Prevention and Early Identification for High Risk Youth in School-based Clinics

校本诊所高危青少年的预防和早期识别

• 批准号: 10610837
• 负责人: Margaret Weiss
• 金额: $ 28.98万
• 依托单位: CAMBRIDGE HEALTH ALLIANCE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10610837
• 关键词: 17 year old; Abuse Reporting; Accounting; COVID-19; Clinic; Cognitive; Communities; Complex; Computers; Counseling; Data; Databases; Diagnosis; Disadvantaged; Disparity; Distress; E-learning; Early Intervention; Early identification; Early treatment; Education; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Electronics; Ethnic Origin; Explosion; Face; Family; Food; Future; Haitian; Health Alliance; Health Promotion; Health Services; Health Services Accessibility; Health system; Individual; Institute of Medicine (U.S.); Insurance; Intervention; Language; Measurement; Measures; Mental Health; Mental disorders; Methods; Minority; Neighborhoods; Outcome; Paper; Parents; Population; Portuguese; Prevention; Preventive; Race; Reporting; Risk; Risk Factors; Sampling; School-Age Population; Schools; Self Efficacy; Social Distance; Structure; Students; Substance abuse problem; Symptoms; Technology; Teenagers; Testing; Therapeutic Intervention; Time; Trauma; Unemployment; Work; Youth; acceptability and feasibility; access disparities; age group; aged; behavioral health; college; compare effectiveness; coping; coping mechanism; disparity reduction; early screening; effective intervention; effectiveness evaluation; effectiveness testing; feasibility testing; follow-up; functional improvement; functional status; help-seeking behavior; high risk; mental health personnel; minority children; minority communities; novel; outreach; peer support; perceived discrimination; prevent; preventive intervention; promote resilience; reduce symptoms; remediation; resilience; school closure; screening; single episode major depressive disorder; social health determinants; social stigma; socioeconomics; stressor; substance use; tool; treatment disparity

PROJECT SUMMARY AND ABSTRACT – Cambridge Health Alliance ALACRITY for Early Screening and Treatment of High Risk Youth (eSToRY) R34 Prevention and Early Identification for High Risk Youth in School-based Clinics The proposed project aims to implement and test tools necessary to prevent transitions to mental illness among at-risk youth, and particularly at-risk racial/ethnic and language (REL)-minority youth. Risk factors for REL-minority youth can be heightened due to their greater likelihood of experiencing discrimination and socioeconomic barriers and their subsequent impacts on access and engagement in treatment and overall wellness. The overall aim of this project is to prevent and remediate a surge in youth mental illness and to reduce persistent treatment disparities. First, we propose to use a remote adaptive testing technology, “K- CAT+”, to provide rapid community-based screening. Second, we will evaluate the effectiveness of a targeted, online health promotion intervention, COPE2THRIVE (C2T), to build resilience in a REL-diverse sample of school-aged youth. Third, we will assess whether this approach mitigates increased risk faced by racial/ethnic and language (REL)-minority youth. In Aim 1, we test the feasibility and acceptability of a parent- and youth-reported electronic mental health screener, K-CAT, among 12-17 year old youth in a school-based setting. The adaptive screening platform, K- CAT, reduces the time and total number of measures that are required. We supplement K-CAT (to make “K- CAT+”) with measures of functional status, complex trauma, and individual- and neighborhood-level social determinants of health (SDOH). In Aim 2, we test the feasibility, acceptability, and preliminary effectiveness of the COPE2THRIVE (C2T) intervention, a resilience intervention targeting the mechanism of coping self- efficacy to reduce symptoms and improve function. We select youth determined by the K-CAT+ to be at moderate risk for mental illness. In Aim 3, we assess whether the combination of early school-based screening and the preventive C2T intervention reduces disparities in engagement in treatment, and reduces symptoms and improves function for REL-minorities. The screening and preventive interventions tested in this project have the potential to reduce persistent REL disparities in access and engagement in treatment and mental health outcomes, by enhancing the availability and ease of screening, overcoming known biases in recognition and referral, and by intervening earlier than usual among at-risk REL-minority youth.

项目总结和摘要-剑桥健康联盟 ALACRITY for Early Screening and Treatment of High Risk Youth（eSToRY） R34预防及及早识别高危青少年校本诊所 拟议的项目旨在实施和测试必要的工具，以防止过渡到精神疾病 在风险青年中，特别是在风险种族/族裔和语言少数群体青年中。的危险因素 少数族裔青年由于更有可能遭受歧视， 社会经济障碍及其对获得和参与治疗的后续影响， 健康该项目的总体目标是预防和治疗青年精神疾病的激增， 减少持续的治疗差异。首先，我们建议使用远程自适应测试技术，“K- CAT+"，以提供基于社区的快速筛查。其次，我们将评估有针对性的， 在线健康促进干预，COPE 2 THRIVE（C2 T），以建立弹性在一个多元化的样本， 学龄青年。第三，我们将评估这种方法是否减轻了种族/民族 语言（REL）-少数民族青年。 在目标1中，我们测试了父母和青少年报告的电子心理健康的可行性和可接受性 筛选，K-CAT，在12-17岁的青年在学校为基础的设置。自适应筛选平台K- CAT减少了所需的时间和措施总数。我们补充K-CAT（使“K- CAT+”）与功能状态的措施，复杂的创伤，和个人和邻里水平的社会 健康决定因素（SDOH）。在目标2中，我们测试了以下方法的可行性、可接受性和初步有效性： COPE 2 THRIVE（C2 T）干预，一种针对应对自我机制的弹性干预， 减轻症状，改善功能。我们选择由K-CAT+决定的年轻人， 中度精神疾病风险。在目标3中，我们评估是否结合早期校本筛查 预防性C2 T干预减少了参与治疗的差异， 并改善少数民族的功能。 本项目中测试的筛查和预防干预措施有可能减少持续性REL 通过提高可获得性， 和易于筛查，克服已知的识别和转诊偏见，并通过早于 这在处于危险中的少数民族青年中很常见。