MH Services & Predictors of Learning in Urban Schools

说明(申请人提供)：本申请将研究为城市低收入儿童和家庭提供校本心理健康服务的模式，该模式以学校教育对儿童的社会和情绪适应至关重要的经验证据为指导，以学业成就对儿童心理健康的直接和间接好处的证据为指导。这项提议的一个主要假设是，与通常的精神健康服务相比，调整精神卫生资源以支持儿童的学习将导致更强的儿童精神健康结果。该模型建立在NIMH资助的芝加哥公立学校研究项目的累积证据基础上，社区心理健康提供者与(1)家长倡导者在校本心理健康计划中有效维持家庭的合作，(2)课堂教师提高孩子学习成绩的合作，以及(3)同行识别的有影响力的教师(关键意见领袖)影响课堂教师行为管理策略的使用。这项建议复制和扩展了这些协作模型，以关注最可靠的教师和家长对学生学习的预测。该提案还建立在研究团队与伊利诺伊州精神卫生部门和芝加哥公立学校之间正在进行的合作的基础上，以向公共政策提供信息，以制定与城市学校进行社区精神卫生合作的有效模式。关键的研究问题将通过2个条件(实验与比较)×5个时间点(基线、时间2、时间3、时间4、后续)的纵向设计进行检验，从43所符合条件的学校中随机分配15所学校到43所符合条件的学校中，这些学校的规模、种族代表性、贫困水平和邻近高贫困社区的成就相似。从幼儿园到四年级有一种或多种破坏性行为障碍的儿童(n=473)将通过教师筛查和后续标准化的家长和教师评级来确定。15所学校将被随机选择并分配到对照心理健康服务照常条件下，或被分配到实验干预条件下，在实验干预条件下，精神健康提供者(MHPS)将与关键意见领袖(KOL)教师和家长倡导者(PA)合作，就儿童学习的定向预测因素向儿童课堂教师和家长提供基于证据的策略咨询。假设相对于对照地点，实验学校心理健康干预将导致儿童的学习成绩、家庭行为和在校行为相对于照常治疗的对照得到改善。教师和家长的表现对学习预测因素的中介作用将与孩子、家庭和教师特征的可能调节作用一起被检验。该实验模式与最近呼吁对儿童的心理健康需求和能力进行背景相关理解的呼吁是一致的，并回应了在贫困、脆弱和服务不足的社区提供心理健康服务的替代模式的需要。-

DESCRIPTION (provided by applicant): This application will study a model for school-based mental health services for urban low-income children and families that is guided by empirical evidence for schooling as critical for children's social and emotional adjustment, and by evidence for the direct and indirect benefits of academic achievement for children's mental health. A primary hypothesis of this proposal is that aligning mental health resources to support children's learning will lead to stronger mental health outcomes for children, relative to mental health services as usual. The model builds on cumulative evidence from a program of NIMH-funded research based in inner city Chicago Public Schools in which community mental health providers collaborated with (1) parent advocates to effectively maintain families in a school-based mental health program, (2) classroom teachers to enhance children's academic performance, and (3) peer-identified influential teachers (key opinion leaders) to influence classroom teacher's use of behavior management strategies. This proposal replicates and extends these collaborative models to focus on the most robust teacher and parent predictors of student learning. The proposal also builds on an ongoing collaboration between the research team with the Illinois State Division of Mental Health and the Chicago Public Schools, to inform public policy on the development of effective models for community mental health collaboration with urban schools. The key research questions will be examined by a 2 conditions (Experimental vs. Comparison) X 5 time points (baseline, time 2, time 3, time 4, follow-up) longitudinal design with random assignment of 15 schools to conditions from a pool of 43 eligible schools of similar size, ethnic representation, poverty level, and achievement in adjacent high poverty neighborhoods. Children (n = 473) with one or more Disruptive Behavior Disorder in Kindergarten through 4th grades will be identified by teacher screening and follow-up standardized parent and teacher ratings. Fifteen schools will be randomly selected and assigned to either a comparison mental health services-as-usual condition, or to the experimental intervention condition, in which mental health providers (MHPs) will work in collaboration with key opinion leader (KOL) teachers, and parent advocates (PAs) to provide consultation to children's classroom teachers and parents on evidence-based strategies for targeted predictors of children's learning. It is hypothesized that, relative to comparison sites, the experimental school mental health intervention will lead to improvement in children's academic performance, behavior at home, and behavior at school relative to the treatment-as-usual comparison. Mediational effects of teacher and parent performance on predictors of learning will be examined along with possible moderating effects of child, family, and teacher characteristics. The experimental model is consistent with recent calls for a contextually-relevant understanding of children's mental health needs and capacities, and responds to the need for alternative models for mental health service delivery in impoverished, vulnerable, and under-served communities. -