University of Kentucky College of Public Health assistant professor, Dr. Christina Studts, was recently awarded a three-year, $450,000 grant from the National Institute of Mental Health (NIMH) to improve the delivery of behavioral parent training (BPT) programs in underserved communities. Through her research, Dr. Studts is partnering with local health departments in the Cumberland Valley District Health Department, UK’s Center of Excellence in Rural Health, and Kentucky Homeplace to increase the accessibility of evidence-based programs in rural Appalachian communities aimed at preventing child behavior disorders and their long-term negative outcomes.
[Photo: Dr. Christina Studts]
Disruptive behavior problems in young children put them at greater risk for antisocial behaviors in later life, such as substance abuse and criminal activity. Behavioral parent training programs are effective in preventing the negative outcomes and public health impact of these disruptive childhood behaviors. However, in Appalachian communities, limited access to BPT programs and lack of willingness of many parents to use them pose a significant challenge to the dissemination and implementation of these evidence-based interventions.
The need is great in many Appalachian communities for improved delivery of parenting interventions to families. Mental health professional shortages exist in nearly 70 percent of Appalachian communities, where poverty rates are high and significant health disparities abound. Additionally, rural and Appalachian parents frequently cite stigma as one of the barriers they navigate in seeking specialized care for their children’s mental health issues. Other cultural considerations may also come into play, including strong self-reliance and a preference for local providers. The combined impact of cultural factors and limited mental health care access presents a major challenge to the delivery of BPT by mental health professionals in clinics and similar settings in the Appalachian region.
Dr. 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 CAB, Dr. Studts found that 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.