Exploring PTSD Symptoms, Barriers and Facilitators to Mindfulness-based Stress Reduction for Justice-Involved Black/African American Female Adolescents and Parents/Caregivers

探索创伤后应激障碍 (PTSD) 症状、障碍和促进因素，为涉及正义的黑人/非裔美国女性青少年和父母/照顾者进行基于正念的减压

• 批准号: 10593806
• 负责人: Camille R. Quinn
• 金额: $ 24.89万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-14 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10593806
• 关键词: Address; Adolescent; African American; Age; Behavior; Behavioral; Biological; Biological Markers; Black race; Caregivers; Child Abuse; Child Rearing; Chronic stress; Clinical; Communities; Conflict (Psychology); County; Crime; Data; Development; Diversion Program; Dreams; Drops; Emotional; Enrollment; Exposure to; Family; Feedback; Female Adolescents; Focus Groups; Fostering; Future; Goals; Health; Hearing; Home; Hostility; Hydrocortisone; Individual; Inflammation; Institution; Intervention; Interview; Investigation; Justice; Knowledge; Life Experience; Link; Literature; Manuals; Mental Health; Methods; Modeling; National Institute on Minority Health and Health Disparities; Nature; Outcome; Outcome Study; Parent-Child Relations; Parents; Participant; Patient Self-Report; Personal Satisfaction; Phase; Physiological; Population; Post-Traumatic Stress Disorders; Prevention; Psychopathology; Reduce health disparities; Reporting; Research; Residential Treatment; Risk; Secure; Social support; Stress; Stress and Coping; Surveys; Symptoms; Testing; Theoretical Domains framework; Trauma; Underserved Population; United States; Violence; Youth; barrier to care; behavior change; biological adaptation to stress; boys; chronic pain; clinically significant; court; design; experience; girls; healing; health disparity; health equity; health equity promotion; hypothalamic-pituitary-adrenal axis; implementation evaluation; improved; innovation; interdisciplinary approach; intersectionality; iterative design; juvenile justice system; life history; male; maltreatment; mindfulness; mindfulness-based stress reduction; multimodality; novel strategies; perceived stress; physical conditioning; pilot test; preventive intervention; primary outcome; probation; procedure safety; psychosocial; racial identity; recidivism; recruit; response; secondary outcome; social culture; stress reduction; theories; therapy design; therapy development; trauma exposure

PROJECT SUMMARY/ABSTRACT High rates of trauma and post-traumatic stress disorder (PTSD) associated with delinquency (and recidivism) persist for justice-involved individuals. This enduring problem denotes a significant gap in our treatment approach. PTSD, the primary outcome of the proposed study about healing informed mindfulness-based stress reduction (MBSR), combines stress-inflammation/cortisol reactivity, recidivism, personal agency, racial identity, and parent-child relationships (secondary outcomes), which contribute to the overall health equity and well-being of justice-involved Black/African American female adolescents (JI BAFAs). The proposed study will investigate the barriers and facilitators to the MBSR intervention with JI BAFAs and their P/Cs. MBSR has been successfully implemented as a treatment for PTSD and is a promising new approach for healing to reduce health disparities among both JI BAFAs and their P/Cs. We will use a healing-informed MBSR approach based on an intersectional trauma-responsive (ITR) framework: Intersectionality theory, Healing Centered Engagement (HCE), and Theoretical Domains Framework (TDF). HCE is based on healing justice, a strengths-based framework to re- center culture and improve and nurture well-being that involves transforming institutions and relationships that cause harm to collectively heal and foster hope. TDF comprises 7 stages to assess implementation problems and supports intervention design as a solution to the theory-practice gap as it helps identify theoretically driven targets for interventions based on content-specific information about the behavior targeted to change, i.e., PTSD symptoms. For this study, we expect to enroll (35 JI BAFAs and P/C dyads) in Franklin County, OH. This two- phase study follows a multimodal mixed methods design, comprising two phases. Phase I includes collecting qualitative interview data about their past barriers to treatment and interventions and use this information as well as self-report survey results to culturally adapt until we reach saturation. Participants will complete study assessments with psychosocial and biological (biomarker) data (n = 10 JI BAFAs-P/Cs dyads) (Aim 1). Phase II consists of conducting a nonrandomized pilot test of the adapted intervention adapted healing intervention to assess the feasibility of recruitment, acceptability, and preliminary effects of the adapted intervention on the study outcomes. Dyads will complete assessments, and psychosocial and biological data at baseline, immediately after the final intervention session (~ 3 months post baseline) and again 6-months post-baseline. Clinically meaningful improvements in PTSD symptoms (primary outcome) and stress/cortisol reactivity, recidivism, agency, racial identity, parent-child relationships (secondary outcomes) will be examined. (n = 25 JI BAFAs-P/Cs dyads) (Aim 2). We will also promote healing of the dyads’ relationship dynamic via the intervention to create a corrective outcome for P/Cs and JI BAFAs, including the use of safety procedures (Exploratory Aim). We will hold two separate focus groups with 6 dyads who completed the MBSR intervention to elicit feedback on the initial qualitative findings. The study findings will be integrated based on the two types of data.

