Pediatric Group Well Child Visits for Detection of Maternal Depression in Latinas

项目摘要 NIMH指导的以患者为导向的研究职业发展的总体目标 奖励（K23）是为我提供必要的技能和高级培训，以建立一个 独立的研究计划，专注于开发和测试两代 在儿科初级保健服务提供模式，以减少心理健康治疗的差距。 为了促进我的长期职业目标，我制定了具体的短期培训目标 包括：1）获得应用，多方法定性研究的高级技能; 2）获得 文化精神病学和跨文化研究的专业知识; 3）发展核心知识库 团体心理治疗干预，包括其效益和评价机制; （4）发展心理健康服务干预发展的核心技能， 在初级保健环境中实施。在颁奖期间，我将进行一系列 相互关联的研究，作为务实学习培训目标的工具 补充正规培训和指导。这些研究试图描述和 随后加强了一种新颖和越来越多地使用儿科健康儿童护理形式， 儿科健康儿童访视，以解决在识别，初始管理， 产后抑郁症状的移民拉丁裔的后续治疗参与。 这些目标将通过以下方式实现：（1）对目前有目的地抽样的两个诊所进行案例研究 与移民拉丁裔家庭进行小组健康儿童访问，对来自直接 观察;深入和半结构化的访谈和调查，家长参与 并选择不参加团体参观、团体参观促进者和其他关键信息提供者 两个有目的的抽样诊所;（2）使用干预措施加强团体访问 映射和以人为本的设计方法和程序;（3）单臂前后 在Aim研究的每个研究中心对一组患者/家庭进行强化访视试点 1.我们预计，这些改进将纳入干预措施中的要素， 先前已证明该患者人群的可接受性和/或有效性，包括 筛查、简短干预和转诊治疗程序、提供者沟通技巧- 建立消除问题识别和寻求治疗的文化障碍的机构， 一个有凝聚力的小组进程，以及心理教育和自我管理战略。

Project Summary The overarching goal of this NIMH Mentored Patient-Oriented Research Career Development Award (K23) is to provide me with the skills and advanced training necessary to establish an independent program of research focused on the development and testing two-generational service delivery models in pediatric primary care to reduce mental health treatment disparities. To facilitate my long-term career goal, I have developed specific short-term training goals including: 1) Obtain advanced skills in applied, multimethod qualitative research; 2) Gain expertise in cultural psychiatry and cross-cultural research; 3) Develop a core knowledge base in group psychotherapeutic interventions including their mechanism(s) of benefit and evaluation; and 4) Develop core skills in mental health services intervention development and implementation in primary care settings. During the award period, I will conduct a series of inter-related studies which will serve as vehicles for pragmatic learning of the training goals complementing formal training and mentorship. The studies seek to characterize and subsequently enhance a novel and increasingly utilized form of pediatric well-child care, group pediatric well-child visits, to address disparities in identification, initial management, and subsequent treatment engagement of immigrant Latinas with postpartum depressive symptoms. The aims will be achieved through (1) a case study of two purposively sampled clinics currently delivering group well-child visits with immigrant Latino families, triangulating data from direct observations; in-depth and semi-structured interviews and surveys with parents participating and electing not to participate in group visits, group visit facilitators and other key informants at two purposively sampled clinics; (2) development of enhanced group visits using Intervention Mapping and Human-Centered Design methods and procedures; and (3) a single-arm pre-post pilot of the enhanced visit with one cohort of patients/families at each of the sites studied in Aim 1. We anticipate that the enhancements incorporate elements from interventions that have previously shown acceptability and/or effectiveness with this patient population including screening, brief intervention and referral to treatment procedures, provider communication skill- building to address cultural barriers to problem identification and treatment-seeking and facilitate a cohesive group process, and psychoeducation and self-management strategies.