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COVID-19 exposed issues in our mental health system, prompting an emergency advisory from the Surgeon General on youth mental health. This Comment offers two lessons drawn from empirically supported aspects of a public health model to guide a transformation of youth mental health services: (1) the importance of recruiting local community members (peer support specialists [PSSs]) with lived experiences to promote engagement in services and (2) the necessity of expanding services to natural settings to enhance access and uptake. Examples of service models applying these lessons and illustrating how they are interrelated are provided. These initiatives are overdue in response to persistent disparities and the need to provide services across the prevention to intervention continuum.

Vocational outcomes among transition-age youth receiving special education services are critically poor and have only incrementally improved since the implementation of the Workforce Innovation Opportunity Act. Few studies highlight whether interviewing may be critical to obtaining vocational outcomes such as competitive employment or internships. This study evaluated vocational interviewing and outcomes among 656 transition-age youth receiving special education pre-employment transition services from 47 schools. Results suggest 20.8% of these youth were currently employed, and 88.8% of these employed youth interviewed prior to obtaining their job, which is higher than anecdotal evidence suggests and speaks to the importance of job interview skills as an intervention target for special education pre-employment transition services. We discuss the implications and directions for further study.

Caregiver strain and social support have been identified as both facilitators and deterrents to parental mental health service use on behalf of their children. This study focused on the relationship between caregiver strain, social support, and mental health service use among African American mothers of children at-risk or meeting criteria for a disruptive behavioral disorder and living in urban communities of concentrated poverty. Mothers ( n  = 89), participating in a five-year NIMH funded study of school-based community mental health services, completed measures at baseline of caregiver strain and both perceived and received social support. Service use was calculated as the sum total of services (sessions) received. Associations between caregiver strain and service use were examined, and perceived and received social support were explored as potential moderators. Baseline covariates included child’s age, gender, symptom severity, and maternal employment status. Findings highlighted child symptom severity as the strongest predictor of caregiver strain and perceived social support as moderating the association between caregiver strain and service use. Mothers were more likely to utilize services when experiencing relatively high levels of perceived support or high caregiver strain but not both, highlighting the importance of their interrelationship. Received support did not moderate the association between strain and service use. In addition, mothers utilized services more often for sons than daughters and when unemployed. Implications for research and practice are discussed. Highlights Mothers reporting high caregiver strain or high perceived social support, but not both, were more likely to use services. Received support did not moderate the association between strain and service use. Mothers were more likely to receive services for their sons than their daughters.

Gentrification changes the neighborhood and family contexts in which children are socialized—for better and worse—yet little is known about its consequences for youth. This review, drawn from research in urban planning, sociology, and psychology, maps out mechanisms by which gentrification may impact children. We discuss indicators of gentrification and link neighborhood factors, including institutional resources and collective socialization, to family processes more proximally related to child development. Finally, we discuss implications for intervention and public policy recommendations that are intended to tip the scales toward better outcomes for low-income youth in gentrifying areas.

OBJECTIVES/GOALS: The Community Engagement and Advisory Board (CEAB) has been an active and sustainable source of expert recruitment, retention, and community engagement advice. Our goal is to describe the strategies offered by the CEAB to university researchers and discuss which are most and least likely to be implemented. METHODS/STUDY POPULATION: The University of Illinois at Chicago’s (UIC) Center for Clinical and Translational Science’s (CCTS) CEAB was established in 2009 and is one of the longest-standing boards across the CTSA network. Our CEAB consists of 28 members, each representing a community-based organization or underrepresented community, which has provided 16 consultations since 2021. Our analysis consisted of: 1) reviewing and coding consultation notes (n= 16) to extract common recruitment and retention strategies provided to researchers; 2) reviewing feedback forms (n = 10) completed by the research team to code the strategies most likely to be implemented by researchers; 3) analyzing the codes to identify the strategies least likely to be implemented. RESULTS/ANTICIPATED RESULTS: Our preliminary analysis indicated that the majority of researchers reported they are most likely to implement strategies to reduce burden for research participants (make study participation more convenient, e.g., allowing participant accompaniment, avoiding commuting to study site, providing transportation provide them with resources to their healthcare) and enhance recruitment from trusted community sources (e.g., Aldermen, local agencies, libraries). Researchers are least able to follow recommendations to alter their budget (e.g., increase participant stipends, hire community staff). DISCUSSION/SIGNIFICANCE: In a previous paper focused on this CEAB, Matthews etal. (2018) found researchers indicated that they plan to implement at least one recommended strategy. In this follow-up examination, we describe the recommended strategies to guide CEABs to align recommendations with researcher priorities to best assist with their translational science goal.

