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Innovative Community Academic Partnership (iCAP)

Project Title

Project Title:   Adolescent Substance Use Intervention for Burmese Refugee Families

Community Partners:  MOSAIC Family Services of Dallas

Community Partner Profile:  For the last 23 years, MOSAIC Family Services of Dallas has established itself as one of the leading providers of social services to refugee families. The agency employs a multicultural staff that is fluent in 26 languages, was a founding member of both Dallas Area Refugee Forum and the Metroplex Refugee Network, and has established numerous relationships with agencies that serve an array of ethnically diverse populations. One manner in which the agency engages targeted youth is through the long-term commitment with Dallas School District to implement interventions that reduce substance use, truancy, and risky sexual behaviors.

Faculty Partners:  Eusebius Small, PhD, Julieann Nagoshi, PhD, Craig Nagoshi, PhD

Project Overview:   Refugees often face a history of trauma and stress related to acculturation, placing them at higher risk for mental health problems which are often comorbid with substance abuse. Compounding these issues, when a child learns the language of the host community first, a shift of power occurs begins to take place. The contribution of the proposed study is expected to meet the needs of refugee adolescents at risk of substance use by orienting both parents and adolescents to the problems associated with substance use and how to improve family communication.

The intervention to be employed and studied will be an adaptation of the established Families Preparing a New Generation for adolescents tailored more specifically to Burmese refugee families. The study aims to evaluate the effectiveness of this intervention by emphasizing parental understanding of substance use and enhancing family communication skills. The study also seeks to empower parents to understand that not speaking English as efficiently as their children is not a deficiency to make them lose parental control.

The adaptation of the Families Preparing a New Generation (FPNG) curriculum represents a substantive departure from the status quo by focusing on the new refugee experience for families, parent-offspring acculturation gap, and formation of parent support groups. This is important because, prior to their immigration, the parents never had to understand the effects of the acculturation gap and what can be done to ameliorate those effects. The positive impact of the program is to bridge the acculturation differences and encouraging parents to be more involved with their offspring’s peer relationships through parent-offspring-peer activities.   

 

Project Outcomes:  

One of the most promising deliverables from this project is an innovative and effective curriculum for substance abuse prevention that has potential for refugee populations across a wide spectrum. It is affordable and developed to decrease risky child behaviors and increase parent/child ties. We will also work with MOSAIC to identify next steps in program delivery, including identifying additional sites for parent substance abuse prevention programs through the Dallas school district.

Outcomes from this research and supporting data from this project will provide the basis for submission of federal grant applications. A specific example of a funding opportunity is from the Substance abuse and Mental Health Services Administration. The purpose of this program is to 1) establish and strengthen collaboration among communities, public and private non-profit agencies and 2) reduce substance use among youth and, over time, reduce substance abuse among adults as well. The funding from this ICAP will aid in the collection of preliminary data, supporting the research team in writing publications, presenting at research conferences, and applying for grants at both the state and federal level.

 

  

Project Title:  Psychoeducational Intervention for Foster Grandparents

Community Partners:   The Senior Source, Inc.

Community Partner Profile: 

For over 50 years, The Senior Source has become the go-to nonprofit for older adults by providing an expansive array of aging related social services. Their mission is to improve the quality of life of older adults in the grated Dallas area through protection, eldercare, financial security, advocacy, volunteerism, and employment services.

Faculty Partners:   Ling Xu, PhD, Noelle L. Fields, PhD, Hui He, PhD

Project Overview: 

Researchers have found that Foster Grandparent Programs have several mutually beneficial results for both the mentors (grandparents) and those who are being mentored (grandchildren). For example, research suggests that through Foster Grandparent Programs (FGP), elders engaged in more productive lifestyles contributed to improved psychological well-being and allowed older mentors to feel more connected to their communities. These grandparent-grandchild intergenerational exchanges significantly promote elders’ mental health. Despite the benefits of participating in Foster Grandparent Programs, it is often a challenge for older Chinese immigrants to participate in volunteerism. This is often due to Chinese immigrant elders experiencing a lack of resources, low acculturation levels, language barriers, and social isolation.

The proposed research tests the effectiveness of a new secondary prevention substance use intervention for both juvenile court- and school­ referred adolescents. In contrast to previous juvenile drug treatment court programs that involve only minimal participation of parents, Second Chance extensively involves parents in both the lessons their teen is being taught and in the implementation of the teen's action plan to achieve life goals without drugs.  Besides testing the effectiveness of this relatively new intervention in the Dallas area, the proposed research also tests whether the intervention differs in its effects for juvenile court- vs. school­ referred teens.  Finally, the research will explore whether behaviors targeted by the intervention, including adaptive coping skills and goal setting, mediate the intervention’s effects on substance use and antisocial behaviors.

