Current Projects

Smoke Free SafeCare, NCI R01

Dr. Self-Brown (MPI) and Dr. Michelle Kegler of Emory University received $3.5 million grant to use systematic braiding to integrate two evidence-based programs, SafeCare, a positive parenting program to prevent child maltreatment and Some Things are Better Outside, a smoke-free homes program. An effectiveness-implementation hybrid trial type 1 will be employed to examine the impact of integrating two evidence-based programs:  Some Things are Better Outside (second-hand smoke [SHS] prevention program) and SafeCare (child maltreatment prevention program), on establishing a smoke-free home and implementation process outcomes.  Aim 1 focuses on the refinement of the standardized integration (systematic braiding) of the two programs into “Smoke-Free SafeCare (SFSC).” Aims 2 and 3 focus on the Hybrid Trial. Fifty certified SafeCare Providers will be recruited and randomly assigned to either SFSC or Standard SafeCare. Providers will each serve ten research families (N=500) who meet the inclusion criteria (Mother or another person residing in the home smokes at home). The primary outcome, smoke-free home status, will be measured via self-report at 4-timepoints (baseline, 8-weeks, 20-weeks, and 1-year), and validated via air nicotine monitor at 8 weeks and 1-year (Aim 2).  Process measures will be collected to examine how the braided intervention impacts provider fidelity, delivery time and costs, and other process measures (Aim 3). If effective, SFSC can be efficiently disseminated for widespread adoption by the National SafeCare Training and Research Center to the over 100 accredited SafeCare agencies across the United States that serve parents involved with child protection services, reducing cancer risk for a high-risk population.

Prevention Research Center

Dr. Self-Brown is a Co-Investigator on the CDC-funded Prevention Research Center housed at Georgia State University. The core research project for PRC, conducted in partnership with the Clarkston community, will address the health and well-being of refugee and migrant children by adapting the Parent-Child Interaction module of SafeCare, an evidence-based positive parenting program. Parenting programs can reduce children’s biological risk for toxic stress and lead to more positive social, emotional, and behavioral development. Disseminating these programs to the most vulnerable populations is key to reducing health disparities.

The implementation of evidence-based parenting programs to address early toxic stress has been recommended broadly and specifically for refugee populations. However, significant barriers to implementation exist, including the linguistic and cultural appropriateness of the intervention and the workforce needed for program delivery. The proposed mixed-method implementation study seeks to adapt and evaluate methods to implement the SafeCare model, an evidence-based parenting program. The aims of the project include: Aim 1. Create culturally appropriate adaptations of the SafeCare model. Aim 2. Develop and test two models of SafeCare implementation in the proposed setting (task shifting versus traditional provider with an interpreter). Aim 3. Identify broader factors that influence program delivery and outcomes to be targeted for intervention.

National Center on Child Trafficking

Dr. Shannon Self-Brown has obtained a 5-year, $3 million dollar grant from the SAMHSA National Child Traumatic Stress Initiative to establish the National Center on Child Trafficking (NCCT). The NCCT is the first Category II SAMHSA grant received by any institution in the State of Georgia and will bring together a national network of experts in trauma, trafficking, and implementation science to develop, adapt, deliver, and disseminate products, resources, and interventions to improve outcomes for youth and families who have experienced commercial sexual exploitation and trafficking (CSET). The NCCT will increase and improve access to trauma-focused evidence-based mental treatments and trauma-informed interventions by (1) developing and disseminating national practice standards and consensus guidelines for mental health treatment crosscutting EBPs to mental health professionals, (2) delivering and evaluating training of Trauma Focused Cognitive Behavioral Therapy (TF-CBT) for CSET to therapists in 5 SAMHSA/HHS regions, developing resources for therapists and trainers to enhance dissemination and service delivery, (3) developing and disseminating standards, guidelines, and training addressing co-occurring trauma and substance use problems to mental health and substance abuse professionals, integrating the guidelines into an existing evidence-based trauma and substance use treatment, Risk Reduction through Family Therapy, and train therapists in the adapted model, (4) adapting and disseminating training in trauma-informed parenting, the Resource Parent Curriculum, adapted for youth who have experienced CSET, (5) adapting and disseminating training in trauma-informed residential care, Think Trauma to Think Trauma trainers, and training staff at targeted CSET congregate care/residential treatment placements, (6) developing and disseminating resources for MDT and CSET specialist professionals, including practice guidelines and training curricula (FORECAST) incorporating CSET response, and (7) developing Secondary Traumatic Stress/Compassion Fatigue awareness materials and strategies and delivering training in the practices to professionals serving Youth who have experienced CSET.