This commentary responds to points raised by Sanders et al in ‘Consent, assent and randomised evaluations’ (Evidence & Policy, XX(XX): 1–12, 10.1332/174426421X16842419724551).

OBJECTIVES/GOALS: Real-world data (RWD) may offer insights into mental health treatment as usual and illuminate targets for implementation and translation. This requires strong research-community partnerships (RCP). In this presentation, we will highlight key components of an ongoing RCP in leveraging RWD to advance translational science. METHODS/STUDY POPULATION: The RCP was formed to develop an infrastructure for NAMI Chicago, a community-based organization that oversees a city-wide social services helpline, to support collection of RWD data to understand whether NAMI helpline support services and referrals meet callers’ emotional and physical needs. This RCP includes three entities: NAMI Chicago, UIC’s Center for Clinical and Translational Science’s Community Engagement and Collaboration (CEC) Core, and UIC’s Institute for Health and Research Policy’s Data Management Core (DMC). From a preliminary review of case notes, this case study details concrete examples that fit into Brookman-Frazee etal. (2012)’s RCP framework to illustrate the trajectory of this partnership through its formation, execution of activities, and sustaining NAMI Chicago’s data capacity. RESULTS/ANTICIPATED RESULTS: In the formation of this RCP, we identified our joint goal of creating a database infrastructure to link NAMI Chicago’s existing helpline data with a database co-created in REDCap through APIs. Based on the identified joint goal, we defined our roles/responsibilities that best aligned with our own individual expertise to execute the necessary operational processes. The RCP is currently executing the activities to create this data infrastructure. Barriers included delays in securing a computing environment and enablers included an established long-standing relationship between NAMI Chicago and CEC. Distal outcomes of this RCP include increasing NAMI Chicago’s capacity to systematically use RWD to better inform their practices and identify barriers in accessing social service resources in Chicago. DISCUSSION/SIGNIFICANCE: The identification of enablers, barriers, and the necessary operational processes and activities will outline a “blueprint” for other institutions and community organizations to successfully utilize RWD to understand mental health practices and advance translational research.

Background Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments. Method Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth’s anxiety. Caregiver attendees ( N = 180) will be cluster randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at 3-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT. Discussion This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments. Trial registration This trial was registered on clinicaltrials.gov ( NCT04929262 ) on June 18, 2021. At the time of trial registration, pre/post-presentation data had been collected from 17 participants; thus, it was retrospectively registered.

Kazdin and Blase aptly describe the enormous mental health burden facing our nation and suggest several ways to reform the workforce, setting, and content of services to address this long-standing unmet need. We propose that current health care reform legislation and associated advances in service delivery provide a unique and timely opportunity for a paradigm shift in mental health research, practice, and training to support services that are comprehensive, readily accessible, and relevant to a broad range of mental health needs and capacities. Using the recent public health initiative to contain the HI NI virus for comparison, and informed by a long-standing and extensive literature documenting the need for a public health model for mental health, we describe the rationale for a three-tiered public mental health model, illustrated with examples from ongoing research, to minimize universal risk for mental health difficulties via capacity building in natural settings; reduce onset and seventy of symptoms by prioritizing high-risk groups via screening and services for targeted populations; and reduce psychiatric impairment among individuals with more intensive needs via individual, family, and group interventions. New priorities for clinical science to support a public health approach are proposed.

OBJECTIVES/GOALS: Community Engagement Advisory Boards (CEAB) serve as a vital resource for engaging and partnering with communities in research. The purpose of this project is to describe the perspectives of members of a long-standing CEAB in providing input and promoting research that aligns with the needs, experiences, and concerns of the communities they represent METHODS/STUDY POPULATION: Three 90-minute focus groups were conducted with a subset of a CEAB(n=17)(M years spent with CEAB =7.3) affiliated with the Center for Clinical and Translational Science at the University of Illinois-Chicago. Members areas of expertise include perspectives from faith-based organizations, community organizing, public health and working with diverse populations. Transcribed audio recordings of the focus groups were coded using thematic analysis wherein two authors coded independently, followed by audited discussion and final consensus codes. Main themes were identified after reviewing final codes. RESULTS/ANTICIPATED RESULTS: CEAB members described the bi-directional nature of their role serving as a conduit between research institutions and their communities, identified strategies to promote research literacy in communities, called for researchers to take a proactive approach in forming and sustaining community partnerships, and helped identify opportunities to promote community engagement in more creative and feasible ways. Additionally, CEAB members identified perceived opportunities for the board as a whole to be more involved in Chicago communities to further their role as a liaison between the university and the community. DISCUSSION/SIGNIFICANCE: These findings may have implications for investigators to better address community priorities in research by understanding unique local realities as well as help other CTSA hubs’ to leverage their communities’ expertise.