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NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development

SUMMARY Reading comprehension (RC) is one of the most complex skills that we utilize daily and is crucial for functioning in modern society, but despite its significance for academic achievement, employment prospects, and mental health, many children and adults do not exhibit proficient RC abilities. New theoretical models aiming to explain variability in RC suggest a dynamic interplay and co-development among ‘precursor’ foundational and cognitive- linguistic skills, interacting with environmental and socio-ecological factors across the developmental timeline of learning to read. Behavioral and neuroimaging studies in school-age children have demonstrated critical mechanistic support for these multifactorial RC models by identifying the developmental trajectories of precursor skills and further showing that brain areas, tracts, and networks typically underlying language and cognitive skills are also involved in RC. Nevertheless, the precursor skills that support RC start developing in infancy and the brain correlates underlying these precursors begin to develop in utero, which suggests that typical and atypical RC developmental trajectories could diverge long before school age. As such, examining RC development using a multifactorial, longitudinal approach that includes brain and behavior starting in infancy is critical for developing theoretical frameworks that can inform early preventative and intervention strategies. Here, we propose a comprehensive longitudinal study of RC development in which we examine direct and indirect effects on RC from brain, behavioral, familial risk, and environmental data from infancy to adolescence. To achieve this goal, we will combine two existing longitudinal cohorts, one ranging from infancy to late childhood (n = 174) and the other from preschool to early adolescence (n = 137). By applying state-of-the-art pediatric neuroimaging analyses, multiple indicator growth model structural equation models, and an innovative behavior- brain co-development measurement index to this unique, combined dataset, we will be able to identify brain and behavioral measures in infancy that directly and indirectly support subsequent RC development (Aim1). We will further characterize how longitudinal trajectories of behavioral measures as well as brain structure, function, and white matter organization contribute to RC development and how familial risk and environmental factors shape these trajectories (Aim 2). Finally, we will examine how the co-development of brain and behavior, as measured with an innovative co-development index, relates to subsequent RC (Aim 3). If successful, we will contribute the first multifactorial longitudinal model of RC development comprising direct and indirect effects from brain, behavior, brain-behavior co-development, familial risk, and environmental measures beginning in infancy. Understanding RC development using a multifactorial longitudinal lens will be crucial for building theoretical models and developing experimental designs focused on early preventative and intervention approaches long before the start of formal schooling.

NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development

Background. Neurodevelopmental disorders (NDDs) present a major global health challenge, particularly in low-resource settings like South Africa, where traditional diagnostic frameworks and access to comprehensive evaluations are limited. This research shifts the focus from formal NDD diagnoses to neurodevelopmental difficulties—measurable impairments in cognitive, social, emotional, and behavioral functioning—offering a more adaptable, resource-efficient approach grounded in the WHO’s International Classification of Functioning, Disability and Health (ICF). Given the rising prevalence of neurodevelopmental difficulties in South Africa and the critical role of caregivers, data-driven approaches are urgently needed to identify and support affected children. This study, which will utilize data from the Asenze Cohort Study (ACS), is the first to use adapted, non- specialist-administered measures alongside data-driven methods for a comprehensive assessment of neurodevelopmental difficulties in an LMIC context. Aims. Aim 1 will cross-sectionally identify neurodevelopmental profiles of children in Asenze at ages 5, 7, and 16 using latent profile analysis to identify distinct strata of children based on patterns of neurodevelopmental difficulties at each timepoint. Aim 2 will longitudinally characterize neurodevelopmental trajectories based on latent profile changes and examine the association between trajectories and cognitive and functional impairments in adolescence. Aim 3 will evaluate caregiver mental health, alcohol and other drug use as predictors of adolescents’ cognitive and functional impairments at age 16. Approach. This study leverages data from Waves 1-3 of the ACS, a longitudinal study conducted in KwaZulu-Natal, South Africa, which followed 1,581 children and caregivers from ages 5 to 16 between 2008 and 2021. Employing Latent Profile Analysis (LPA), we will identify distinct neurodevelopmental profiles at each wave, capturing the dynamic nature and heterogeneity of child development. Subsequently, these profiles will be used to track neurodevelopmental trajectories into adolescence, enabling us to assess the associations between trajectories and cognitive and functional impairments in adolescents. Finally, we will use Marginal Structural Models to evaluate the effects of caregiver mental and behavioral health on impairments in adolescents. Training. In this F31, the PI will establish expertise in the epidemiology of child and adolescent mental, neurological, and substance use disorders in low-resource settings, while developing a deeper understanding of neurodevelopmental difficulties and their assessment within LMIC contexts. Additionally, the PI will enhance professional development through manuscript and grant preparation, conference presentations, and engagement within scientific communities. This research will inform the development of focused interventions, applicable to resource-limited US populations, aiming to improve neurodevelopmental outcomes in vulnerable children and adolescents. This F31 will equip the PI with the expertise to become an independent researcher, driving advancements in global child neurodevelopment.