The Next Generation of Evidence-Based Home Visiting Services: Learning from COVID-19 Pandemic Experiences with Virtual Delivery

Evidence-based parenting programs that aim to support child safety and well-being are contemplating what “usual care” should look like as we transition out of the COVID-19 pandemic. SafeCare, an evidence-based home visiting program with more than 100 accredited agencies delivering services across the U.S., has typically delivered its curriculum through certified home visitors (providers) in the family’s home. However, the public health guidelines of social distancing during the COVID-19 pandemic led SafeCare and others to pivot to delivering sessions via telephone and/or video communication in lieu of face-to-face home visits. This project will collect and analyze data about the virtual delivery experience from focus groups of SafeCare providers (nine hourlong virtual focus groups with three to four participants each). Results will help us understand how home visiting programs can pursue innovative service delivery methods going forward to reach families most effectively. This project is funded was awarded to Dr. Lindsay Bullinger (Georgia Tech) and Dr. Shannon Self-Brown by the Doris Duke Charitable Foundation. 

National Center for Sexual Violence Prevention

Co-Principle Investigators, Drs. Shannon Self-Brown and Amanda Gilmore have secured Department of Defense funding ($668,677; 06/01/2020 – 05/30/2022) through an IPA (Intergovernmental Personnel Act) to establish the National Center for Sexual Violence Prevention (NCSVP) that will implement the U.S. military’s national institute for certifying its sexual assault prevention workforce professionals. The current IPA establishes eligibility to apply for continuous annual renewals in the amount $300,000 to sustain the work of the NCSVP’s institute for certifying U.S military sexual assault prevention workforce professionals. In addition to the NCSVPs recognition for certifying the U.S. military’s sexual violence prevention workforce, Dr. Gilmore’s established research on sexual assault prevention will be housed in this center and will stimulate future research focused on sexual violence prevention, which is currently a national priority and a priority of the Mark Chaffin Center for Healthy Development, to develop evidence-based interventions to prevent abuse, including sexual abuse, and to study real-world implementation and effectiveness of accessible interventions and their scaling to maximize public health benefit. 

The impact of SafeCare on stress biomarkers

Examinations of child maltreatment (CM) prevention programs highlight positive reductions in self-reported parental stress, a commonly reported risk factor for CM perpetration among parents. However, there are a limited number of studies exploring the impact of these programs on the physiological biomarkers for stress, such as cortisol and salivary alpha amylase (sAA) levels. The goal of this project is to expand a previous multidisciplinary study that assessed cortisol and sAA levels to include two new biomarkers, telomere length and DNA methylation) and stress responses with at-risk mother-child dyads who participate in a modified version of SafeCare, an evidence-based, behavioral-parenting program. High-risk mothers (n=20) will be randomly assigned to participate in the parenting intervention (n=10) or receive parenting materials via the mail (n=10). Parents and children will be assessed at pre-, and post-intervention for parental stress and behavior (self-report and observational), and have the physiological biomarkers measured.  The primary objective is to compare self-reported stress levels to biomarker assessments, as well as to examine changes in parental stress, CM risk, and biomarker measures from pre- to post-intervention for parents who do and do not complete the parenting intervention. The biomarker data collected here for this project will be included in an NIH R01 to be submitted in FY 22.

JoyPop 

Dr. Self-Brown and PREVenT Lab Alumna, Dr. Ashwini Tiwari, received pilot funding to explore the feasibility of integrating the mobile application, JoyPop, for use in child maltreatment-related evidence-based programs, Trauma-Focused Cognitive Behavioral Therapy and SafeCare. The goal of this study is to explore the feasibility of utilizing mobile health app technology to augment evidence-based services for victimized youth and at-risk parents for maltreatment. The specific aims are as follows:

Aim 1:  Examine attitudes and feasibility concerns regarding augmenting service delivery practices with mobile technology among providers of evidence-based practices. 