项目摘要/摘要 与犯罪（和累犯）相关的创伤和创伤后应激障碍（PTSD）的高发病率 对涉及正义的人来说是持续的。这个长期存在的问题表明我们的治疗存在重大差距 approach.创伤后应激障碍，拟议研究的主要成果，关于愈合知情的正念为基础的压力 减少（MBSR），结合压力炎症/皮质醇反应，累犯，个人机构，种族认同， 和亲子关系（次要结果），这有助于整体健康公平和福祉 涉及正义的黑人/非洲裔美国女性青少年（JI BAFAs）。拟议的研究将调查 用JI BAFAs及其P/C进行MBSR干预的障碍和促进因素。MBSR已成功 作为创伤后应激障碍的治疗方法实施，是一种有前途的新方法， 在联合执行最佳财务安排及其方案/承诺中。我们将使用一种基于交叉研究的治疗知情的正念减压疗法。 创伤响应（ITR）框架：交叉性理论，以治疗为中心的参与（HCE）， 理论领域框架（TDF）。HCE基于愈合正义，一个基于力量的框架，以重新 以文化为中心，改善和培养福祉，包括改变机构和关系， 造成伤害，共同治愈和培育希望。发展基金分七个阶段评估推行问题 并支持干预设计作为理论与实践差距的解决方案，因为它有助于识别理论驱动的 基于关于目标改变的行为的内容特定信息的干预目标，即，PTSD 症状对于本研究，我们预计在俄亥俄州富兰克林县入组（35例JI BAFAs和P/C二联体）。这两个- 阶段研究遵循多模态混合方法设计，包括两个阶段。第一阶段包括收集 关于他们过去在治疗和干预方面的障碍的定性访谈数据，并使用这些信息 作为自我报告的调查结果，以适应文化，直到我们达到饱和。参与者将完成研究 使用心理社会和生物（生物标志物）数据进行评估（n = 10个JI BAFAS-P/Cs二联体）（目标1）。相 II包括进行适应性干预适应性愈合干预的非随机试点试验， 评估招募的可行性、可接受性和适应性干预对儿童的初步影响。 研究结果。Dyads将完成评估，以及基线时的心理和生物数据， 末次干预后即刻（基线后约3个月）和基线后6个月再次进行。 PTSD症状（主要结局）和应激/皮质醇反应性的临床有意义的改善， 将检查累犯、代理、种族认同、亲子关系（次要结果）。（n = 25） BAFAs-P/Cs二联体）（目标2）。我们还将通过干预来促进二元关系的愈合 为P/C和JI BAFAs创建纠正结果，包括使用安全程序（探索性 Aim）。我们将举行两个独立的焦点小组，由6对完成正念减压疗法干预的人组成， 对初步定性结果的反馈。研究结果将根据这两种类型的数据进行整合。