Judge Baker Childrens Center

CLINICAL RESEARCH IN BIOLOGICAL AND SOCIAL PSYCHIATRY

PHYSICAL HEALTH IN MIDLIFE:INFLUENCES OF ADVERSITIES AND RELATIONSHIPS

THE CENTER FOR TRAUMATIC STRESS AND COMORBIDITY (CTSC) - THE CENTER FOR TRAUMATIC STRESS AND COMORBIDITY (CTSC) WILL PROVIDE COMPREHENSIVE TRAINING, IMPLEMENTATION, AND TECHNICAL ASSISTANCE TO SUPPORT NCTSN CATEGORY III SITES CURRENTLY IMPLEMENTING TRAUMA-FOCUSED TREATMENTS BY TRAINING PARTICIPATING AGENCIES IN TWO COMPLEMENTARY TRAUMA-INFORMED EVIDENCE-BASED PRACTICES (EBPS), THE MODULAR APPROACH TO THERAPY FOR CHILDREN (MATCH) AND PARENT CHILD INTERACTION THERAPY (PCIT). THE GOALS OF THE CTSC ARE TO: 1) IMPROVE YOUTH AND FAMILY OUTCOMES RELATED TO TRAUMATIC STRESS, COMORBID CONDITIONS, AND ASSOCIATED FAMILY PROBLEMS BY INCREASING THE QUALITY OF TRAUMA-INFORMED CARE; 2) INCREASE AGENCY CAPACITY TO TREAT TRAUMATIC STRESS AND COMORBIDITIES SUCH AS ANXIETY, DEPRESSION AND BEHAVIOR PROBLEMS BY IMPLEMENTING AND SUSTAINING COMPLEMENTARY TRAUMA-INFORMED EBPS; 3) IMPROVE CLINICIAN EMPOWERMENT (ATTITUDES, SELF-EFFICACY, AND SATISFACTION) FOR IMPLEMENTATION OF EBPS FOR TRAUMATIZED YOUTH; AND 4) INCREASE THE CAPACITY OF NCTSN MEMBERS TO PARTNER WITH SURROUNDING COMMUNITIES AND POLICYMAKERS TO INTEGRATE COMPLEMENTARY EBPS INTO TRAUMA-INFORMED TREATMENT. HIGHLY EFFECTIVE EBPS ARE AVAILABLE TO TREAT TRAUMATIC STRESS SYMPTOMS IN CHILDREN; HOWEVER, NONE OF THESE TREATMENTS HAVE THE CAPACITY TO INCLUSIVELY TREAT TRAUMA-RELATED DISORDERS AND POTENTIAL COMORBIDITIES THAT COULD INTENSIFY THE SERIOUS MENTAL AND PHYSICAL HEALTH CONSEQUENCES ASSOCIATED WITH TRAUMA EXPOSURE. RESEARCH AND A RECENT SURVEY OF NCTSN SITES DEMONSTRATE A CRUCIAL NEED FOR TRAINING AND EDUCATION IN THE CONCURRENT USE OF EBPS TO ADDRESS TRAUMATIC STRESS AND COMORBID CONDITIONS. THROUGH THIS INITIATIVE, THE CTSC WOULD: A) PROMOTE COMPREHENSIVE TREATMENT OF CHILDHOOD TRAUMA AND RELATED SEQUELAE; AND B) HELP NCTSN SITES USE CLINICAL EVIDENCE AND DECISION-MAKING FRAMEWORKS TO TREAT CHILD TRAUMATIC STRESS WHILE SKILLFULLY ADAPTING TREATMENT TO ADDRESS COMORBIDITIES AND STRESSORS THAT INTERFERE WITH TREATMENT. CTSC WILL PROVIDE TRAINING AND IMPLEMENTATION FOR TWO EBPS, MATCH AND PCIT. THESE TRAUMA-INFORMED EBPS OFFER A UNIQUE COMPLEMENT TO EXISTING TREATMENTS FOR TRAUMATIC STRESS. COLLECTIVELY, THESE TWO PROGRAMS PROVIDE SERVICES FOR YOUTH AGES 2-17 AND COVER APPROXIMATELY 80% OF THE COMORBID PROBLEMS ASSOCIATED WITH TRAUMATIC STRESS. CTSC WILL PROVIDE MULTIPLE MATCH AND PCIT TRAININGS USING A STRUCTURED IMPLEMENTATION FRAMEWORK, THE LEARNING COLLABORATIVE METHODOLOGY, IN A REGIONALLY STAGED APPROACH OVER THE 5 YEARS OF THIS INITIATIVE. CTSC WILL TRAIN OVER 138 PROVIDERS IN THE MODELS ACROSS APPROXIMATELY 26 SITES AND BUILD SUSTAINABLE TRAINING CAPACITY AT EACH AGENCY, ALLOWING SITES TO INDEPENDENTLY TRAIN ADDITIONAL PROVIDERS IN THESE EBPS INDEFINITELY. THE RESULTS OF THIS INITIATIVE WILL PROVIDE TRAUMA-INFORMED SERVICES TO OVER 3,400 YOUTH ANNUALLY AND 17,000 YOUTH OVER THE 5 PROJECT YEARS. CTSC WILL ALSO PROVIDE TECHNICAL ASSISTANCE AND CONSULTATION AND DEVELOP TRAUMA-INFORMED TOOLKITS AND PROCESS MANAGEMENT GUIDES TO SUPPORT THE IMPLEMENTATION OF COMPLEMENTARY EBPS FOR TRAUMATIC STRESS AND COLLABORATE WITH COMMUNITY PROVIDERS AND NCTSN PARTNERS TO ENHANCE THE TREATMENT OF TRAUMA AND COMORBIDITY IN YOUTH.

