Community Health Aides; Control Groups; Development; Discipline; Effectiveness of Interventions; Elements; Emotional; Ensure; Evidence based intervention; Experimental Designs; Family; Funding; Future; Goals; Head Start Program; Health; Health Promotion; Indigenous; Individual; Informal Social Control; Intervention; Learning; Life; Life Cycle Stages; Mental Depression; Mental Health; Names; National Institute of Drug Abuse; Native Americans; Outcome; Parents; Participant; Personal Satisfaction; Phase; Plant Roots; Population; Problem behavior; Randomized; Randomized Controlled Trials; Readiness; Research; Research Personnel; Risk; Risk Factors; Self-Injurious Behavior; Sioux Indians; Stress; Substance abuse problem; Suicide; Symptoms; Testing; Training Programs; Translational Research; Trauma; Trust; Wolves; Work; Youth; active control; base; behavioral health; behavioral outcome; commune; control trial; design; disorder prevention; early childhood; effectiveness evaluation; effectiveness testing; empowerment; evidence base; experience; externalizing behavior; health disparity; improved; indigenous community; innovation; intergenerational; nutrition education; patient engagement; peer; prevent; preventive intervention; protective factors; reduce symptoms; substance use; substance use prevention; suicidal risk; teacher; trial design; tribal community; uptake; young adult

The overall goal of this study is to develop, adapt and evaluate an intergenerational prevention intervention, named “Wa’ Kan ye’ zah (Little Holy One),” with Fort Peck Assiniboine and Sioux caregivers and their 3-to-5- year-old children. The intervention aims to: 1) reduce symptoms of historical trauma and everyday stress among parents/caregivers, 2) improve parenting, and 3) improve children’s emotional and behavioral developmental outcomes to reduce future risk for suicide and substance use. The scientific premise of this work is rooted in understanding that high rates of historical and current trauma in Native communities compromise caregivers’ mental health and parenting, which in turn affect early childhood behavior problems and adverse events that increase children’s risk for suicide and substance use in adolescent and young adulthood. Without intervention, this intergenerational cycle may repeat. Wa’ Kan ye’ zah will combine adapted elements of: 1) Trauma-Focused Cognitive Behavioral Therapy, an evidence-based intervention proven effective to reduce stress, depression and trauma-related symptoms, 2) Family Spirit, an evidence-based parent training program to promote positive early child development in Native American communities, and 3) cultural components informed by tribal-specific risk and protective factors for suicide and substance abuse identified in community-based studies that led to this proposal. The intervention will consist of 12 weekly individual lessons taught to parents and children (ages 3 to 5) at the Poplar and Wolf Point Head Start facilities by indigenous community health workers, a delivery strategy selected to enhance participant engagement, local acceptability and sustainability. Intervention timing is focused at a critical developmental phase—when primary attachment is still to parents, but while children are transitioning to greater self-regulation and cooperation with teachers and peers in Head Start classrooms. This study will use a randomized control trial (RCT) with an embedded single-case experimental design (SCED) to determine the effectiveness of the intervention on mental health and behavioral outcomes among N=120 parent-child dyads, while empirically exploring the added benefit of specific cultural components on parent/caregiver outcomes. on mental health and behavioral outcomes among N=120 parent-child dyads, while exploring the added benefit of cultural components on parent outcomes. The study plan is situated within a well-established trust relationship with tribal communities, innovative formative research that led to this proposal, and an experienced, multi- disciplined study team led by an indigenous PI.

本研究的总体目标是开发、调整和评估代际预防干预措施， 名为“Wa' Kan ye' zah（小圣人）”，与佩克堡阿西尼博因和苏族护理人员以及他们的 3 到 5- 岁儿童。干预的目的是：1）减轻历史创伤和日常压力的症状 在父母/照顾者中，2) 改善养育方式，3) 改善儿童的情绪和行为 降低未来自杀和药物滥用风险的发展成果。这样做的科学前提 工作植根于理解原住民社区历史和当前创伤的高发生率 损害照顾者的心理健康和养育方式，进而影响幼儿行为问题 以及增加青少年自杀和药物滥用风险的不良事件 成年期。如果不干预，这种代际循环可能会重复。 Wa' Kan ye' zah 将结合改编 要素：1) 以创伤为中心的认知行为疗法，一种经过验证的循证干预措施 有效减轻压力、抑郁和创伤相关症状，2) Family Spirit，一种基于证据的 家长培训计划，以促进美国原住民社区儿童早期积极发展，以及 3) 文化成分反映了部落特定的自杀和药物滥用风险和保护因素 在基于社区的研究中确定了导致该提案的内容。干预措施将包括每周 12 在 Poplar 和 Wolf Point Head Start 设施中为家长和儿童（3 至 5 岁）提供单独课程 由土著社区卫生工作者选择的交付策略，以提高参与者的参与度， 当地的可接受性和可持续性。干预时机集中在关键的发展阶段——当 主要依恋仍然是对父母，但是当孩子们正在过渡到更大的自我调节和 在 Head Start 课堂上与老师和同学合作。本研究将使用随机对照试验 （RCT）与嵌入式单案例实验设计（SCED）来确定有效性 对 N=120 亲子二人组的心理健康和行为结果进行干预，同时根据经验 探索特定文化成分对父母/照顾者结果的额外好处。关于心理健康 和 N=120 亲子二人组的行为结果，同时探索文化的额外好处 父母成果的组成部分。该研究计划与以下机构建立了良好的信任关系： 部落社区、促成本提案的创新形成性研究以及经验丰富的多学科专家 由本土 PI 领导的纪律严明的研究团队。