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Principal Investigator: Erika Luz Gustafson
Organization: UNIVERSITY OF ILLINOIS AT CHICAGO
Fiscal Year: 2024
Award: $177,012
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT SUMMARY/ABSTRACT
This K08 proposal will address a critical need for evaluating and understanding the implementation of
community health worker (CHW) mental health models to reduce treatment disparities for underserved groups,
specifically, Spanish-speaking Latine parents. The Common Elements Treatment Approach (CETA) is an
effective transdiagnostic evidence-based treatment (EBT) designed to be delivered by lay providers with little
to no prior mental health training (i.e., CHWs). As members of the community served, CHWs can facilitate
culturally and linguistically relevant services, making them a crucial resource given the shrinking availability of
Spanish services in the U.S. CHWs have demonstrated effectiveness in delivering CETA and other EBTs
globally, but there is little evidence to guide domestic implementation of these models. The goal of this project
is to evaluate the implementation of CHW delivered CETA in Spanish with Latine parents. In Aim 1, the PI will
collaborate with stakeholders to refine CETA fit for a Spanish-speaking Latine parent population. Guided by
ADAPT-ITT, an implementation framework for EBT refinement, a community advisory board (CAB) will lead
refinement around areas of cultural relevance and engagement. Aim 2 will use mixed methods to assess
multilevel implementation determinants during the CETA training period, which includes initial CHW
implementation with training cases, and use this information for ethics-driven implementation planning. Aim 3 is
to conduct a randomized feasibility pilot of CHW-delivered CETA in Spanish with Latine parents to examine
intervention acceptability and feasibility; feasibility of recruitment, randomization, and measurement
procedures; and treatment engagement. Latine parents will be randomized to receive CETA immediately or
after a 5 month delay. Administrative data (i.e., patient attendance, retention), patient-report data (i.e.,
validated mental health symptom measures pre-, during-, and post-treatment), and provider-report data (i.e.,
fidelity) will be used to evaluate feasibility. Dr. Gustafson’s long-term career goal is to evaluate, adapt, and
implement CHW mental health models to reduce disparities in mental health treatment for Latine and other
underserved populations in the U.S. To meet her career objectives and the aims of this research project, the
applicant requires additional training in: 1) community-engaged clinical trials; 2) implementation science, with a
focus on contextual fit optimization; and 3) ethics related to implementing CHW models to address disparities
in care for marginalized communities. Supported by an interdisciplinary team of experts and an institutional
environment invested in supporting innovative initiatives to improve the mental health of marginalized
populations, this K08 will launch the PI into a successful career as an independent clinical scientist. This
project will also provide necessary data for Dr. Gustafson’s future R01 submission of a large-scale
effectiveness-implementation trial of CHW-delivered EBT across multiple clinics and community settings. This
project aligns with NIMH’s priorities of addressing mental health disparities for minority groups.
Terms: <0-11 years old><Address><After Care><After-Treatment><Aftercare><Anxiety><Area><Assess implementation><Attention><Chicago><Child><Child Mental Health><Child Youth><Children (0-21)><Clinic><Clinical><Clinical Trials><Collaborations><Communities><Community Health Aides><Consolidated Framework for Implementation Research><Consolidated Framework for Implementation Science><Consolidated Framework for Implementing Change><Data><Data Reporting><Decrease disparity><Diagnostic><Disparities><Disparity><Effectiveness><Elements><Emotional Depression><Environment><Equity><Espanol><Ethics><Ethnic Group><Ethnic People><Ethnic Population><Ethnic individual><Ethnicity People><Ethnicity Population><Evaluation><Evidence based treatment><Family><Future><Goals><Health><Health Care Providers><Health Expenditures><Health Personnel><Healthcare Providers><Healthcare worker><Home><Hospitals><Household><Implementation assessment><Implementation readiness><Improve Access><Individual><Individuals from minority><Individuals of minority><Inequity><Institution><Interruption><Intervention><Intervention Strategies><Investigators><Investments><Knowledge><Language><Latine><Latinx><Lead><Limited English Proficiency><Linguistic><Linguistics><Link><Low-resource area><Low-resource community><Low-resource environment><Low-resource region><Low-resource setting><Lower disparity><Measurement><Measures><Mental Depression><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Mental disorders><Mental health disorders><Methods><Minority Groups><Minority People><Minority Population><Minority individual><Modeling><NIMH><National Institute of Mental Health><Outcome><Parents><Patients><Pb element><Persons><Population><Position><Positioning Attribute><Prevalence><Procedures><Process><Provider><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Psychopathology><Public Health><R-Series Research Projects><R01 Mechanism><R01 Program><Randomization trial><Randomized><Research Grants><Research Personnel><Research Project Grants><Research Projects><Research Resources><Researchers><Resource-constrained area><Resource-constrained community><Resource-constrained environment><Resource-constrained region><Resource-constrained setting><Resource-limited area><Resource-limited community><Resource-limited environment><Resource-limited region><Resource-limited setting><Resource-poor area><Resource-poor community><Resource-poor environment><Resource-poor region><Resource-poor setting><Resources><Risk><Savings><Scientist><Services><Social Identification><Social Identity><Spanish><Symptoms><System><Training><Translating><Trauma><Underserved Population><abnormal psychology><acceptability and feasibility><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><anxious><assess effectiveness><career><community advisory board><community advisory committee><community advisory panel><community engagement><community health worker><community marginalization><community setting><compare treatment><cultural competence><culturally competent><data representation><data representations><depression><depression symptom><depressive><depressive symptoms><design><designing><determine effectiveness><disparities in treatment><disparity in care><disparity in healthcare><disparity reduction><effectiveness and implementation trial><effectiveness assessment><effectiveness evaluation><effectiveness trial><effectiveness/implementation hybrid trial><effectiveness/implementation trial><engagement with communities><ethical><ethnic subgroup><ethnicity group><evaluate effectiveness><evaluate implementation><evaluation of implementation><evidence base><examine effectiveness><global health><health care access><health care availability><health care disparity><health care expenditure><health care inequality><health care inequity><health care personnel><health care service access><health care service availability><health care worker><health equity><health provider><health training><health workforce><healthcare access><healthcare accessibility><healthcare availability><healthcare disparity><healthcare expenditure><healthcare inequality><healthcare inequity><healthcare personnel><healthcare service access><healthcare service availability><heavy metal Pb><heavy metal lead><homes><implementation determinants><implementation evaluation><implementation factors><implementation framework><implementation intervention><implementation research framework><implementation science><implementation science framework><improved><improved outcome><inequality in treatment><innovate><innovation><innovative><intergenerational><intervention design><interventional strategy><kids><marginalization><marginalized community><marginalized group><marginalized individual><marginalized people><marginalized population><medical expenditure><medical personnel><member><mental function><mental health care><mental healthcare><mental illness><minority health disparity><mitigate disparity><organizational readiness><parent><post treatment><psychiatric illness><psychological disorder><randomisation><randomization><randomized trial><randomly assigned><recruit><reduce disparity><reduction in disparity><safety net><skill acquisition><skill development><social health determinants><social stigma><stigma><stress symptom><therapy design><traumatic stress><treatment comparison><treatment design><treatment disparity><treatment inequality><treatment inequity><treatment provider><under served community><under served group><under served individual><under served people><under served population><underserved community><underserved group><underserved individual><underserved people><youngster>