Standardized Clinical Observation: Catalyst for Culturally Responsive Engagement

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Engagement of low-income ethnic minority participants in family-based interventions for disruptive behavior presents significant challenges. Initial clinical experience at the time of assessment may importantly influence their engagement but this has received little attention in studies of ethnic minority families. In this study we examine whether the use of a culturally enhanced observational feedback paradigm increases engagement of low income ethnic minority families referred to a preschool disruptive behavior clinic. Using a sequenced design, Phase I of the study focuses on methods development in which the candidate uses a mixed method approach to (a) develop a format for integrating joint video observations into clinical feedback procedures, (b) gather qualitative data from diverse clinicians and parents to reflect diverse perspectives on cultural competence; (c) integrate qualitative information on cultural competence into the observational feedback procedures by generating culturally responsive codes to accompany the joint observations and; (d) develop a coding system to assess clinician competence (cultural competence and alliance-building) and parental engagement observed during these feedback sessions. Phase II uses the culturally enhanced feedback procedure developed above within a randomized controlled trial that compares the effect of this feedback on clinician competence and family engagement. Specific aims of the proposed study are as follows: Aim): Develop and pilot a standardized paradigm for cultural enhanced observational feedback and Aim II: Conduct a randomized trial to test the impact of culturally enhanced observational feedback on parent-clinician engagement and clinician cultural competence. The additional effects of the culturally enhanced observational feedback procedure over the standard feedback will be examined, including whether this enhanced procedure increases clinician cultural competence. The innovative application of observational methodology within intervention contexts is likely to elucidate important familial and clinician therapeutic influences that effect families' capacity to fruitfully engage in intervention and pinpoint modifiable barriers to engagement in ethnic minority families.