Food and Drug Administration

In 2018, OPSA launched an effort to develop of a quantitative system-dynamic model of the opioid crisis to help FDA a) understanding the complexity of the interconnected mechanisms of the crisis, and b) assess potential impacts (intended and unintended) of possible policy actions to address the crisis. In Sept 2019, OPSA awarded a 1-year cooperative agreement (Harvard/Mass General; FDA's RFA-FD-19-026) to complete an initial version of the model ready for policy analysis, and in Aug 2020, OPSA awarded a 1-year cooperative agreement (Harvard/Mass General; FDA's RFA-FD-20-031) to account for societal outcomes beyond overdose as well as cost-effectiveness of potential policies. The current proposal will expand the FDA's model to more comprehensively incorporate fentanyl, stimulants and polysubstance use and their interactive effects on opioids use, misuse, addiction, use disorder treatment, and associated outcomes. The main focus of this project would be on modeling the growing number of opioid overdose deaths involving people who are primarily stimulant or polysubstance users, as an important emerging aspect of the opioids crisis. The research will also include quantification of the effects of harm reduction approaches (e.g., naloxone distribution to opioid users, increasing treatment availability for Opioid Use Disorder [OUD]) on overdoses involving fentanyl and other polysubstance use . Additionally the research will identify and incorporate aspects of mental health that are feasible for inclusion into the model.

NIH

Significance to VA: Tinnitus is a common, but frequently misunderstood, chronic condition that negatively impacts function and quality of life. As of fiscal-year 2023, 2.9 million Veterans were diagnosed with tinnitus, the most prevalent service-connected disability. Tinnitus affects 10-15% of the adult population. Of this population, approximately 80% do not seek tinnitus-specific clinical services. For the remaining 20%, tinnitus impacts their lives—most commonly impairing sleep, concentration, and/or emotional reactions. Tinnitus often co-occurs with other chronic conditions, including post-traumatic stress disorder [PTSD], traumatic brain injury [TBI], anxiety, depression, and suicidal ideation. Access to rehabilitative services for bothersome tinnitus is inconsistent across VA settings. Innovation and Impact: This proposal expands the foundational work of a SPiRE pilot study (1 I2I RX004098- 01) by finalizing a patient health narrative module on bothersome tinnitus and evaluating the utility of patient narratives for clinician education. Patient narratives—stories told by patients about their health conditions and care experiences—are increasingly recognized for their ability to enhance medical consultation skills, support patient education and decision-making, and inform quality improvement initiatives. The “Database of Individual Patient Experiences” (DIPEx) is the gold standard for rendering patients’ narratives. DIPEx uses a maximum variation sampling strategy to illustrate the range and diversity of patient health experiences by including 35-50 narratives on a specific health topic. Specific Aims: This proposed project will address a critical need to improve Veterans’ access to patient- centered tinnitus care by: Aim 1: Amplify Veterans’ voices on bothersome tinnitus by conducting interviews (n=30) to expand our existing DIPEx module to reach saturation on non-biomedical themes (e.g., activity limitations and participation restrictions) known to impact patients with bothersome tinnitus. We will leverage a maximum sampling strategy to elicit diverse health experiences of Veterans living with tinnitus and use those narratives to expand our prototype DIPEx module into a full, web-based resource for those living with bothersome tinnitus and create a catalyst film for Aim 2; Aim 2: Evaluate the potential impact of integrating patient narratives into clinical education. VA clinicians (audiologists and mental health) will review a “catalyst” film developed from the patient narratives and complete an evaluation (n=50) to assess barriers and facilitators associated with the use of the catalyst film for clinician training. Catalyst films include clinically actionable content from patients’ narratives; Aim 3: Assess barriers and facilitators of the use of patient narratives for clinician education among VA operational partners (facility-level, VACO, VISN). We will conduct interviews with operational partners in audiology and mental health (n=15). Methodology: A five-phase qualitative analysis strategy will be used to analyze Aim 1 interview data. Semi- structured interviews (or Qualtrics survey) will be used to evaluate the catalyst film for use as a clinician training tool in Aim 2. Semi-structured interviews will be used to assess the barriers and facilitators on the use of patient narratives for provider training (Aim 3). A thematic qualitative analysis, using a hybrid deductive/inductive approach, guided by principles of rapid qualitative inquiry will be employed to analyze Aim 2 and 3 data. Path to Translation: This proposal involves multi-level stakeholder engagement (Veteran advisory panel members, VA clinicians and VA operational partners) to evaluate the utility of the catalyst film as a training tool for providers. Findings from Aims 2 and 3 will be presented to the VA Center for Evaluation and Implementation (CEIR) which provides individualized guidance to researchers, operations partners, managers, and policy makers to enable the scale up and spread of clinical innovations in VA settings.

