Adaptation of post-disaster mental health training for black communities

描述(由申请人提供)：适应和采用基于证据的精神健康战略对于那些在自然灾害后果中受到不成比例影响的亚群工作的人来说是具有挑战性的，并可能导致在获得精神健康服务、诊断和治疗精神健康状况方面出现越来越大的种族差距。外部援助小组面临着对工具的压倒性需求，这些工具要考虑到精神健康状况的文化和族裔背景，并促进采取权宜之计和成本效益高的措施，以减轻灾害对精神健康的影响。我们拟议的灾后心理健康干预培训工具将有助于应对这些挑战，并有望向需要支持的人提供有效的干预措施，因为它将通过与卫生服务提供者和在最近遭受飓风影响最严重的东南部和海湾国家工作的黑人社区领导人进行迭代协作的方法来开发。我们首先将在北卡罗来纳州的沿海和东部进行彻底的需求评估，并通过对斯坦·库彻博士开发的材料进行实施测试，继续纳入回应观众学习需求的材料。该模式基于世界卫生组织和NIMH推荐的灾后心理健康实践。新的培训方案还将包括能力和社会资本建设技术，并通过培训培训员部分进行扩展。这一形成性研究的结果将被编织到一个新的灾害干预培训计划中，该计划可以连续为高危地区的其他少数民族群体量身定做。原型培训包将包括1)核心知识/护理能力手册；2)临床提供者和社区领导者受训人员工具包(包括针对1个已完成的核心能力的可测试的合作学习练习，实用的心理健康转介和治疗方法的资源列表，以及培训评估前后测试，用于测试使用基于网络的培训组件的格式进行未来远程学习的接受度的样本光盘)；以及3)培训员促进手册，其中包括实施培训培训员计划的幻灯片和可测试的说明。我们将制定一项进行多地点现场评估试验的计划。在第二阶段，我们将根据第一阶段的概念证据，进一步开发培训部分，包括远程学习光盘和基于网络的教学。公共卫生相关性：我们建议开发的灾害心理健康培训工具将促进适当和具有成本效益的应对需要，使卫生服务提供者和黑人社区领导人为应对灾害带来的不利心理健康后果做好准备。通过反复调整教材以适应有色人种社区的文化背景，我们将拥有一个有用的工具，以解决在提供心理健康服务方面挑战外来者的文化障碍。扩展到其他形式，以便远程学习不同的培训内容并为其他弱势社区量身定做，将使当地的急救人员能够获得可持续的技能。

DESCRIPTION (provided by applicant): Adaptation and adoption of evidence based mental health strategies has been challenging for those working with subpopulations disproportionately affected by the aftermath of natural disasters and may contribute to the growing racial disparities seen in access to mental health services, diagnosis, and treatment of mental health conditions. Outside assistance teams have faced overwhelming demands for tools that take into account the cultural and ethnic context of mental health conditions and facilitate expedient and cost effective measure to mitigate the mental health effects of disasters. Our proposed post disaster mental health intervention training tool will assist in addressing these challenges and holds promise for delivering effective interventions to those in need of support because it will be developed through an iterative collaborative approach with health providers and black community leaders working in areas in the Southeastern and Gulf states that have experienced the greatest impact of recent hurricanes. We first will conduct thorough needs assessment in coastal and eastern North Carolina and continue to incorporate materials that respond to audience learning needs through implementation testing of materials developed by Dr. Stan Kutcher. This model is based on World Health Organization and NIMH recommended post disaster mental health practices. The novel training program will also include capacity and social capital building techniques and expansion through a train the trainer component. The results of this formative research will be woven into a novel disaster intervention training program that can be successively tailored to other minority groups in high risk areas. The prototype training package will consists of 1) a core knowledge/care competencies manual; 2) clinical provider and community leader trainee toolkits (with testable cooperative learning exercises for 1 completed core competency, a list of resources for practical mental health referral and treatment approaches, and training evaluation pre and post tests, a sample CD rom to test the acceptance of future distance learning using web based format for training components); and 3) a trainer facilitation manual with slide sets and testable instructions for implementing a train the trainer program. We will elaborate a plan for conducting a multi site field evaluation trial. In Phase II we will further develop the training components, including distance learning CD rom and web based instruction based on the Phase I proof of concept evidence. PUBLIC HEALTH RELEVANCE: The disaster mental health training tool that we propose to develop will promote an appropriate and cost effective response to the need to prepare health providers and black community leaders for addressing the adverse mental health consequences to disasters. Through the iterative adaptation of teaching materials to the cultural context of communities of color, we will have a useful tool to address cultural barriers that challenge outsiders in providing mental health services. Expansion to other formats for distance learning of different training components and tailoring for other vulnerable communities will allow local first responders to gain the sustainable skills.