Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California, USA.
Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA.
BMJ Open. 2019 Jul 18;9(7):e028988. doi: 10.1136/bmjopen-2019-028988.
Behavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successful implementation of evidence-based practices (EBPs) in community settings that serve low-income, ethnic minority families. Lay health workers (LHWs)-individuals without formal mental health training-represent an important workforce to increase engagement, as they are members of the communities they serve. However, the mobilisation of LHWs has not been well studied as an implementation strategy to extend the reach or effectiveness of EBPs in the USA. LHW-delivered implementation interventions that specifically support the engagement of Latinx parents in evidence-based BPT programmes have the potential to improve clinical and implementation outcomes.
A community-partnered approach will use the Quality Implementation Framework (QIF) to tailor and implement an LHW-delivered implementation intervention that aims to promote Latinx parent engagement in BPT programmes. Steps from the QIF will guide study activities to (1) conduct a mixed methods needs assessment to fit the implementation intervention to the local context, (2) adapt LHW-delivered implementation strategies to promote parent access to and engagement in Parent-Child Interaction Therapy and (3) conduct a hybrid effectiveness-implementation pilot trial to examine the feasibility, acceptability and preliminary effectiveness of the LHW implementation intervention at increasing engagement.
Study procedures have been approved by the Institutional Review Board at the University of California, Santa Barbara. Results will be shared with the community-advisory group, at community-based meetings for other stakeholders involved in the pilot project, and submitted for publication in peer-reviewed journals.
行为家长培训 (BPT) 计划在预防和治疗早期行为问题和儿童虐待方面非常有效。不幸的是,普遍存在的心理健康服务差距继续限制了这些干预措施的获得和参与。此外,父母参与方面的挑战可能会阻碍在为低收入、少数民族家庭服务的社区环境中成功实施循证实践 (EBP)。非专业心理健康工作者 (LHW)——没有正式心理健康培训的人——是增加参与度的重要人力,因为他们是他们所服务社区的成员。然而,作为一种实施策略,LHW 的动员在美国尚未得到很好的研究,以扩大 EBP 的覆盖范围或有效性。由 LHW 提供的实施干预措施,专门支持拉丁裔父母参与循证 BPT 计划,有可能改善临床和实施结果。
一种社区伙伴关系方法将使用质量实施框架 (QIF) 来调整和实施由 LHW 提供的实施干预措施,旨在促进拉丁裔父母参与 BPT 计划。QIF 的步骤将指导研究活动:(1) 进行混合方法需求评估,以根据当地情况调整实施干预措施;(2) 调整 LHW 提供的实施策略,以促进父母获得和参与亲子互动疗法;(3) 进行混合有效性-实施试点试验,以检查 LHW 实施干预措施在增加参与度方面的可行性、可接受性和初步有效性。
研究程序已获得加利福尼亚大学圣巴巴拉分校机构审查委员会的批准。结果将与社区咨询小组、参与试点项目的其他利益相关者的社区会议以及提交给同行评议期刊发表分享。