Journal of Prevention & Intervention in the Community最新文献

This paper introduces the second installment of the two-issue series in the Journal of Prevention and Intervention in the Community with a focused theme on "Cardiovascular Diseases and Risk Factors for Minoritized Communities." Building on Part I, which examined cardiovascular health disparities through intersectional and multiscale frameworks, Part II shifts attention from understanding inequities to translating knowledge into action through community engagement and intervention. The paper situates cardiovascular disease (CVD) disparities within structural contexts shaped by systemic racism, socioeconomic inequality, environmental exposures, and inequitable healthcare access that disproportionately affect minoritized populations. The articles in this issue highlight community-engaged and practice-oriented approaches to addressing cardiometabolic risk across diverse settings. Collectively, these contributions demonstrate the value of integrating clinical care with social support systems, strengthening community capacity, and leveraging culturally grounded strategies to improve prevention and disease management. The issue also explores how structural disruptions, such as the COVID-19 pandemic, interact with chronic disease burden to heighten vulnerability among older adults and underserved groups, underscoring the importance of resilience-focused and system-level interventions. The paper concludes with a call for research and practice that combines intersectional and multilevel perspectives with implementation of science and community-based participatory approaches to ensure interventions are culturally relevant, scalable, and sustainable. By emphasizing empowerment, partnership, and structural accountability, Part II underscores the importance of moving beyond documenting disparities toward mobilizing communities and implementing solutions to advance cardiovascular health equity among minoritized populations.

Police are often called to address concerns about people experiencing homelessness and mental health crises. These interactions often lead to arrests, which lead to fines that many are unable to pay, loss of personal belongings, and additional barriers to housing and employment. Based on concerns about the over-policing of people experiencing homelessness, communities have become increasingly interested in alternatives to police response to calls involving people experiencing mental health distress and homelessness. Portland Street Response (PSR) is one such alternative that was developed and implemented in Portland, Oregon. Although specifically focused on mental and behavioral health crises, a large portion of PSR's calls respond to individuals experiencing homelessness. For this reason, it is critical to assess unhoused community members' knowledge of PSR and their experiences with and attitudes toward the program. 719 surveys of unhoused community members and 29 follow-up qualitative interviews were conducted across four evaluation timepoints. Knowledge of PSR was low at the beginning of the program but increased significantly over the evaluation period. Unhoused community members, particularly those who were Black, Indigenous, and other People of Color (BIPOC), reported feeling unsafe calling 911 to request service from PSR, though their trust increased over time. While only a small percentage of unhoused community members we spoke with reported direct experience interacting with PSR, those who did expressed high levels of satisfaction, appreciating the compassionate, person-centered care they received in the community; the connection to housing, health services, and other resources; and the collaborative manner in which PSR staff engaged with them. As cities across the country implement alternative first responder programs, our findings help identify important areas to consider to ensure that unhoused community members are aware of how to access the programs, and, importantly, that they trust the programs will help them rather than harm them.

Traditional treatment models are insufficient to meet youth mental health needs, particularly in marginalized communities. A public health approach that includes mental health promotion can broaden impact. Sports-Based Youth Development (SBYD) programs leverage sport to teach life skills and promote positive youth development (PYD) in socially vulnerable communities. More rigorous research is needed to understand how SBYD staff support youth within specific socio-ecological contexts to promote PYD. This qualitative study examined how SBYD staff supported predominantly Black/Latine youth in low child opportunity neighborhoods. Direct service staff (N = 7) participated in semi-structured interviews. Thematic analyses yielded three themes: Staff provided support that was (1) holistic (e.g., emotional, instrumental, and informational support), (2) contextually-responsive (e.g., informed by similar lived experiences, collaborated across settings), and 3) flexible. Findings illustrate that SBYD staff are integral to the social safety net and can play a critical role in strengthening mental health for vulnerable youth.

Contingency Management (CM) is an evidence-based intervention with demonstrated efficacy for stimulant use disorder, yet its uptake has been largely limited to clinical settings. This project examined the implementation of a stimulant-focused CM protocol within a Permanent Supportive Housing (PSH) setting. Using thematic analysis of meeting notes collected over 16 months of implementation meetings we identified four themes related to implementation: philosophical alignment of CM and the PSH, barriers and facilitators, implementation adaptations and support, and broader organizational changes. These themes provide insight into implementing clinical interventions within non-clinical sites, like PSH. Despite implementation challenges (e.g., physical space limitations; enrollment and engagement difficulties), CM was launched in the PSH setting with 28 residents enrolled. Lessons learned highlight that sustained high touch technical assistance is critical, which can be further strengthened by engaging in early CM model development and maintaining ongoing conversations about the organizational landscape.

