Organizational Context and Children's Mental Health in Urban After School Program

这项申请扩展了一项研究计划，该计划旨在研究公共资助的课外活动的能力。 促进城市贫困社区儿童心理健康的计划，这些社区的心理健康风险 困难极大，可用于满足这些需要的资源极为有限。的 拟议中的研究将在芝加哥公园区的公园儿童计划中进行，该计划是最大的 为芝加哥的儿童和青少年提供公共资助的课后项目。我们最近完成 该研究计划中的第一项研究（NIMH R34-MH 070637; PI：Frazier;见初步研究项目 NAFASI）检查心理健康咨询的可行性，以放学后的计划工作人员周围的学术 丰富，辅导行为，活动参与和行为管理。这些发现揭示了强有力的 干预可行性的证据，工作人员的高满意度，以及尽管适度但令人鼓舞的 改善儿童的适应功能。目前的应用程序将扩大NAFASI干预， 反映了儿童心理健康服务中越来越多的文献将组织社会背景与服务联系起来 质量和结果表明，在项目层面上进行有效和可持续的变革， 在组织层面进行更集中的干预。因此，我们建议在第1-3年通过 混合效应回归模型如何社会背景（通过直接观察和工作人员的看法）运作， 与儿童和家长报告的课程质量和儿童心理健康有关的课后课程 结果（工作人员和自我报告）为12个随机选择的儿童年龄8至16岁的84个公园的孩子 整个芝加哥的项目（n=357名工作人员，1,008名儿童）。这些数据将用于（1）提供规范 课后计划对组织社会背景的测量，（2）估计方差分量 与将用于为后续临床试验提供动力的研究中心相关的结构，以及（3）通知 在第四年扩大NAFASI干预的组织一级干预组成部分。的 提出的研究将有助于本研究的总体目标，开发新的社区心理模型， 卫生实践的重点是支持使命，提高质量，提高能力后， 学校方案，以促进城市贫困儿童的心理健康和适应功能。

This application extends a program of research that examines the capacity of publicly-funded after-school programs to promote children's mental health in urban, poor communities, where the risks for mental health difficulties are extremely high and the resources available to meet those needs are severely limited. The proposed study will be conducted at the Chicago Park District's Park Kids program, one of the largest providers of publicly-funded after school programs for children and youth in Chicago. We recently completed the first study in this program of research (NIMH R34-MH070637; PI: Frazier; see Preliminary Studies Project NAFASI) examining the feasibility of mental health consultation to after school program staff around academic enrichment, coaching behaviors, activity engagement and behavior management. Those findings reveal strong evidence for the feasibility of intervention, high staff satisfaction, and encouraging though modest improvements in children's adaptive functioning. The current application will expand the NAFASI intervention to reflect a growing literature in children's mental health services linking organizational social context with service quality and outcomes which suggests that effective and sustainable change at a program level will require more concentrated intervention at an organizational level. Hence, we propose to examine in Years 1-3 via mixed-effects regression models how social context (by direct observation and staff perceptions) operates in after school programs in relation to child and parent reported program quality and children's mental health outcomes (staff and self report) for 12 randomly selected children ages 8 to 16 in each of the 84 Park Kids programs throughout Chicago (n=357 staff, 1,008 children). These data will be used to (1) provide norms for after school programs on a measure of organizational social context, (2) estimate the variance component structures associated with site that will be used to power a subsequent clinical trial, and (3) inform the expansion in Year 4 of organizational-level intervention components for the NAFASI intervention. The proposed study will contribute to the overall goal of this research to develop new models of community mental health practice focused on supporting the mission, improving the quality, and enhancing the capacity of after- school programs to promote mental health and adaptive functioning for children living in urban poverty.