COMMUNITY-DRIVEN DRUG PREVENTION IMPLEMENTATION STRATEGIES FOR NATIVE HAWAIIAN AND PACIFIC ISLANDER YOUTH IN RURAL HAWAI'I - PROJECT SUMMARY/ABSTRACT I AM AN IMPLEMENTATION SCIENTIST, YOUTH SUBSTANCE USE AND MENTAL HEALTH SERVICES RESEARCHER, CLINICAL PSYCHOLOGIST, AND DESCENDANT OF OKINAWAN-JAPANESE IMMIGRANTS TO HAWAIʻI. I PROPOSE TO USE A COMMUNITY- BASED PARTICIPATORY RESEARCH APPROACH TO STUDY THE IMPLEMENTATION OF A CULTURALLY GROUNDED SUBSTANCE USE PREVENTION CURRICULUM, HO`OUNA PONO. THE INTERVENTION HAS BEEN CREATED, EVALUATED, AND SPREAD THROUGH SEVERAL NIDA-FUNDED GRANTS TO ADDRESS THE HIGH RATES OF SUBSTANCE USE IN NATIVE HAWAIIAN AND PACIFIC ISLANDER YOUTH, ESPECIALLY IN RURAL AREAS. OUR WORK HAS REVEALED THAT MANY IMPLEMENTATION BARRIERS INTERSECT AT THE YOUTH, FAMILY, AND TEACHER LEVELS, INDICATING A PRESSING NEED FOR COMMUNITY-LED IMPLEMENTATION EFFORTS. IN THIS RACIAL EQUITY INITIATIVE VISIONARY AWARD, I PROPOSE AN INNOVATIVE COMBINATION OF IMPLEMENTATION SCIENCE AND PARTICIPATORY METHODS TO SPREAD AND SUSTAIN HO`OUNA PONO IN THE WINDWARD DISTRICT OF THE HAWAIʻI STATE DEPARTMENT OF EDUCATION. I HYPOTHESIZE THAT HO`OUNA PONO ADOPTION AND SUSTAINABILITY WILL INCREASE BY USING COMMUNITY-LED INNOVATION TOURNAMENTS, WHICH ACTIVELY PROMOTE ENGAGEMENT AND OWNERSHIP IN THE IMPLEMENTATION PROCESS. I ALSO HYPOTHESIZE THAT REAL-TIME ASSESSMENTS OF IMPLEMENTATION THROUGH ECOLOGICAL MOMENTARY ASSESSMENT WILL ENABLE RAPID AND ACCURATE IMPLEMENTATION AND INTERVENTION ADAPTATION. THESE TWO INNOVATIVE APPROACHES HAVE NEVER BEEN TESTED FOR NATIVE HAWAIIAN AND PACIFIC ISLANDER YOUTH LIVING IN GEOGRAPHICALLY REMOTE AND RURAL AREAS, MAKING THIS A NOVEL HIGH-RISK, HIGH-REWARD STUDY. MOREOVER, THIS IS THE FIRST STUDY TO USE ECOLOGICAL MOMENTARY ASSESSMENT TO FACILITATE IMPLEMENTATION OF YOUTH SUBSTANCE USE PREVENTION. I INTEND TO CHALLENGE THE EXISTING RESEARCH PARADIGM THROUGH THIS RACIAL EQUITY INITIATIVE VISIONARY AWARD THROUGH REDISTRIBUTING POWER TO COMMUNITY TO LEAD THE RESEARCH EFFORT. TRADITIONALLY, IMPLEMENTATION SCIENCE AND RESEARCH HAS PRIVILEGED THE RESEARCHERS' VOICE, OFTEN LEADING TO HIGHLY CONTROLLED, COMMUNITY-BASED STUDIES THAT CREATE MISTRUST IN THE SCIENTIFIC PROCESS AND PRODUCE UNSUSTAINABLE INTERVENTIONS WITH LIMITED COMMUNITY ACCEPTABILITY. THESE CONCERNS ARE EVEN MORE PRONOUNCED IN POPULATIONS THAT HAVE SYSTEMATICALLY BEEN THE FOCUS OF INCREASED SCIENTIFIC INQUIRY, LIKE INDIGENOUS AND RURAL POPULATIONS. THE IMPACT OF THIS PARADIGM-SHIFTING PROJECT HAS THE POTENTIAL TO CHANGE HOW IMPLEMENTATION RESEARCH IS CONDUCTED BY PUTTING COMMUNITY IN THE LEADERSHIP ROLE. FURTHERMORE, IT WILL BUILD SCIENTIFIC SKILLS AND EXPERTISE DIRECTLY INTO THE COMMUNITY TO FOSTER ONGOING IMPLEMENTATION AND GENERALIZABILITY TOWARD FUTURE IMPLEMENTATION EFFORTS. IT IS IMPERATIVE THAT STUDIES WITH THE POTENTIAL FOR RESHAPING INSTITUTIONAL STRUCTURES AND SYSTEMS BE CONDUCTED TO FURTHER ADVANCE RACIAL EQUITY, ESPECIALLY FOR NATIVE HAWAIIAN AND PACIFIC ISLANDER YOUTH. THE PROPOSED STUDY ADDRESSES THIS IMPERATIVE.