The goal of our proposed project is to develop a psychoeducational intervention to address the needs of Chinese immigrant foster grandparents with particular attention given to empowering elders and addressing cultural barriers for volunteers who serve children with special or exceptional needs. The use of a community-based participatory research (CBPR) approach to designing and implementing this type of intervention for Chinese immigrant foster grandparents is innovative and will be among one of the first studies utilizing this method.  The proposed study is feasible and sustainable, as it will utilize Chinese immigrant participants as well as agency staff in an already existing and large Foster Grandparent Program.

Project Outcomes:   

This proposed foster grandparents intervention will result in positive impacts for both The Senior Source and the researchers. More importantly, the proposed project will support older minority grandparents by enhancing their skills, knowledge, and confidence thereby improving the quality of mentorship that they provide to children with special needs as well as support their own overall health and wellness. Deliverables will include an 8-session intervention for foster grandparents involved with the FGP and will result in the joint ownership of an intervention manual between the researchers and The Senior source.

Study findings will be disseminated to service providers and academic audiences at local, state, national and international levels using multiple venues. Locally, study findings will be presented at the Dallas Area Gerontological Society (DAGS) conference.  At the state level, findings will be presented at the annual Aging in Texas conference sponsored by the Texas Association of Area Agencies on Aging. Nationally, study results will be presented at the Gerontological Society of America annual meeting, the premiere interdisciplinary academic conference in the field of aging.   It is also the goal of the researchers to present study findings in an international venue such as the International Alzheimer’s Association Conference. Finally, the project is expected to result in several published manuscripts in top tier journals  such as Alzheimer's and Dementia, Journals  of Gerontology, The Gerontologist, The Journal of Gerontological Social Work, and Age and Aging

 

Project Title:  Mixed-Modality Family-Centered Intervention for Adolescent Organ Transplant Recipients and Their Families

Community Partners:  Children’s Medical Center of Dallas

Community Partner Profile:  For 100 years, the mission of Children’s Health℠ has been to make life better for children. Today, the team takes great pride in being the seventh-largest pediatric health care provider in the country, and the only academically affiliated pediatric hospital in the area with UT Southwestern. Children’s Health provides treatment for the full range of healthcare issues affecting children, offering routine and wellness care as well as specialized and advanced comprehensive treatment for the most acute and complex cases such as heart disease, cancer, and cystic fibrosis. It has also been at the forefront in the field of pediatric transplants as a major center for kidney, liver, intestine, heart and bone marrow transplantation.

Faculty Partners:  Michael Killian, PhD.

Project Overview:  The purpose of this project aims to examine a theoretically-grounded family-centered intervention with adolescent organ transplant recipients and their parents. The family-centered intervention includes 1) technology-enhanced peer mentorship to adolescents who have received a heart, kidney, or liver transplant and 2) supportive problem-solving skills training for their parents. In collaboration with Children’s Medical Center of Dallas and their Solid Organ Transplant Program, 40 adolescents and their families will be entered into a randomized, waitlist control trial. Adolescent transplant recipients will be connected with a trained peer mentor, who is also an organ transplant recipient, and receive a tablet computer (Apple iPad Mini 2) capable of connecting their assigned peer mentor. The parents will meet for problem-solving skills training and supportive group meetings during this time. Treatment phase for each group will last for 4 months.

This mixed-modality intervention and collaboration with Children’s Medical Center of Dallas builds on a number of emerging trends in research and practice in pediatric organ transplantation and pediatric organ transplant social work practice. Increased focus and calls for advancement in family-centered treatment models, trials of problem-solving skills with parents of children with transplanted organs, peer mentoring, and integration of technology within pediatric interventions have each received recent attention (Fredericks & Dore-Stiles, 2010; Law et al., 2014; Cantrell et al., 2010; Guilfoyle, Goebel, & Pai, 2011). Research on promotion of health behaviors and self-management skills in adolescents experiencing a chronic illness has a number of implications for sustainability, future external funding, and clinical implications for the care of these adolescents and their families.

Project Outcomes:   This project is intended to serve as key pilot data on the hypothesized issues surrounding a) medication adherence, b) general and disease-specific health related quality of life, and c) perceived barriers to medication adherence. Parents will be assessed on their a) problem-solving skills, b) stress levels, c) quality of their family environment, and d) on their perceptions of their child’s general and disease-specific issued and e) perceived barriers to their child’s medication adherence. The implications for the proposed project are relevant to a number of areas of pediatric health. The National Institutes of Health (NIH) considers adherence research, especially during adolescence, a major health problem and research priority. Similarly, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) supports research on the health and well-being of children and their development from prenatal through adulthood. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Heart, Lung, and Blood Institute (NHLBI) support research focusing on the well-being of patients experiencing end-stage organ failure leading to transplantation. Findings from the current project have direct implications for pediatric oncology services, patients, and parents, which would coincide with research priorities of the National Cancer Institute (NCI). NCI priorities include research on bone marrow transplantation, cancer-types occurring during the posttransplant period (e.g., posttransplant lymphoproliferative disorder), and supportive services for both pediatric oncology patients and their families.


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