The CLS-A-FUERTE project in Mexico. Neurodevelopmental disorders of Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) are extremely common but underserved with Evidence-Based Treatments worldwide. Thus, our team developed, implemented and evaluated a school clinician training and ADHD/ODD intervention (i.e., the Collaborative Life Skills [CLS] program) for Mexico: a setting with high unmet need. We integrated technology into our in-person program (CLS-FUERTE) to create a digitally-enahnced version (CLS-R- FUERTE). Given findings demonstrating feasibility, acceptability, and efficacy of both program versions, we are conducting a Type 2 Hybrid Effectiveness-Implementation Design to evaluate the program effectiveness, mechanisms of intervention change, and maintenance barriers/facilitators in a scaled-up cluster randomized controlled trial with n = 40 schools across two Mexican states -while simultaneously- exploring the impact of an implementation strategy in which we adapt the program to fit school’s needs/resources during the maintenance period to encourage sustainability (i.e., CLS-A-FUERTE). Our implementation process is guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) model with evaluation following the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. This R01 study funded by the National Institute of Mental Health and National Institute of Health-Fogarty International Center seeks to:
Aim 1) Test the effectiveness and implementation of the CLS-A-FUERTE school clinician training and ADHD/ODD intervention program in schools across Mexico.
Aim 2) Evaluate mechanisms of sustained intervention change.
Aim 3) Identify CLS-A-FUERTE maintenance barriers and facilitators.
Aim 4) Expand research capacity to a novel university setting.
For more information on the CLS-A-FUERTE project, visit: https://reporter.nih.gov/project-details/10986915
To view our CLS-A-FUERTE program overview video in Spanish, click below:
VOCES-NUEVAS: Empowering newcomer VOICES by implementing and evaluating a trauma-informed and gender-responsive group intervention in school and school based health center sites. The U.S. has seen a rapid increase in recently arriving immigrant youth (i.e., “newcomers”) from Latin America in the past two decades. Mental and stress-related health disparities exist between newcomer youth and their peers who have not undergone the process of migration. Offering culturally-attuned and trauma-informed evidence-based interventions in trusted settings easily accessible to newcomer youth, such as schools and school-based health centers (SBHCs), may be a solution. Thus, our study funded by the UCSF Resource Allocation Program seeks to:
Aim 1) Iteratively refine “VOCES-NUEVAS” with feedback from our partners about cultural-adaptations needed to align VOICES-LITE (a gender and trauma-responsive, strengths-based substance use and mental health group intervention) for school/SBHC providers serving newcomer students, and
Aim 2) Conduct an open-trial of VOCES-NUEVAS in n = 4 school/SBHC sites to evaluate its feasibility, acceptability, and effectiveness, as well as inform a final iteration to be tested in a subsequent scaled-up study