Developing an engagement intervention for Black and Latinx caregivers to improve children’s receipt of mental health services after sexual abuse

项目摘要 K23指导以患者为导向的研究职业发展奖的申请旨在支持 波士顿儿童医院虐待儿童儿科医生方晓辉博士的职业发展， 哈佛医学院，成为一名独立调查员，其工作改善了精神卫生保健 以及对受虐待儿童影响的家庭的影响。方博士提议开发一种新的 针对性虐待儿童的黑人和拉丁裔照顾者的参与干预， 这些儿童心理健康需求未得到满足的负担。参与干预措施，其中儿童服务 专业人员（例如，社会工作者）与照顾者合作，以增加儿童接受卫生保健服务， 代表了一种解决未满足的心理健康需求的有希望的方法，但尚未得到充分研究， 性虐待儿童的黑人和拉丁裔照顾者。K23项目旨在开发一种新的 针对这一新的护理人员群体的参与干预，整合了两个证据的组成部分- 基于干预措施（McKay的参与干预措施和DECIDE干预措施）。研究将使用 基于社区的参与性研究的原则和文化适应的系统过程， 在三个目标上发展参与干预。Aim 1将使用对Black和Latinx的深入采访 性虐待儿童的照顾者，以确定对儿童性虐待的社会文化观念， 寻求心理健康。目标2将使用焦点小组，从为黑人服务的社会工作者那里获得反馈 性虐待儿童的拉丁裔照顾者和社区咨询委员会的投入， 根据具体情况调整干预组件。目标3将对新的参与干预措施进行可行性试点测试 和接受性虐待儿童的黑人和拉丁裔照顾者。这项研究将导致 制定一项新的参与干预措施，为大规模测试做好准备，作为减少种族和 性虐待后精神卫生保健的种族差异。方博士召集了一位经验丰富的 导师团队，包括玛格丽塔阿莱格里亚博士（多元文化人群的干预发展）， Megan Bair-Merritt（以创伤为重点的研究）和Michael Lindsey博士（少数民族治疗参与） 指导她通过严格的培训计划，以获得以下方面的专业知识：1） 文化多样性的人口; 2）以少数民族为重点的创伤研究中的社会文化和伦理问题 行为干预的临床试验方法。方博士会利用 波士顿儿童医院（一家领先的儿科医疗保健和研究机构， 儿童性虐待专业转诊中心）和更广泛的哈佛社区（哈佛医学院， 哈佛T. H.哈佛大学公共卫生学院）开展她的研究和职业生涯 发展规划K23奖将帮助Fong博士应对不充分和 作为未来的独立研究人员，为受虐待儿童及其家庭提供不公平的精神卫生保健。

PROJECT SUMMARY This application for a K23 Mentored Patient-Oriented Research Career Development Award aims to support the career development of Dr. Hiu-fai Fong, a child abuse pediatrician at Boston Children’s Hospital and Harvard Medical School, in becoming an independent investigator whose work improves mental health care and outcomes for families affected by child abuse. Dr. Fong proposes to develop and pilot test a novel engagement intervention for Black and Latinx caregivers of sexually abused children to address the significant burden of unmet mental health need for these children. Engagement interventions, in which child-serving professionals (e.g., social workers) work with caregivers to increase children’s receipt of MH services, represent a promising approach to address unmet mental health need but have not been well studied with Black and Latinx caregivers of sexually abused children. This K23 project seeks to develop a novel engagement intervention for this new population of caregivers that integrates components from two evidence- based interventions (McKay’s engagement intervention and the DECIDE intervention). The research will use principles of community based participatory research and a systematic process of cultural adaptation to develop the engagement intervention over three Aims. Aim 1 will use in-depth interviews with Black and Latinx caregivers of sexually abused children to identify sociocultural perceptions about child sexual abuse and mental health care seeking. Aim 2 will use focus groups to elicit feedback from social workers that serve Black and Latinx caregivers of sexually abused children and input from a community advisory board to culturally and contextually adapt intervention components. Aim 3 will pilot test the new engagement intervention for feasibility and acceptability with Black and Latinx caregivers of sexually abused children. This research will lead to the development of a new engagement intervention ready for large-scale testing as a strategy to reduce racial and ethnic disparities in mental health care after sexual abuse. Dr. Fong has assembled a highly experienced mentorship team, including Dr. Margarita Alegria (intervention development for multicultural populations), Dr. Megan Bair-Merritt (trauma-focused research), and Dr. Michael Lindsey (treatment engagement for minority families) to guide her through a rigorous training plan to gain expertise in: 1) intervention development for culturally diverse populations; 2) sociocultural and ethical issues in trauma-focused research with minority groups; and 3) clinical trial methodology for behavioral interventions. Dr. Fong will leverage the unique resources available at Boston Children’s Hospital (a leading pediatric healthcare and research institution, and a specialty referral center for child sexual abuse) and the broader Harvard community (Harvard Medical School, Harvard T.H. Chan School of Public Health, Harvard Catalyst) to carry out her research and career development plan. The K23 award will prepare Dr. Fong to tackle the substantial challenges of inadequate and inequitable mental health care for abused children and their families as a future independent researcher.