THE METROWEST EVIDENCE-BASED TRAUMA-INFORMED REFERRAL & TREATMENT INITIATIVE FOR CHILDREN (METRIC) - THE METROWEST EVIDENCE-BASED TRAUMA-INFORMED REFERRAL & TREATMENT INITIATIVE FOR CHILDREN (METRIC) WILL INCREASE ACCESS TO TRAUMA-FOCUSED, EVIDENCE-BASED SERVICES FOR CHILDREN AND ADOLESCENTS AGES 2 TO 18, AND THEIR FAMILIES, IN SCHOOL AND COMMUNITY-BASED SETTINGS IN WALTHAM AND SURROUNDING METROWEST COMMUNITIES. BASED AT THE BAKER CENTER WALTHAM (BCW), A DIVISION OF THE JUDGE BAKER CHILDREN'S CENTER, THIS INITIATIVE WILL PROVIDE TRAUMA-FOCUSED SERVICES TO A PROJECTED 2,350 CHILDREN AND ADOLESCENTS AND THEIR FAMILIES DURING THE FIVE-YEAR GRANT-PERIOD. THE METRIC INITIATIVE INCLUDES COLLABORATION AMONG BCW EXPERT STAFF, THE WALTHAM PUBLIC SCHOOLS AND NCTSI-II CENTERS, INCLUDING THE CHILD TRAUMA TRAINING CENTER AT UMASS MEDICAL CENTER. METRIC WILL INCLUDE COMPREHENSIVE SCREENING; ASSESSMENT, EVIDENCE-BASED TRAUMA-FOCUSED TREATMENT, TRAINING FOR SCHOOL AND OUTPATIENT CLINICIANS, AND REFERRAL SYSTEMS TO STRENGTHEN THE INFRASTRUCTURE SUPPORTING THE LONG-TERM NEEDS OF THE COMMUNITY. METRIC'S MULTILINGUAL CLINICAL STAFF WILL BE TRAINED IN FOUR EVIDENCE-BASED PRACTICES TO MEET THE NEEDS OF CHILDREN AND ADOLESCENTS IMPACTED BY TRAUMATIC STRESS. THROUGHOUT THE FIVE-YEAR PROJECT, WE WILL ENGAGE METROWEST STAKEHOLDERS INCLUDING SCHOOLS, EARLY CARE AND EDUCATION PROVIDERS, PEDIATRIC PROVIDERS, HOSPITALS, CHILD WELFARE STAFF, FAITH-BASED ORGANIZATIONS, AND OTHER CHILD-SERVING ORGANIZATIONS THROUGH EDUCATIONAL OUTREACH, DEVELOPMENT OF SCREENING AND REFERRAL MECHANISMS, AND CONSULTATION. METRIC WILL ALSO EMPLOY A NEW FAMILY SUPPORT COORDINATOR (FSC) AT THE BAKER CENTER WALTHAM TO ASSIST PARENTS AND CAREGIVERS IN NAVIGATING