Development of a Training Intervention to Improve Mental Health Treatment for Gender Minority Youth

项目总结/摘要 背景：性别少数青年（GMY;儿童，青少年和年轻人的性别认同不同， 他们的出生分配的性别）面临着严重的心理健康问题相对于顺性别青年不成比例的高风险 （他们的性别认同与他们的出生性别一致）。这些心理健康的不平等加剧了 治疗利用障碍，包括缺乏接受过性别平等护理培训的心理健康提供者（即，做法 解决性别少数群体的独特经历和心理健康需求）。美国国立卫生研究院和许多学者 呼吁加强努力，制定和部署干预措施，改善获得、参与和质量， 针对性别少数群体的卫生干预措施。研究：拟议的研究将开发和试点测试培训 采取干预措施，以增加心理健康提供者使用肯定性别的做法。干预设计（目标1）将利用 社区参与和以用户为中心的设计方法，与关键利益相关者的系统参与：GMY，他们的 照顾者以及具有和不具有确认性别平等护理专门知识的提供者。使用受支持的 行为干预发展的框架，干预将被设计为影响三种机制 假设导致提供者的行为改变（即，更多地采用肯定性别平等的做法）：知识， 态度和自我效能。将通过整合移动健康强调干预措施的可扩展性 技术.干预细化（目标2）将涉及两个阶段的以用户为中心的设计可用性测试：（1）基于实验室的 测试与焦点小组的供应商和（2）一个案例系列研究与3供应商治疗GMY消费者3个月。 可用性测试的反馈将用于迭代地完善干预措施，并确保干预措施准备就绪， 试点测试。试点测试（目标3）将是一个多诊所精神卫生机构的开放试验，旨在检查 进行未来RCT的可行性和可接受性。来自两个提供者的有效性和实施数据（N = 44)和消费者（即，GMY及其护理人员; N = 50 GMY）进行收集和分析。候选人的职业生涯 发展，目标和环境：建议指导患者为导向的研究职业发展奖 (K23)将为普莱斯博士提供开展独立研究项目所需的高级培训和技能 通过开发和评估培训， 干预措施，重点是GMY。（T1）机制驱动干预的正规培训和辅导 开发和测试，（T2）以用户为中心的设计，（T3）社区参与的研究，（T4）实施科学 将支持主要研究目标的成功执行和Price博士的职业发展。的巨大 在波士顿学院可用的资源，加上博士的指导和咨询团队成员的广泛专业知识， 将进一步确保研究和培训目标的成功，并为未来的培训RCT铺平道路 干预

PROJECT SUMMARY/ABSTRACT Background: Gender minority youth (GMY; children, adolescents, and young adults whose gender identity differs from their birth-assigned sex) face a disproportionately high risk for serious mental health problems relative to cisgender youth (whose gender identity is congruent with their birth-assigned sex). These mental health inequities are exacerbated by treatment utilization barriers, including the dearth of mental health providers trained in gender-affirming care (i.e., practices that address the distinct experiences and mental health needs of gender minorities). The NIH and numerous scholars have called for increased efforts to develop and deploy interventions that improve access to, engagement in, and quality of, mental health interventions for gender minorities. Research: The proposed research will develop and pilot test a training intervention to increase mental health providers’ use of gender-affirming practices. Intervention design (Aim 1) will utilize community-engaged and user-centered design methods, with systematic engagement from key stakeholders: GMY, their caregivers, as well as providers with and without expertise in gender-affirming care. Using an empirically-supported framework for behavioral intervention development, the intervention will be designed to affect three mechanisms hypothesized to result in behavioral change in providers (i.e., increased use of gender-affirming practices): knowledge, attitudes, and self-efficacy. Scalability of the intervention will be emphasized through the integration of mHealth technology. Intervention refinement (Aim 2) will involve two phases of user-centered design usability testing: (1) lab-based testing with focus groups of providers and (2) a case series study with 3 providers treating GMY consumers for 3 months. Feedback from usability testing will be used to iteratively refine the intervention and ensure the intervention’s readiness for pilot testing. The pilot test (Aim 3) will be an open trial in a multi-clinic mental health agency, aimed at examining the feasibility and acceptability of conducting a future RCT. Effectiveness and implementation data from both providers (N = 44) and consumers (i.e., GMY and their caregivers; N = 50 GMY) will be collected and analyzed. Candidate’s Career Development, Goals, and Environment: The proposed Mentored Patient-Oriented Research Career Development Award (K23) will provide Dr. Price with the advanced training and skills necessary to launch an independent research program focused on reducing mental health inequities for stigmatized youth and families through developing and evaluating training interventions, with an emphasis on GMY. Formal training and mentorship in (T1) mechanism-driven intervention development and testing, (T2) user-centered design, (T3) community-engaged research, and (T4) implementation science will support the successful execution of the primary research aims and Dr. Price’s career development. The immense resources available at Boston College, coupled with the vast expertise of Dr. Price’s mentorship and advisory team members, will further ensure the success of the research and training aims, and pave the way for a future RCT of the training intervention.