Barbara Caplan, Teresa Lind, Colby Chlebowski, Kassandra Martinez, Gina C May, Casandra J Gomez Alvarado, Lauren Brookman-Frazee
{"title":"Training Community Therapists in AIM HI: Individual Family and Neighborhood Factors and Child/Caregiver Outcomes.","authors":"Barbara Caplan, Teresa Lind, Colby Chlebowski, Kassandra Martinez, Gina C May, Casandra J Gomez Alvarado, Lauren Brookman-Frazee","doi":"10.1080/15374416.2022.2096046","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Publicly funded mental health services play an important role in caring for children with mental health needs, including children with autism spectrum disorder (ASD). This study assessed the associations between individual family- and neighborhood-level sociodemographic factors and baseline family functioning and long-term outcomes when community therapists were trained to deliver <i>An Individualized Mental Health Intervention for ASD</i> (AIM HI).</p><p><strong>Method: </strong>Participants included 144 children with ASD (ages 5 to 13 years; 58.3% Latinx) and their caregivers whose therapists received <i>AIM HI</i> training within a cluster-randomized effectiveness-implementation trial in publicly funded mental health services. Sociodemographic strain (e.g., low income, less education, single-parent status, minoritized status) was coded at the individual family and neighborhood level, and caregivers rated caregiver strain at baseline. Child interfering behaviors and caregiver sense of competence were assessed at baseline and 6-, 12- and 18-months after baseline.</p><p><strong>Results: </strong>Higher caregiver strain was associated with higher intensity of child behaviors (<i>B</i> = 5.17, <i>p</i> < .001) and lower caregiver sense of competence (<i>B</i> = -6.59, <i>p</i> < 001) at baseline. Child and caregiver outcomes improved over time. Higher caregiver strain (<i>B</i> = 1.50, <i>p</i> < .001) and lower family sociodemographic strain (<i>B</i> = -0.58, <i>p</i> < .01) were associated with less improvements in child behaviors. Lower caregiver strain (<i>B</i> = -2.08, <i>p</i> < .001) and lower neighborhood sociodemographic strain (<i>B</i> = -0.51, <i>p</i> < .01) were associated with greater improvements in caregiver sense of competence.</p><p><strong>Conclusions: </strong>Findings corroborate the importance of considering both family and neighborhood context in the community delivery of child-focused EBIs.</p><p><strong>Trial registration: </strong>Clinical Trials NCT02416323.</p>","PeriodicalId":48350,"journal":{"name":"Journal of Clinical Child and Adolescent Psychology","volume":" ","pages":"783-795"},"PeriodicalIF":4.2000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877246/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Child and Adolescent Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/15374416.2022.2096046","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Publicly funded mental health services play an important role in caring for children with mental health needs, including children with autism spectrum disorder (ASD). This study assessed the associations between individual family- and neighborhood-level sociodemographic factors and baseline family functioning and long-term outcomes when community therapists were trained to deliver An Individualized Mental Health Intervention for ASD (AIM HI).
Method: Participants included 144 children with ASD (ages 5 to 13 years; 58.3% Latinx) and their caregivers whose therapists received AIM HI training within a cluster-randomized effectiveness-implementation trial in publicly funded mental health services. Sociodemographic strain (e.g., low income, less education, single-parent status, minoritized status) was coded at the individual family and neighborhood level, and caregivers rated caregiver strain at baseline. Child interfering behaviors and caregiver sense of competence were assessed at baseline and 6-, 12- and 18-months after baseline.
Results: Higher caregiver strain was associated with higher intensity of child behaviors (B = 5.17, p < .001) and lower caregiver sense of competence (B = -6.59, p < 001) at baseline. Child and caregiver outcomes improved over time. Higher caregiver strain (B = 1.50, p < .001) and lower family sociodemographic strain (B = -0.58, p < .01) were associated with less improvements in child behaviors. Lower caregiver strain (B = -2.08, p < .001) and lower neighborhood sociodemographic strain (B = -0.51, p < .01) were associated with greater improvements in caregiver sense of competence.
Conclusions: Findings corroborate the importance of considering both family and neighborhood context in the community delivery of child-focused EBIs.
期刊介绍:
The Journal of Clinical Child and Adolescent Psychology (JCCAP) is the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association. It publishes original contributions on the following topics: (a) the development and evaluation of assessment and intervention techniques for use with clinical child and adolescent populations; (b) the development and maintenance of clinical child and adolescent problems; (c) cross-cultural and sociodemographic issues that have a clear bearing on clinical child and adolescent psychology in terms of theory, research, or practice; and (d) training and professional practice in clinical child and adolescent psychology, as well as child advocacy.