NIMH - National Institute of Mental Health

PROJECT SUMMARY Over 930 million people worldwide are estimated to be living in fragile and conflict-affected settings (FCAS) – characterized by recurrent violence, conflict, or war – and experiencing food insecurity and mental distress. The detrimental effects of violent political events on food insecurity, and separately, on mental health are well documented. However, the impact of non-violent political events on food insecurity in FCAS is lesser explored. Furthermore, little is known about the differential cumulative impact of repeated political events – ranging from violent events (e.g., military assaults) to less extreme non-violent events (e.g., agreements) – on the relationship between food insecurity and mental health in FCAS. Quantifying the cumulative impact and capturing the intensity and severity of violent and non-violent political events is especially important in the context of protracted FCAS, where individuals endure prolonged exposure to violent and non-violent events, and stressors, such as food deprivation and insecurity, are likely to accumulate through time and impact mental health outcomes. We will leverage a longitudinal, geo-location political events dataset and three waves of repeated cross- sectional, representative household and corresponding individual survey datasets from a protracted conflict- affected setting, the occupied Palestinian territories (oPt); together, these data are uniquely positioned to permit examination of the relationships between political events, food insecurity, and mental health, and their intervening pathways. We reason that each discrete political event may function as a stressor and contribute to feelings of insecurity (across varying needs and including food) and mental distress. We expect that repeated occurrences of even non-violent, low extremity political events (e.g., establishing a political headquarter) each year can add up and exert its cumulative impact on food diversity, food insecurity experience, and on mental distress in a FCAS. Understanding the cumulative impact of violent and non-violent political events on food insecurity, incorporating individual behavioral changes and coping mechanisms, and mental health, will inform evidence- based interventions in FCAS. The evidence can allow for rapid response and improve the efficacy of humanitarian interventions during time of crises. This information is especially important given the recent increase in conflict and political events worldwide.

NIH

Significance: Tobacco smoking and its health consequences disproportionally impact Veterans. Veterans with serious mental illness (SMI Veterans; schizophrenia spectrum, bipolar spectrum, and other psychotic disorders) have among the highest rates of smoking in VA and die 10-15 years earlier than those without SMI, largely due to smoking-related conditions. Seven FDA-approved tobacco medications are available in VA that are low-cost, safe, and effective for SMI Veterans when combined with brief behavioral counseling: nicotine replacement therapies (lozenge, gum, patch, nasal spray), bupropion, and varenicline. Nearly 70% of SMI Veterans who smoke want to quit, but they are 26% less likely to be prescribed tobacco medication (10.9% vs. 14.3% prescription rate). SMI providers face numerous barriers to treating smoking. External facilitation can address these barriers by coordinating evidence-supported implementation activities, such as educational outreach and auditing with feedback, and shows promise for improving tobacco medication prescriptions in VA mental health clinics. Despite the availability of tobacco treatment in VA, smoking-related conditions remain the leading cause of death for SMI Veterans and account for nearly 8% of VA health care expenditures: $2.7 billion annually. Integrating tobacco medication into routine mental health care can maximize the use of existing resources and expand the reach of tobacco medication to Veterans with the highest smoking, but lowest treatment rates. Innovation & Impact: Innovations of this project include evaluating evidence-supported implementation strategies in mental health clinics, addressing barriers to tobacco treatment across patient, provider, and system levels, evaluating changes in prescribing practices for all FDA-approved tobacco medications, including non- prescribers in implementation activities, using data to refine the implementation strategy, and capitalizing on existing VA resources that support quality improvement and tobacco treatment. This project will serve as preliminary data for a fully powered effectiveness-implementation trial with the potential to improve timely access to care, address a leading cause of death for SMI Veterans, and reduce smoking-related health care costs. Specific Aims: This pilot study will refine and evaluate the feasibility and acceptability of an externalfacilitation strategy that aims to increase prescriber adoption of tobacco medication. Specific aims are to: Aim 1: Trial an external facilitation strategy designed to improve tobacco medication prescribing in Perry Point SMI clinics. Aim 2: Evaluate the feasibility and acceptability of the external facilitation strategy, monitor provider adoption of tobacco medication, and refine the strategy accordingly. Aim 3: Implement the refined external facilitation strategy in Baltimore SMI clinics, re-evaluate feasibility, acceptability, and adoption, and explore reach and effectiveness of tobacco medication. Methodology: This pilot study will use mixed methods to evaluate changes in the feasibility and acceptability of an external facilitation strategy and provider adoption of tobacco medication through activity tracking, surveys, and semi-structured interviews with providers (Perry Point n ~ 11, Baltimore n ~ 24) at two VA Maryland Health Care System facilities. Secondary outcomes will be changes in monthly reach of tobacco medication to SMI Veterans (Perry Point n ~ 75, Baltimore n ~ 165) and changes in smoking rates using EHR data. Path to Implementation: With support from local leadership, VA’s Quality Enhancement Research Initiative, and operational partners, results from this proposal will a yield an implementation blueprint for how to tailor implementation activities designed to improve tobacco medication to local needs. Additionally, findings from this proposal will serve as preliminary data for a fully powered, multisite hybrid effectiveness-implementation trial as part of a Merit application that can establish the effectiveness of using external facilitation to expand the reach of underutilized, cost-effective tobacco medications for SMI Veterans.