THE TREATMENT PROCESS AND REFER CAREGIVERS TO NEEDED COMMUNITY-BASED, CULTURALLY COMPETENT SERVICES. THE FSC WILL ALSO HELP FAMILIES ENROLL IN MASSHEALTH (MEDICAID) OR PRIVATE INSURANCE AS NEEDED IN ORDER TO ENSURE ACCESS TO CARE. METRIC WILL ADD TO THE KNOWLEDGE BASE OF BOTH THE NATIONAL CHILD TRAUMATIC STRESS INITIATIVE NETWORK AND ONGOING TRAUMA-FOCUSED INITIATIVES IN MASSACHUSETTS SUCH AS THE CHILDHOOD TRAUMA TASK FORCE. WE WILL WORK COLLABORATIVELY WITH LOCAL AND STATE LEADERSHIP TO PROMOTE HIGH QUALITY TRAUMA-FOCUSED CARE FOR VULNERABLE CHILDREN AND FAMILIES AND DERIVE IMPORTANT LESSONS LEARNED FROM THIS INITIATIVE THAT CAN BE APPLIED ACROSS OUR COMMONWEALTH. THE METRIC INITIATIVE WILL POSITIVELY IMPACT THOUSANDS OF UNDERSERVED CHILDREN AND ADOLESCENTS IN WALTHAM AND THE METROWEST REGION OF BOSTON. METRIC WILL IMPROVE THE QUALITY OF TRAUMA-FOCUSED CARE, FURTHER DEVELOP A TRAUMA-INFORMED SYSTEM OF CARE, AND INCREASE ACCESS FOR UNDERSERVED POPULATIONS INCLUDING ECONOMICALLY DISADVANTAGED, BLACK AND LATINX CHILDREN AND TEENS AND LGBTQ+ YOUTH. THIS FIVE-YEAR INITIATIVE WILL PROVIDE MUCH NEEDED SUPPORT TO VULNERABLE FAMILIES FOR MANY YEARS TO COME AND THROUGH METRIC WE WILL ESTABLISH THE NECESSARY INFRASTRUCTURE AND MECHANISMS TO SUSTAIN THIS WORK INTO THE FUTURE.

MALNUTRITION AND MENTAL HEALTH: A RAT MODEL

PREVENTION OF DEPRESSION IN AT-RISK ADOLESCENTS

BEHAVIORAL AND AFFECTIVE SKILLS IN COPING: PRACTICE-ADAPTED CHILD PSYCHOTHERAPY

TRAJECTORIES OF ADVERSE CHILDHOOD EXPERIENCES AND ADOLESCENT SUBSTANCE ABUSE

CONSUMER AND CLINICIAN FEEDBACK IN YOUTH MENTAL HEALTH CARE

MENTAL HEALTH OUTCOMES FOLLOWING CHILDHOOD MALNUTRITION

PRACTICE BASED EVIDENCE: ENHANCING THE EVIDENCE BASE FOR ADOLESCENT DEPRESSION