The Development of PATH, a Program to Support NICU Parent Mental Health Through the Transition from Hospital to Home

项目摘要/摘要 此K08奖项申请包括培训和研究活动，以支持我过渡到 独立的心理健康服务研究人员专注于改善为患有精神疾病的父母提供的服务。我 我是一名受过博士培训的临床社会工作者，也是波特兰州立大学的终身教授， 为家长和家庭提供心理健康服务的背景。我正在完成机构K12课程 该奖项旨在研究新生儿重症监护病房(NICU)父母的心理健康需求。本次K08大奖 将以我的定性研究为基础，通过提供受保护的时间、指导和 和结构化支持，1)学习实施科学方法，2)增加我对 综合精神卫生服务，3)掌握进行严格的随机对照试验的技能，包括 分析结果所需的统计方法，以及4)获得成为行业领导者所需的技能 家长心理健康服务研究领域。我的多学科指导团队在 注重部署和参与性的方法、卫生服务研究、实施科学、家长 精神卫生研究、随机对照试验、卫生经济学、卫生信息学、农村卫生和 生物统计学。NICU住院早产儿的父母心理健康风险极高 具有潜在破坏性后果的条件。然而，围产期保健系统并没有系统地 支持NICU家长心理健康。美国预防服务工作组和州级孕产妇 死亡率审查委员会呼吁围产期护理系统优先考虑父母的心理健康。这个 这项提案的目标是开发和试点基于远程健康的精神健康筛查和 参与计划，支持父母从NICU过渡到家。该程序将使用 分级护理方法，筛查父母的抑郁、焦虑和创伤后应激障碍；提供简短的行为 对那些被筛选为至少有低风险的这些情况的人进行干预；并提供热情的交接 为中高危人群提供社区精神卫生服务。我们会在以下方面达致研究目标 满足3个具体目标：1)使用RE-AIM框架与前一方合作开发该计划 NICU家长和NICU以及初级保健利益相关者；2)进行迭代病例系列以确定 实际执行细节和后勤，完善心理健康筛查和参与计划， 并定性评估所谓的作用机制；以及3)进行试点随机对照试验，以 评估该计划的可接受性和可行性；测试其针对心理健康自我的初步效果 效力和其他潜在的行动机制；以及为了更好地了解采用的促进者， 实施和维护。拟议的活动将提供初步数据，并允许 改进R01应用程序进行类型1混合所需的数据收集程序 在美国多个NICU进行的有效性/实施试验。

Project Summary/Abstract This application for a K08 Award includes training and research activities that support my transition to an independent mental health services researcher focused on improving services for parents with mental illness. I am a PhD-trained clinical social worker and tenure-track Assistant Professor at Portland State University, with a background in providing mental health services to parents and families. I am completing an Institutional K12 Award to study the mental health needs of parents in the neonatal intensive care unit (NICU). This K08 Award will build off my qualitative research and advance my research career by providing protected time, mentorship, and structured support to 1) learn implementation science methods, 2) increase my understanding of integrated mental health services, 3) obtain skills to conduct rigorous randomized control trials, including statistical methods necessary to analyze results, and 4) gain the skills necessary to become a leader in the field of parent mental health services research. My multidisciplinary mentorship team brings expertise in deployment-focused and participatory methods, health services research, implementation science, parent mental health research, randomized control trials, health economics, health informatics, rural health, and biostatistics. Parents of NICU-hospitalized preterm infants are at extremely high risk for mental health conditions with potentially devastating consequences. Yet, perinatal systems of care do not systematically support NICU parent mental health. The U.S. Preventive Services Task Force and state-level Maternal Mortality Review Committees have called upon perinatal systems of care to prioritize parent mental health. The objectives of this proposal are to develop and pilot test a telehealth-based mental health screening and engagement program that supports parents as they transition from the NICU to home. The program will use a stepped-care approach to screen parents for depression, anxiety, and PTSD; provide a brief behavioral intervention to those who screen as having at least a low risk of these conditions; and provide a warm hand-off to community mental health services for those at medium to high risk. We will achieve the study objectives by meeting 3 specific aims: 1) to use a RE-AIM framework to develop the program in collaboration with former NICU parents and NICU and primary care stakeholders; 2) to conduct an iterative case series to work out practical implementation details and logistics, refine the mental health screening and engagement program, and qualitatively assess purported mechanisms of action; and 3) to conduct a pilot randomized control trial to assess the program's acceptability and feasibility; to test its preliminary efficacy in targeting mental health self- efficacy and other potential mechanisms of action; and to better understand facilitators to adoption, implementation, and maintenance. The proposed activities will provide preliminary data and allow for the refinement of data collection procedures necessary for an R01 application to conduct a Type 1 hybrid effectiveness/implementation trial in multiple NICUs across the U.S.