Project 1

项目1 社区学院（CC）的学生经历更普遍和严重的心理健康问题相比， 他们的四年制大学同行1，2却不太可能得到心理健康服务。这些 种族和少数民族学生之间的差距扩大，他们经历了多种态度和 心理健康服务的逻辑障碍以及社会和经济压力4，7，23，25，34。符合 ALACRITY中心目标2为了优化STAND的实施，此R34将侧重于文化响应 和社区知情干预措施，以提高社区中心的STAND筛查率和初始使用率， 学生主要是低收入和拉丁裔。通过以用户为中心的设计，我们的目标是使用学生的输入 在四年内迭代开发和测试参与干预措施，最大限度地提高招聘和初始 在东洛杉矶学院接受STAND。最初，将与60-72名ELAC进行12个焦点小组讨论 已完成1）仅筛查，2）筛查和知情同意/基线评估，3）筛查， 同意/基线和参加定向访问，和4）那些还没有登记进行筛选的人， 以探索这些参与阶段的促进者和抑制者。定性调查结果，初步 研究和现有文献将为解决障碍的参与干预措施的内容提供信息 众所周知，影响拉丁裔学生的初始服务利用，包括心理健康耻辱，心理 健康知识和感知需求18，19，21，27。我们还选择了可行的干预措施， 一个可以被移植到各种社区学院环境中的结构，以支持未来的传播。期间 第二年，我们将研究视频推荐（低强度信息干预）的有效性， 通过比较那些患有焦虑和抑郁症的学生的比例， 在第1年（标准招募）至第2年（带视频的标准招募）期间完成STAND筛选 见证）。在今年3，我们将研究一个文化嵌入式数字fotonovela与方面， 动机增强疗法（一种旨在告知和激活的干预措施）。270名ELAC学生将在 随机分配到Fotonovela条件或活性对照组（例如，标准教材）。 在第四年，我们将研究一个同伴主导的电话参与干预，旨在告知和激活 通过与同伴教练的合作; 308名学生将被随机分配到同伴主导的参与条件 或者像往常一样招募。两项RCT的主要结局将是STAND的初始摄取，定义如下： 完成一次定向访问。我们还将研究每种参与干预是否会导致 心理健康知识、耻辱感、自我效能感和感知需求的变化，这些变化导致了更高的 服务吸收。努力改善像STAND这样的心理健康项目的筛查和吸收， 在CC校园成功实施心理健康计划，减少持续的心理健康问题， 健康差距。

Project 1 Abstract Community college (CC) students experience more prevalent and severe mental health problems compared to their four-year university counterparts1,2 yet are much less likely to receive mental health services. These disparities are amplified among racial and ethnic minority students, who experience multiple attitudinal and logistic barriers to mental health service as well as social and economic stressors4,7,23,25,34. Consistent with the ALACRITY Center Aim 2 to optimize the implementation of STAND, this R34 will focus on culturally responsive and community informed interventions to improve rates of screening and initial uptake of STAND in a CC where students are primarily low-income, and Latinx. With a user-centered-design, we aim to use student input iteratively across four years to develop and test engagement interventions that maximize recruitment and initial uptake of STAND at East Los Angeles College. Initially, 12 focus groups will be conducted with 60-72 ELAC students who have completed 1) screening only, 2) screening and consent/baseline assessment, 3) screening, consent/baseline and attendance at an orientation visit, and 4) those who have not yet signed up for screening, in order to explore facilitators and inhibitors of these phases of engagement. Qualitative findings, preliminary studies, and extant literature will inform the content of the engagement interventions that address barriers commonly known to affect initial service utilization in Latinx students, including mental health stigma, mental health knowledge, and perceived need18,19,21,27. We also have selected interventions that are feasible and have a structure that can be transported to various community college contexts to support spread in the future. During Year 2, we will examine the effectiveness of video testimonials (a low intensity informational intervention) which feature Latinx CC students with lived experiences of anxiety and depression, by comparing rates of those who complete STAND screening during Year 1 (standard recruitment) to Year 2 (standard recruitment with video testimonials). During Year 3, we will examine a culturally embedded digital fotonovela with aspects of motivational enhancement therapy (an intervention that aims to inform and activate). 270 ELAC students will be randomized to the fotonovela condition or to an active control group (e.g., standard educational materials). During year 4, we will examine a peer-led telephone engagement intervention which aims to inform and activate through collaboration with a peer coach; 308 students will be randomized to the peer-led engagement condition or to recruitment as usual. The primary outcome for both RCTs will be initial uptake in STAND as defined by completion of an orientation visit. We will also examine whether each of the engagement interventions leads to changes in mental health knowledge, stigma, self-efficacy, and perceived need that account for higher rates of service uptake. Efforts to improve screening and uptake for mental health programs like STAND are critical to the successful implementation of mental health programs on CC campuses and the reduction of ongoing mental health disparities.