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

项目摘要/摘要 创伤和创伤后应激障碍(PTSD)与犯罪(和再犯罪)相关的高比率 坚持为涉及正义的个人服务。这一长期存在的问题表明我们的治疗存在很大差距。 接近。创伤后应激障碍，关于治愈知情正念压力的拟议研究的主要结果 减少(MBSR)，结合应激-炎症/皮质醇反应性，累犯，个人代理，种族认同， 和亲子关系(次要结果)，有助于总体健康公平和福祉 参与司法的黑人/非裔美国女青少年(JI BAFAs)。拟议的研究将调查 使用联检组BAFA及其P/C干预MBSR的障碍和促进者。MBSR已成功 作为创伤后应激障碍的一种治疗方法，是一种很有前途的治疗方法，可以减少健康差距 在JI BAFA和它们的P/C中。我们将使用基于交叉点的康复信息MBSR方法 创伤反应(ITR)框架：交叉性理论、以愈合为中心的接触(HCE)和 理论领域框架(TDF)。HCE基于治愈正义，这是一个基于力量的框架，以重新 以文化为中心，改善和培育福祉，包括转变机构和关系 造成伤害，集体疗伤，孕育希望。TDF分7个阶段评估实施中的问题 并支持将干预设计作为理论-实践差距的解决方案，因为它有助于识别理论驱动 根据针对改变的行为的具体内容信息制定的干预目标，即创伤后应激障碍 症状。对于这项研究，我们希望在俄亥俄州富兰克林县注册(35个JI BAFA和P/C二元)。这两个人- 阶段研究遵循多模式混合方法设计，包括两个阶段。第一阶段包括收集 关于他们过去治疗和干预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。参与者将完成学习 使用心理、社会和生物(生物标记物)数据进行评估(n=10次联席会议BAFAs-P/Cs二元组)(目标1)。阶段 II包括对适应的干预进行非随机的试点测试，使康复干预适应于 评估招募的可行性、可接受性和适应性干预的初步效果 研究结果。DUADS将在基线上完成评估以及心理社会和生物数据， 在最后一次干预后立即(基线后约3个月)，并在基线后6个月再次进行干预。 临床上有意义的PTSD症状(主要结果)和应激/皮质醇反应性的改善， 将审查累犯、中介机构、种族认同、亲子关系(次要结果)。(n=25 Ji) BAFAs-P/Cs二联体)(目标2)。我们还将通过干预促进两人关系的动态愈合 创建P/C和JI BAFA的纠正结果，包括使用安全程序(探索性 目标)。我们将举行两个独立的焦点小组，由6名完成MBSR干预的人组成，以引发 对初步定性调查结果的反馈。研究结果将基于这两种类型的数据进行整合。

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.