Community-Based Research Examines Behavioral Disorders in Children, Delivers Training to Parents

LEXINGTON, Ky. (March 23, 2015) — Children exhibiting disruptive behaviors are at a greater risk for antisocial behaviors, such as substance abuse and criminal activity, later in life. With the support of a grant from the National Institute of Mental Health (NIMH), University of Kentucky College of Public Health researcher Tina Studts, Ph.D, is partnering with health departments in rural Appalachia to help parents access programs to prevent behavioral disorders in children.


Studts, an assistant professor in the UK Department of Health Behavior, was recently awarded a three-year, $450,000 grant from NIMH to improve the delivery of behavioral parent training programs (BPT) in underserved communities. Studts is working with local health departments in the Cumberland Valley district, UK’s Center of Excellence in Rural Health and Kentucky Homeplace to disseminate the training to families.


BPT programs are effective in preventing negative outcomes and public health consequences stemming from disruptive childhood behaviors. In Appalachian communities, limited access to BPT programs and a lack of engagement from parents in utilizing these program pose significant challenges to implementing evidence-based interventions. Mental health professional shortages exist in nearly 70 percent of Appalachian communities, where poverty rates are high and health disparities are significant. 


“The need is great in many Appalachian communities for improved delivery of parenting interventions," Studts said. "Parents in the Appalachian region frequently cite stigma as one of the barriers they navigate in seeking specialized care for their children suffering from mental health issues. Other cultural consideration can also come into play as well, including strong self-reliance and a preference for local providers. These can present major challenges to the delivery of BPT programs by mental health professionals in settings such as clinics.”


Studts, who is completing her final year as a KL2 scholar with the UK Center for Clinical and Translational Science (CCTS), initiated her research in BPT programs through a CCTS community-engaged pilot grant, “Preventing Conduct Disorder: Valuing Parent and Provider Perspectives in Appalachia.” Aims of the pilot study were to establish a Community Advisory Board (CAB) in Perry County focused on early childhood mental health and to assess parent and provider preferences regarding modality, location and interventionist of BPT in rural Appalachian communities. Guided by the board, Studts found parents preferred brief interventions delivered by local health workers and that child service providers recognized the needs but lacked resources and staff to provide preventive BPT services in the community. 


Studts' newly funded project will adapt the delivery method of a BPT program, the Family Check-Up, to be administered to families by community health workers instead of mental health professionals. The Family Check-Up is a brief preventative intervention designed to help parents address young children’s challenging behaviors before they become more serious.


In collaboration with the Center of Excellence in Rural Health and the Perry County Early Childhood CAB, Studts and her team will adapt and pilot-test the training and intervention protocols of the Family Check-Up, assessing the feasibility, acceptability and costs of service delivery by existing community health workers in four under-resourced Appalachian counties. This study will provide the data and infrastructure needed for a future large-scale implementation trial of the Family Check-Up in underserved communities.