Aim 2:  Explore the acceptance of the JoyPopTM mobile app among providers and clients of these evidence-based practices

SafeCare Haiti

Dr. Self-Brown and Dr. Sarah McCool are currently exploring the feasibility of implementing SafeCare in Haitian Birthing homes. This research proposes to implement SafeCare in Haiti birthing homes, targeting outcomes of positive parent-child interaction, child safety, and child health. Haiti is the poorest country in the Western Hemisphere and has one of the highest under-five mortality rates. The United States Agency for International Development (USAID) has designated Haiti as a priority country for maternal and child health (MCH) due to the low percentage of children who receive medical care. This initiative could decrease the risk for under-five morbidity and mortality through the delivery of effective parenting education.

In this proposed project, the investigators will explore the feasibility of implementing SafeCare in birthing homes across Haiti. Four focus groups (two for birthing home providers and two for mothers of young children) will be conducted in two birthing homes in Haiti to explore parenting practices and acceptance of SafeCare modules.

SafeCare NICU

Dr. Self-Brown and Dr. Rachel Culbreth received pilot funding to explore the feasibility and acceptability of SafeCare adapted for NICU parents. The proposed study seeks to modify an existing, evidence-based parent-training program, SafeCare, for administration to NICU families. SafeCare has demonstrated efficacy for promoting parent and child bonding, reducing parental stress, improving parental depression, and ultimately reducing child abuse and neglect. Through the traditional SafeCare program, trained professionals work with caregivers and their young children involved with state prevention or child protection services in their home environments to improve parents’ skills in several domains. Parents are taught, for example, how to plan and implement activities with their children, respond appropriately to child behaviors, improve home safety, and address common health issues. SafeCare is generally provided in weekly home visits lasting approximately 1 hour. SafeCare has shown reductions in parental stress via self-report and biomarkers and improvements in-home safety, parent-child interaction skills, and healthcare skills. SafeCare has also been adapted for paternal/father caregivers and is implemented in international settings, including Kenya, Australia, England, Spain, and Israel.

Project Intersect

Dr. Self-Brown is the Co-Director of Project Intersect with Dr. Kelly Kinnish, Clinical Director of the Georgia Center for Child Advocacy. Project Intersect is a National Child Traumatic Stress Network initiative funded by the Substance Abuse and Mental Health Services Administration. Project Intersect draws upon existing trauma-focused, evidence-based practices, as well as knowledge of the complex needs of those who have experienced commercial sexual exploitation.  Combining these existing practices and knowledge to serve our clients and train mental health providers throughout Georgia, Project Intersect continues to build and sustain a statewide network of therapists trained in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), as well as a separate intensive training in CSEC-specific applications of TF-CBT.  Treatment is then provided to clients by therapists who have participated in the training. In addition, Project Intersect seeks to facilitate training, trauma-informed skill development, and increased CSEC awareness for professionals working in systems that intersect with CSEC at high rates, including Juvenile Justice, Foster Care, and Homeless/Runaway youth-serving organizations.

Envision Project

Dr. Self-Brown is the Lead Evaluator on the Office of Victims of Crime-funded service grant, The Envision Project, awarded to the Georgia Center for Child Advocacy. The Envision Project provides educational and life-skills training and workshops to youth who have experienced commercial sexual exploitation or trafficking. 

 

Secondary Data Analyses

Violence Against Children Surveys (VACS)

Violence Against Children Surveys are nationally representative surveys conducted collaboratively by CDC, Together for Girls, governments, and other international partners to measure the prevalence of physical, sexual, and emotional violence, and other social and health outcomes among children 13-24. The VACS surveys have been implemented in over 24 countries across Africa, Asia-Pacific, Latin America, and the Caribbean. PREVent Lab members have contributed to conference presentations and manuscripts using the VACS surveys from Lesotho, Nigeria, and Zambia.

National Violent Deaths Reporting System

The National Violent Death Reporting System (NVDRS) is an active, state-based surveillance system that uses a Centers for Disease Control and Prevention web-based platform to link data from death certificates, law enforcement reports, and coroner/medical examiner records. Death certificates indicate both an underlying cause of death and a manner of death, for which the medical examiner or coroner is primarily responsible for certifying, whereas risk factors, contextual factors, and precipitating circumstances emerge from law enforcement reports and coroner/medical examiner records. Each incident includes two narratives: one based on information from the coroner/medical examiner records and one based on information from the law enforcement report, both of which provide details surrounding the fatal event.