Black youth living in poverty-impacted communities are disproportionately burdened by behavioral health challenges, notably serious disruptive behavioral difficulties (DBDs). Without access to care, children with DBDs frequently suffer serious impairment. This study is based on the premise that if care navigation models are going to succeed in eliminating racial disparities in child mental health care, then the preparation and support for child behavioral health navigators (cbhNs) needs to include: 1) training to deliver evidence-based family engagement, psychoeducation and support interventions; 2) ongoing coaching and supervision focused on building collaborative relationships between families and provider partners and; 3) skills to enhance community/system buy-in, as well as to analyze and interrupt multi-level structural influences on disparities and system gaps. involves individuals STL. integrates education, The proposed study (in response to PAR 18-428) will be conducted in 2 phases. Phase 1 the r ecruitment and training of a new cohort of cbhNs (n=15), intentionally involving committed of color from an existing community-based network of outh service system partners, HomeGrown CbhNs will be prepared to collaborate with youth/families via an interactive training protocol which existing vidence-based approaches, including engagement interventions 19 , family support and adapted care navigation models and empirically supported implementation strategies to address y e barriers. Phase 2 is a mixed methods, hybrid effectiveness implementation experimental study, enrolling 390 early adolescent youth (10 to 14 years) of African descent and their families living in geographically defined St. Louis north city and county neighborhoods (racially segregated areas with high poverty concentration). The study aims to simultaneously examine multi-level factors that enhance or impede cbhN interaction and youth/family outcomes. In stakeholders, addition, the study explores the response to cbhNs by key network and system as well as of the cbhNs.This study is being conducted by a transdisciplinary network of scientists at Washington University in St. Louis and New York University in collaboration with St. Louis service organizations, policy officials and the HomeGrown STL Advisory Board. This application aligns with NIH's priorities to address underlying health disparities, as well as to enhance public health impact of mental health focused research studies.

Public Health Relevance

Black youth living in poverty-impacted communities are disproportionately burdened by behavioral health challenges, notably serious disruptive behavioral difficulties (DBDs). If care navigation models are going to succeed where previous efforts have failed in eliminating racial disparities in child mental health care, then child behavioral health navigator (cbhN) training needs to include: 1) preparation to deliver evidence-based family engagement, psychoeducation and support interventions; 2) ongoing coaching and supervision focused on building collaborative family/provider relationships; 3) skills and community/system buy-in to analyze and interrupt multi-level structural influences on disparities and system gaps. This study will examine youth/family level outcomes associated with cbhNs and identify multi-level factors that impede or facilitate navigation.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH116895-01A1
Application #
9818073
Study Section
Mental Health Services Research Committee (SERV)
Program Officer
Juliano-Bult, Denise M
Project Start
2019-08-01
Project End
2024-05-31
Budget Start
2019-08-01
Budget End
2020-05-31
Support Year
1
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Washington University
Department
Type
Schools of Social Welfare/Work
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130