Resettled Refugee Families for Healing (RRF4H): A Study of the Intergenerational Impact of War Trauma and Resilience

项目摘要/摘要 来自重新安置的难民家庭的年轻人患严重心理健康挑战的风险增加 与他们的美国本土同龄人相比。研究发现，生活在高收入国家的难民青年 创伤相关精神障碍的高患病率，如创伤后应激障碍(19%至54%)和抑郁症(3%至30%)。 此外，属于这些弱势社区的青年吸毒率、辍学率、 监禁、暴力，包括与帮派有关的杀人案，自杀成为严重的公共卫生问题 威胁。K01的目的是为应聘者提供以下方面的正式培训和指导：(1) 系统地调整和实施以社区为基础的干预措施；(2)收集、管理和 定性和混合方法数据的分析；以及(3)高级执行科学研究，包括 应用理论和框架、确定执行决定因素并确定其优先次序的方法、 以及制定和测试执行战略的系统方法。这项培训将为 独立研究候选人，进行多学科研究，开发和测试社区- 旨在解决重新安置青年中的各种心理健康挑战的干预措施 难民社区。因此，候选人将进行类型1的混合有效性-实施 测试旨在改善代际创伤相关心理健康的组合干预措施的试验 第二代难民儿童症状(SGRC)。以社会行动和家庭制度为导向 理论，并将其应用于ITT框架，建议的组合干预包括：家庭 通过多个家庭小组(MFG)+同伴指导计划提供强化(FS)模式，称为 适合在虚拟环境中提供的青少年健康顾问(Tahc)(虚拟Tahc)。干预措施 将有以下具体目标：(1)系统地采用循证家庭强化(FS)模式 通过多个家庭小组(MFG)与同行指导计划(虚拟Tahc)相结合提供(目标 1)；(2)评估联合干预(MFG+虚拟Tahc)的初步短期和长期影响 行为情绪障碍(攻击性行为、反社会行为、焦虑、抑郁和创伤后应激障碍) 与试验中SGRC之间的代际创伤有关(目标2)；以及(3)使用混合方法和 应用探索、准备、实施、可持续(EPIS)框架，检查实施情况 RRF4H干预的战略、促进者和障碍(目标3)。在给定的跨诊断应用程序 干预，这项研究具有重要意义，因为它有可能促进我们对如何缓解 战争创伤对没有直接经历过战争创伤的儿童的代际影响。

PROJECT SUMMARY/ABSTRACT Youth from resettled refugee families are at elevated risk of developing serious mental health challenges compared to their U.S. native peers. Studies have found that refugee youth living in high income countries have high prevalence of trauma-associated mental disorders like PTSD, (19% to 54%) and depression (3% to 30%). Additionally, youth belonging to these vulnerable communities have high rates of substance use, school dropout, incarcerations, violence including gang-related homicides, with suicides emerging as a serious public health threats. The purpose of this K01 is to provide the candidate with formal training and mentoring in: (1) systematically adapting and implementing community-based interventions; (2) collection, management, and analysis of qualitative and mixed methods data; and (3) advanced implementation science research, including the application of theories and frameworks, methods for identifying and prioritizing implementation determinants, and systematic approaches to developing and testing implementation strategies. This training will prepare the candidate for independent research conducting multidisciplinary research that develops and tests community- based interventions aimed at addressing the myriad of mental health challenges among youth in resettled refugee communities. Accordingly, the candidate will conduct a type 1hybrid effectiveness-implementation trial to test a combination intervention designed to improve intergenerational trauma-related mental health symptoms among second generation refugee children (SGRC). Guided by Social Action and Family Systems theories, and applying them to the ITT framework, the proposed combination intervention consists of: family strengthening (FS) model delivered through multiple family groups (MFG) + peer mentoring program called TeenAge Health Consultants (TAHC) adapted for delivery in virtual environment (Virtual TAHC). The intervention will have the following specific aims: (1) systematically adapt an evidence-based family strengthening (FS) model delivered through multiple family groups (MFG) combined with a peer mentoring program (Virtual TAHC) (Goal 1); (2) assess preliminary short- and long-term impact of the combination intervention (MFG + Virtual TAHC) on behavioral emotional disorders (aggressive behavior, antisocial behaviors, anxiety, depression, and PTSD) related to intergenerational trauma among SGRC in the trial (Goal 2); and (3) utilizing mixed methods and applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, examine implementation strategies, facilitators, and barriers of the RRF4H intervention (Goal 3). Given the transdiagnostic application of the intervention, this study is significant because it has potential to advance our understanding on how to mitigate the intergenerational impact of war trauma among children who have not directly experienced war trauma.