Trauma Interventions for Low-income Women in PrimaryCare

描述(申请人提供)：创伤暴露和创伤相关精神障碍在美国造成了公认的健康差距，因为低收入人群很少获得心理健康专科护理，往往觉得这是一种耻辱，而且由于初级保健环境中对精神健康问题的关注有限，他们的创伤相关问题几乎没有得到专业人员的关注。初级保健创伤干预中心(C-TIP)的目标是开发创新和可持续的干预措施，通过与地方司法机构的学术界-社区研究伙伴关系，向初级保健环境提供与创伤相关的精神卫生需求，为低收入、主要是少数族裔人口提供服务。为了增加这些干预措施的采用率和可持续性，正在与三个投资巨大的社区合作伙伴密切合作，将开发的创伤相关服务概念化：马里兰州乔治王子县的卫生部、马里兰州蒙哥马利县的初级护理联盟和哥伦比亚特区的联合保健公司。该中心将通过与乔治敦大学护理与健康研究学院及其家庭医学系等新的学术合作伙伴的积极合作，扩展我们的研究基础设施支持计划(RISP)已经在这一研究不足的人群中产生的高质量研究。中心的工作将通过三个核心(业务、研究方法和主要研究)进行，提供行政监督、统计支持和进入专家咨询小组的机会；整合应用人类学和公共卫生观点的创新方法/研究设计；以及为发展有前途的研究提供专门知识和支持。C-TIP资助的研究项目包括：1)一系列定性的人种学研究，描述医疗保健系统的相关层面和将开展工作的临床环境；2)评估三种招募战略和两种留住参与者战略的可行性和可接受性的方法研究；以及3)由护理人员提供的以创伤为重点的团体干预的试点研究。通过C-TIP继续和培育的工作伙伴关系和基础设施能力将使我们能够开发全面的创伤干预模式，这些模式将转化为我们建议通过高级中心和其他赠款机制研究的服务于低收入个人的环境。

DESCRIPTION (provided by applicant): Trauma exposure and trauma-related mental disorders make substantial contributions to widely recognized health disparities in the U. S. Because low-income populations have little access to mental health specialty care and often find it stigmatizing, and because attention to mental health issues in primary care settings is limited, their trauma-related problems receive little if any professional attention. The goal of the Center for Trauma Interventions in Primary Care (C-TIP) is to develop innovative and sustainable interventions to address the spectrum of trauma-related mental health needs presenting to primary care settings serving low-income, mostly minority populations through academic-community research partnerships with local jurisdictions. To increase the adoption and sustainability of these interventions, the trauma-related services to be developed are being conceptualized in close collaboration with three highly invested community partners: the Department of Health in Prince George's County, MD; the Primary Care Coalition in Montgomery County, MD; and Unity Health Care, Inc. in the District of Columbia. The Center will extend the high quality research our Research Infrastructure Support Program (RISP) has already generated in this under-studied population by active collaboration with new academic partners: Georgetown's School of Nursing and Health Studies and its Department of Family Medicine. The Center's work will be conducted through three cores (Operations, Research Methods, and Principal Research) providing administrative oversight, statistical support, and access to expert advisory groups; innovative methods/research designs integrating perspectives from applied anthropology and public health; and expertise and support for the development of promising research. C-TIP funded research projects include: 1) a series of qualitative ethnographic studies describing relevant dimensions of the health care systems and clinical settings in which the work will take place; 2) a methods study evaluating the feasibility and acceptability of three strategies of recruitment and two strategies of retention of participants to trauma-related intervention research; and 3) a pilot study of a trauma-focused group intervention delivered by nursing personnel. The working partnerships and infrastructure capability that will be continued and fostered through C-TIP will allow us to develop comprehensive trauma intervention models whose translation to settings serving low income individuals we propose to study through an advanced center and other grant mechanisms.