Pediatric Group Well Child Visits for Detection of Maternal Depression in Latinas

项目摘要 NIMH指导的以患者为导向的研究事业发展的总体目标 奖励(K23)是为我提供必要的技能和高级培训，以建立 独立的研究项目专注于开发和测试两代人 儿科初级保健的服务提供模式，以减少精神卫生治疗的差异。 为了促进我的长期职业目标，我制定了具体的短期培训目标 包括：1)获得应用、多方法定性研究的高级技能；2)获得 文化精神病学和跨文化研究方面的专业知识；3)开发核心知识库 团体心理干预，包括其受益机制和评价机制(S)； 以及4)培养心理健康服务干预发展的核心技能 在初级保健环境中实施。在获奖期间，我将进行一系列的 将作为务实学习培训目标的工具的相互关联的研究 作为正式培训和指导的补充。这些研究试图刻画和描述 然后加强一种新颖且越来越多使用的儿科儿童保健形式，小组 儿科健康儿童访问，以解决在识别、初始管理和 有产后抑郁症状的拉丁裔移民的后续治疗。 这些目标将通过(1)对目前有目的地抽样的两家诊所的个案研究来实现 提供与拉美裔移民家庭的亲子小组访问，直接从三角测量数据 观察；父母参与的深度和半结构化访谈和调查 并选择不参加小组访问、小组访问协调员和其他主要线人 两个有目的地抽样的诊所；(2)利用干预措施加强小组访问 测绘和以人为本的设计方法和程序；以及(3)单臂前柱 在AIM研究的每个地点对一名患者/家属进行加强探视的试点 1.我们预计，增强措施将纳入以下干预措施的要素 以前显示的对该患者群体的可接受性和/或有效性包括 筛查、简单干预和转介到治疗程序，提供者沟通技能- 建设以解决发现问题和寻求治疗的文化障碍--并促进 具有凝聚力的团队过程，以及心理教育和自我管理策略。

Project Summary The overarching goal of this NIMH Mentored Patient-Oriented Research Career Development Award (K23) is to provide me with the skills and advanced training necessary to establish an independent program of research focused on the development and testing two-generational service delivery models in pediatric primary care to reduce mental health treatment disparities. To facilitate my long-term career goal, I have developed specific short-term training goals including: 1) Obtain advanced skills in applied, multimethod qualitative research; 2) Gain expertise in cultural psychiatry and cross-cultural research; 3) Develop a core knowledge base in group psychotherapeutic interventions including their mechanism(s) of benefit and evaluation; and 4) Develop core skills in mental health services intervention development and implementation in primary care settings. During the award period, I will conduct a series of inter-related studies which will serve as vehicles for pragmatic learning of the training goals complementing formal training and mentorship. The studies seek to characterize and subsequently enhance a novel and increasingly utilized form of pediatric well-child care, group pediatric well-child visits, to address disparities in identification, initial management, and subsequent treatment engagement of immigrant Latinas with postpartum depressive symptoms. The aims will be achieved through (1) a case study of two purposively sampled clinics currently delivering group well-child visits with immigrant Latino families, triangulating data from direct observations; in-depth and semi-structured interviews and surveys with parents participating and electing not to participate in group visits, group visit facilitators and other key informants at two purposively sampled clinics; (2) development of enhanced group visits using Intervention Mapping and Human-Centered Design methods and procedures; and (3) a single-arm pre-post pilot of the enhanced visit with one cohort of patients/families at each of the sites studied in Aim 1. We anticipate that the enhancements incorporate elements from interventions that have previously shown acceptability and/or effectiveness with this patient population including screening, brief intervention and referral to treatment procedures, provider communication skill- building to address cultural barriers to problem identification and treatment-seeking and facilitate a cohesive group process, and psychoeducation and self-management strategies.