Implementation and Scale-Up of a Caregiver Intervention for Mothers who have Survived Intimate Partner Violence: the Mediational Intervention for Sensitizing Caregivers

项目总结 暴露于亲密伴侣暴力(IPV)构成了创伤性应激环境，并导致 对母亲的照料和孩子的心理健康结果都有影响。接触IPV的儿童 更有可能发展成各种精神病。敏感和反应迅速的照顾一直是 被确定为可能缓冲IPV暴露的负面影响的重要保护因素。这个 对照顾者敏感的中介干预(MISC)显示出积极的治疗效果 儿童心理健康问题，目前正在赞助商的随机对照试验中进行调整和评估 (R01HD102436；PI：SHARP)适用于社区合作伙伴组织中接触IPV的非裔美国人母亲 安置计划。虽然MISC对这一群体充满希望，但还没有收集到任何数据来评估 MISC是否能够扩展以在社区组织环境中交付。此翻译 研究差距很大，因为非洲裔美国家庭感染IPV的比例很高(每4个家庭中就有1个 美国的非裔美国儿童接触到IPV)，以及缺乏有关相关因素的现有数据 对采用IPV育儿干预措施的支持。符合NIMH的战略目标3(预防 精神疾病)和4(公共健康影响)，拟议的研究将评估基于证据的MISC 实施的育儿干预使用 混合方法论 和综合框架 在两个IPV社区组织环境中进行纵向扩展的实施研究(CFIR)。这个项目将 确定实施MISC的主要障碍和促进者，这些障碍和促进者将纳入未来的扩展 并在另一份研究提案中对项目进行评估。使用CFIR构造 在并行收敛中 设计 ，详情如下 混合法 目标将会完成。对于目标1，我们将确定以下各项的MISC特征 通过与MISC-实施专家(个案工作者和 在赞助商的RCT中的IPV组织中实施MISC的行政领导)。采访 将专注于对MISC的看法以及它如何适应他们现有的工作负荷。对于目标2，我们将评估 通过对MISC的利益相关者(N=50)进行定量调查，得出MISC扩展适宜性的外部设置特征 IPV场。调查将侧重于推动IPV倡议的政策和激励措施。对于目标3，我们将评估内部 通过与IPV个案工作者(N=20)的重点小组在两个社区伙伴机构设置特征，以 探索与工作量和文化相关的因素。 每个目标都将确定显著的障碍和促进者 将根据以下内容创建与每个CFIR结构和综合建议相关的实施 这些发现为未来的扩大提供了参考。 拟议中的项目将是第一个评估能力和可行性的项目。 在IPV社区组织环境中采用基于证据的照顾者干预的可能性和意愿 扩展文献以考虑实施基于社区的干预措施中的多层次因素。

PROJECT SUMMARY Exposure to intimate partner violence (IPV) constitutes a traumatic stress environment and incurs profound impacts on both mothers’ caregiving and children’s’ mental health outcomes. Children who are exposed to IPV are more likely to develop a variety of psychopathology. Sensitive and responsive caregiving has been identified as an important protective factor that may buffer the negative impact of IPV exposure. The Mediational Intervention for Sensitizing Caregivers (MISC) has demonstrated positive treatment effects on child mental health problems and is currently being adapted and evaluated in the sponsor’s RCT (R01HD102436; PI: Sharp) for African American IPV-exposed mothers in a community partner organization’s rehousing program. While MISC holds promise for this population, no data has yet been collected to evaluate whether MISC is amenable to scale-up for delivery in community organization settings. This translational research gap is significant because of the high prevalence of IPV exposure in African American families (1 in 4 African American children in the U.S. are exposed to IPV) and the paucity of available data on factors related to the adoption of IPV-parenting interventions. Consistent with the NIMH’s strategic objectives 3 (prevention of mental illness) and 4 (public health impact), the proposed research will evaluate the evidence-based MISC parenting intervention for implementation using mixed methodology and the Consolidated Framework for Implementation Research (CFIR) for scale-up in two IPV-community organization settings. This project will identify key barriers and facilitators to the implementation of MISC that will be incorporated in a future scale-up and evaluation project in an additional research proposal. Using CFIR constructs in a parallel convergent design , the following mixed method aims will be completed. For Aim 1, we will identify MISC Characteristics for scale-up suitability using qualitative interviews (N=10) with MISC-Implementation experts (caseworkers and administrative leaders who are implementing MISC in their IPV organization in the sponsor’s RCT). Interviews will focus on the perception of MISC and how it may fit into their existing workload. For Aim 2, we will assess outer setting characteristics for MISC scale-up suitability via quantitative survey of stakeholders (N=50) in the IPV field. Surveys will focus on policies and incentives that drive IPV initiatives. For Aim 3, we will assess inner setting characteristics at two community partner agencies via focus groups with IPV caseworkers (N=20) to explore factors related to workload and culture. Each aim will identify salient barriers and facilitators to implementation related to each CFIR construct and comprehensive recommendations will be created based on these findings for future scale-up. The proposed project will be the first to evaluate the capacity and feasibility of adoption of an evidence-based caregiver intervention in an IPV-community organization setting and will extend the literature to consider multi-level factors in implementing community-based interventions.