Jump Start+:COVID Support to improve resiliency and mitigate risks in childcare centers serving children from low-income ethnic minority backgrounds.

快速启动：新冠疫情支持，旨在提高为低收入少数族裔背景的儿童提供服务的托儿中心的弹性并降低风险。

• 批准号: 10605262
• 负责人: JASON F JENT
• 金额: $ 64.55万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-07 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10605262
• 关键词: Address; Adult; Affect; Anger; Anxiety; Area; Attitude; Behavior; Belief; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Child; Child Behavior; Child Care; Child Development; Child Health; Child Support; Chronic; Cluster randomized trial; Communication; Communities; Community Networks; Consultations; Control Groups; County; Data; Development; Disasters; Distress; Education; Educational process of instructing; Emotional; Environment; Environmental Risk Factor; Evaluation; Exhibits; Family; Family Characteristics; Future; Goals; Guidelines; HIV; Hurricane; Individual; Intervention; Link; Long-Term Effects; Low income; Measures; Mediating; Mental Depression; Mental Health; Methods; Minority; Modeling; National Institute of Child Health and Human Development; Needs Assessment; Nursery Schools; Occupations; Outcome; Parents; Personal Satisfaction; Policies; Poverty; Problem behavior; Program Effectiveness; Psychosocial Assessment and Care; Public Health; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Recovery; Research; Research Priority; Resources; Risk; Robot; Role; Safety; Self Care; Self Efficacy; Social isolation; Societies; Stress; Support System; System; Testing; Time; Toddler; Trauma; UNICEF; Uncertainty; Well in self; ZIKA; attentional control; care systems; contextual factors; coping; coronavirus disease; early childhood; effectiveness evaluation; effectiveness study; effectiveness testing; effectiveness/implementation hybrid; effectiveness/implementation trial; ethnic diversity; ethnic minority; executive function; experience; follow-up; group intervention; high risk; hybrid type 1 design; implementation barriers; implementation evaluation; implementation/effectiveness; improved; innovation; minority communities; obesity prevention; pandemic disease; pandemic impact; preventive intervention; primary outcome; programs; promote resilience; psychologic; psychosocial; psychosocial development; public health intervention; racial diversity; resilience; risk mitigation; scale up; social factors; teacher; teleconsultation; telepresence; uptake; vaccine acceptance; virtual

Background. This is a Type 1 hybrid effectiveness-implementation trial studying the role of a community- based, childcare center-support system in improving resilience and mitigating the long-term impacts of the pandemic on child development. Public health disasters have disproportionate and long-term impacts on poor, disenfranchised communities. Miami-Dade County has one of the US's highest rates of chronic poverty, is minority majority, and has been an epicenter of the pandemic. COVID-19 is having psychosocial impacts on children that is producing anxiety, irritability, anger, and depression. Teachers in childcare centers continue to be overwhelmed by changing guidelines and how to address the downstream psychological effects children are experiencing. While numerous resources exist that can help childcare centers with disaster recovery, the information can be overwhelming and difficult to navigate, and research is yet to show the actual benefits of the resources. Approach. We will leverage our existing community-based intervention, Jump Start, with its extensive reach in Miami-Dade County, to childcare centers participating in the County’s Quality Improvement System. This system prioritizes children living in poverty who are at highest risk for problems. This study will be modeled on a successful Early Childhood Mental Health Consultation (ECMHC) intervention which utilizes mental health consultants to deliver a Jump Start+: COVID Support virtual toolkit to childcare centers via a Kubi robot. The toolkit is comprised of four strength-based strategies likely to be effective in improving resiliency following disasters: Safety Planning, Effective Communication, Adult Self-Care, and Trauma-Informed Behavior Support. We will use Reach, Effectiveness-Adoption, Implementation, Maintenance (RE-AIM) framework to guide the evaluation of our Type 1 hybrid design. Our first aim will utilize a cluster randomized trial to examine the effectiveness of Jump Start+: COVID Support on improving the psychosocial functioning of young children, as compared to an obesity-prevention intervention control group. Child development is the primary outcome, with children followed at 6, 12,18, and 24 months. The second aim will examine the mechanisms that contribute to effective teachers’ uptake of Jump Start+: COVID Support strategies on child outcomes. The third aim will explore implementation barriers/facilitators as well as potential societal contextual factors (e.g., vaccine uptake) to help centers serving disproportionately affected minority communities recover from and prepare for future crises. Impact. These aims meet a high-priority research area for NICHD because they address the social and environmental factors that can enhance children’s resilience. Employing a Type 1 hybrid design will inform the refinement and scaling of Jump Start+: COVID Support and generalize impacts to other childcare center interventions in the context of disasters. We have the potential to influence long-term trajectories of childcare center practices and child development which, in turn, can chart a course for future child health and well-being in the face of crises.

背景这是一项1型混合有效性-实施试验， 儿童保育中心-支助系统在提高复原力和减轻大流行病对儿童的长期影响方面的作用 儿童发展。公共卫生灾难对穷人、被剥夺权利者和弱势群体造成不成比例的长期影响。 社区.迈阿密-戴德县是美国长期贫困率最高的县之一，是少数民族占多数， 一直是疫情的中心COVID-19正在对儿童产生心理社会影响， 焦虑易怒愤怒和抑郁托儿中心的老师们仍然不堪重负， 不断变化的指导方针以及如何解决儿童正在经历的下游心理影响。而 有许多资源可以帮助儿童保育中心进行灾难恢复，这些信息可以 这是一个巨大的、难以驾驭的问题，研究尚未显示出资源的实际好处。 Approach.我们将利用我们现有的社区干预，跳跃开始，其广泛的影响， 迈阿密戴德县，儿童保育中心参加县的质量改进系统。该系统 优先考虑生活在贫困中的儿童，他们面临的问题风险最高。这项研究将以一个 成功的幼儿心理健康咨询（ECMHC）干预，利用心理健康 顾问通过Kubi机器人向儿童保育中心提供Jump Start+：COVID Support虚拟工具包。的 一个工具包由四个基于实力的战略组成，这些战略可能有效地提高弹性， 灾害：安全规划，有效的沟通，成人自我护理，和创伤知情的行为支持。 我们将使用Reach，Adjustiveness-Adoption，Implementation，Maintenance（RE-AIM）框架来指导 我们的1型混合动力设计的评估。我们的第一个目标是利用一个集群随机试验来检查 Jump Start+：COVID Support在改善幼儿心理社会功能方面的有效性， 与肥胖预防干预对照组相比。儿童发展是主要成果， 儿童在6、12、18和24个月时随访。第二个目标是审查有助于实现以下目标的机制： 有效的教师对Jump Start+的理解：关于儿童成果的COVID支持战略。第三个目标将 探索实施障碍/促进因素以及潜在的社会背景因素（例如，疫苗摄取） 帮助服务于不成比例地受到影响的少数民族社区的中心从未来恢复并为未来做好准备 危机。冲击这些目标符合NICHD的高度优先研究领域，因为它们涉及社会和 环境因素可以增强儿童的适应力。采用1型混合动力设计将告知 完善和扩展Jump Start+：COVID支持并将其影响推广到其他托儿中心 在灾害情况下的干预措施。我们有可能影响儿童保育的长期轨迹 中心的做法和儿童发展，反过来，可以图表未来的儿童健康和福祉的课程 在危机面前。