Locally-Tailored Prevention Programming for Children of Incarcerated Mothers

描述（由申请人提供）：这份修订后的提案，《为母亲被监禁的孩子制定地方量身定制的预防方案》，采用基于社区的参与式研究（CBPR）方法来定制和实施现有的选择性预防方案（Kumpfer的强化家庭方案），以促进母亲被监禁的5至11岁儿童的心理健康和预防行为障碍。被监禁母亲的子女出现精神健康问题、学业失败和未来犯罪的风险非常高，这既是个人健康问题，也是公共健康问题，因为这类儿童的人数估计超过20万，而且还在迅速增加（司法部，2005年）。现有的以证据为基础的干预措施并没有专门针对儿童的独特需求，也没有针对那些母亲被监禁的儿童的负担过重且往往准备不足的照料者的需求。基于社区和参与者投入的本地定制的基于经验的干预措施被认为是预防研究的一个有前途的方向，并且可能是帮助这些难以接触到的家庭的最佳方式，因为当项目在文化上被接受并响应社区需求时，家庭更有可能参与和参与（Kumpfer et al. 2002a）。密歇根大学公共卫生学院和密歇根预防研究中心（PRC/MI）与密歇根州弗林特市的社区组织“母亲代祷”（Motherly Intercession）建立了伙伴关系，该组织为被监禁母亲的子女及其照顾者提供服务，目的是利用CPBR方法调整这一模式预防方案，以满足这一人群的需求，并在社区环境中实施和评估该方案。这个项目是社区和大学合作伙伴共同努力的结果，并将继续为项目的规划、设计、写作和预算计划提供信息。R21期间的目标是在当地量身定制和实施加强家庭计划（SFP），以满足社区需求。我们将：1)利用焦点小组来征求看护者对家庭和儿童需求的关注和问题，并调整SFP以纳入母亲被监禁的家庭的关注；2)通过组建社区咨询委员会、培训当地工作人员和建立数据管理系统，建立社区合作伙伴的组织能力，以实施和维持适应的干预措施并参与研究；3)在试点随机对照试验（RCT）中提供和评估适应干预对儿童和照顾者心理健康结局的影响。我们将收集过程数据，以记录我们的适应方法，并为实施战略提供信息，以便在更大范围内实施适应当地情况的项目。

DESCRIPTION (provided by applicant): This revised proposal, Developing Locally-Tailored Prevention Programming for Children of Incarcerated Mothers, uses a community-based participatory research (CBPR) approach to tailor and deliver an existing selective prevention program (Kumpfer's Strengthening Families Program) to promote mental health and prevent behavior disorders among 5- to 11-year-old children whose mothers have been incarcerated. Children of incarcerated mothers are at very high risk for mental health problems, academic failure, and future criminal offenses, which are both individual and public health problems given that the number of such children is estimated as over 200,000 and increasing rapidly (Bureau of Justice, 2005). Existing evidence-based interventions do not specifically address the children's unique needs, or the needs of the overburdened and often ill- prepared caregivers responsible for the children whose mothers are incarcerated. Locally tailoring empirically-based interventions based on community and participant input has been suggested as a promising direction for prevention research, and may be the best way to help hard-to-reach families like these because families are more likely to be engaged and participate when the program is culturally accepted and responds to community needs (Kumpfer et al. 2002a). The University of Michigan School of Public Health and the Prevention Research Center of Michigan (PRC/MI) have formed a partnership with Motherly Intercession, a community-based organization in Flint, Michigan that serves children of incarcerated mothers and their caregivers, with the goal of using CPBR methods to adapt this model prevention program to address the needs of this population, and implement and evaluate the program in a community setting. This project is a collaborative effort whereby community and university partners have contributed to and will continue to inform the planning, design, writing, and budget plan of the project. Goals for the R21 period are to locally tailor and implement the Strengthening Families Program (SFP) to meet community needs. We will: 1) use focus groups to solicit caregiver concerns and issues about family and child needs, and tailor SFP to incorporate concerns of families with an incarcerated mother; 2) build our community partner's organizational capacity to implement and sustain the adapted intervention and participate in research by forming a community advisory board, training local staff, and building data management systems; and 3) deliver and evaluate effects of the adapted intervention on child and caregiver mental health outcomes in a pilot randomized controlled trial (RCT). We will collect process data to document our adaptation methods and to inform implementation strategies for delivering the locally-adapted program on a larger scale.