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-enhanced 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 (R01MH134368) 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
North Coast VOICES: Championing a Trauma-Informed and Gender-Responsive Behavioral Health Program Co-Designed with the Del Norte School District Community
Given the compelling evidence that the evidence-based VOICES-Lite program reduces student cannabis use, the program’s foundation in trauma-informed and developmentally appropriate approaches, as well as the opportunity to build upon the proof-of-concept model established for program co-design grounded in community-driven partnership established in the VOCES-NUEVAS project, we aim to attune VOICES-LITE to the rural Northern California context in parntership with the Del Norte school district community. Thus, our study funded by the UCSF Pivot/Resilience Program seeks to:
Aim 1: Co-Design) Conduct remote biweekly focus groups with our Del Norte behavioral health providers and UCSF will conduct concurrent Rapid Qualitative Analysis (RQA) to align the program with the needs and resources of the context.
Aim 2: Open Trial) Support Del Norte behavioral health providers implementing the co-designed curriculum and clinical assessment protocol (i.e., student mental health and substance use measures completed before and after the program, as well as session rating forms completed after each group).
Aim 3: Randomized Controlled Trial; RCT) Iterate the co-designed program informed by the open-trial evaluation and compare the refined curriculum to school-services-as-usual (SAU) using a clustered waitlist control design.