This paper introduces the themed issue of Journal of Prevention and Intervention in the Community with a focus on "Mental health services delivered in non-clinical settings." Background is given on the use of non-clinical spaces for delivering mental health services and support. The included papers are organized by type of setting and briefly summarized. This introduction highlights the promise of non-clinical settings for reaching underserved populations and outlines future areas of focus for research and practice.

Young adults experiencing homelessness have high mental health needs but low service utilization due to barriers such as lack of insurance, transportation, and mistrust of systems. Many struggle to recognize or acknowledge their mental health needs which impacts engagement in care. The point of transition into housing presents a key opportunity to connect young adults with mental health support, yet housing programs do not systematically integrate these services. To address this gap, we developed the Healing Partner (HP) role through a participatory approach that integrated mental health support into a congregate transitional housing to rapid rehousing program for young adults. The HP role was adapted from existing evidence informed models and designed to provide time-limited mental health support in nonclinical settings. A feasibility pilot (n = 8) tested the intervention, with qualitative feedback from young adults and staff. The HP model included a six-month phased approach, beginning with weekly sessions and transitioning to biweekly meetings, then ending with a celebratory "level-up" session. The HP used a flexible transdisciplinary approach based on young adult needs with sessions focused on building coping skills and processing daily stressors and situations. Participants appreciated the HP's accessibility, flexibility and relational approach, noting that the HP met them where they were, both physically and emotionally. Findings from interviews suggest that the HP role was feasible to implement and acceptable to participants and staff. By extending care beyond clinical settings, the HP model offers a promising approach to engaging young adults in mental health support during key life transitions.

Lesbian, gay, bisexual, transgender, queer, asexual, and Two-Spirit (LGBTQA2S+) young adults (18-30 years) living in politically conservative regions (i.e., "red states") face stigmas and stressors that compound their mental health inequalities. Yet, healthcare-related constraints can deter them from seeking formal, clinical care. Centering the voices of the underresourced and underserved, we assess the following research question: How do LGBTQA2S + young adults establish communities of care to promote their well-being and resilience across multiple levels of social life? We applied an exploratory sequential mixed method design to merge meaning across in-depth interviews (N = 20) and survey data (N = 451) with LGBTQA2S + young adults in red states. Qualitatively, participants described resilience-building processes of community building, coping strategies, and connections with companion animals and nature. Quantitative patterns revealed that LGBTQA2S + pride and self-compassion were positively associated. with resilient coping, These findings can enhance both formal and informal mental health resources for LGBTQS+ young people's resilience in red state regions.

Children in the U.S. face a continuing mental health crisis that demands a public health framework. Sustainable innovations that keep pace with dynamic community settings require community-academic partnerships. Out-of-school time (OST) is a natural setting for mental health promotion as OST program goals align with social-emotional skills common in evidence-based programs. This manuscript describes an iterative process to refine Leaders@Play (L@P), an OST model for youth promoting mental health and co-facilitated by park and university staff promoting mental health, by University of Illinois Chicago researchers and Chicago Park District staff and administrators. We describe two phases: (a) Refinement: adapting content and format from the original L@P, and developing a training system; (b) Open Trial: exploring feasibility of the refined curriculum and impact on youth social skills and behavior. Results revealed high feasibility and potential support for program impact on youth mental health among high-risk youth. Implications for workforce development and program refinement are discussed.

This qualitative study investigates the development of the Integrative School Based Mental Health Services ("ISBMHS") Model, an initiative for delivering school-based mental health services (SBMHS) in educational settings. This model is implemented through a collaborative partnership between the County Office of Education (COE) and the local Department of Health Services, which grants schools Federally Qualified Health Center (FQHC) status to access Medicaid and sustain SBMHS. Researchers conducted interviews with 23 key stakeholders (i.e., COE leaders, school-based clinicians, county health partners, and school administrators) to understand the model's development. Thematic analysis revealed four themes: 1) leveraging a multi-tiered approach for systemic change, 2) prioritizing equity to address disparities in mental health care access, 3) utilizing innovative financing to bridge education and health sectors, and 4) building relationships and trust to facilitate cross-system partnerships. The model seeks to provide schools with a holistic approach to transform mental health care in schools.

Suicide is a leading cause of death among youth experiencing homelessness (YEH) and prevention interventions are needed for nontraditional settings. This study presents the adaptation of Cognitive Therapy for Suicide Prevention (CTSP) within a supportive housing randomized trial for YEH (18 to 24 years). CTSP was delivered by trained youth advocates in community settings. Both youth (n = 11) and advocates (n = 5) were interviewed and shared perspectives on acceptability and feasibility. Advocates felt CTSP was easy to implement and could be integrated into advocacy sessions. Despite initial discomfort discussing suicide, YEH were open to CTSP, and advocates felt they understood and utilized the content. Advocates noted the importance of ensuring that youth's basic needs were met first, the need for building rapport, and the challenges of limited time with YEH. Interventions to address suicide among YEH that are flexible and ensure youth feel cared about could be more acceptable and increase engagement.