NIDA - National Institute on Drug Abuse

PROJECT SUMMARY / ABSTRACT Methadone is a highly effective medication for opioid use disorder (OUD) treatment. When taken regularly, it is associated with a 50% mortality reduction. Unfortunately, less than 5% of the estimated 7.6 million individuals with OUD receive methadone treatment. Hospitalization is a touch point to initiate methadone for out-of- treatment adults with OUD. While there are no federal restrictions on in-hospital methadone use for OUD, until recently, federal rules required that patients present to an Opioid Treatment Program (OTP) to complete a methadone intake before receiving methadone treatment in the outpatient setting. Current usual care for hospital to OTP linkage includes a referral to an OTP at hospital discharge. At best, only 40% of patients referred to an OTP at hospital discharge link to an OTP. Patient-reported barriers to hospital-to-OTP linkage include opioid withdrawal, lack of transportation, uncontrolled medical and mental health conditions, and stigma. Recent federal regulations governing OTPs relaxed methadone intake rules now allow non-OTP affiliated clinicians to compete the medical evaluation required for a federally compliant OTP intake. In one study, 77% of patients who completed an in-hospital OTP intake linked to an OTP after hospital discharge. Federal regulatory changes and the expanding workforce of hospital-based addiction clinicians provide a unique opportunity to expand in-hospital OTP intakes. Using a novel staircase cluster randomized design with a hybrid type 2 approach, sites will be randomly assigned a time when the study team implements a series of core activities encompassed in “implementation facilitation” (IF). These core IF activities support uptake of clinical activities by hospital-based addiction clinicians and facilitate completion of a federally compliant in-hospital OTP intake. Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), we will begin by identifying site-specific contextual factors important to the implementation of core IF activities including collection of quantitative and qualitative data to inform tailoring of IF activities to account for the local needs and resources at diverse study sites. Next, we will implement IF across study sites based on their randomly assigned start date to cross over from usual care to IF. We will test the effectiveness of IF on hospital-to-OTP linkage by comparing linkage rates during the usual care phase versus the post IF evaluation phase. Implementation outcomes are informed by PRISM's Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, and include measuring implementation fidelity to use of the core IF activities, adoption of the clinical activities required to complete an in-hospital OTP intake, measuring IF implementation costs, and measuring the proportion and characteristics of patients who did and did not link to the OTP. This study aims to measure the effectiveness of IF on hospital-to-OTP treatment linkage while also obtaining important implementation data for scaling to other treatment sites with an ultimate goal of expanding lifesaving OUD treatment to a vulnerable population.

NIH

Background and Innovation: The psychedelic serotonin 5-HT2A agonist psilocybin has shown unprecedented efficacy in the treatment of depression and post-traumatic stress disorder (PTSD). Veterans are up to four times more likely to experience PTSD compared to non-Veterans. Vivid intrusive memories of traumatic events are a primary symptom of PTSD. An appreciation for the critical role of mitochondrial dynamics in learning and memory is emerging. Individuals with PTSD and depression exhibit signs of mitochondrial dysfunction, possibly contributing to the chronic nature of these psychiatric conditions. Intriguingly, agonism of the serotonin 5-HT2A receptor induces robust biogenesis of mitochondria. We hypothesize that increased mitochondrial biogenesis is a critical mediator of the therapeutic effects of psilocybin. In this VA Merit Award proposal, our studies model the intrusive memories of PTSD using Pavlovian fear conditioning in mice. The overarching hypothesis is that psilocybin rapidly induces mitochondrial biogenesis and enhances plasticity, making therapy (i.e., extinction of fear) more durable. Our goal is to determine whether compounds that modulate mitochondrial dynamics can improve the efficacy and efficiency of psilocybin. We will use novel transgenic mouse models to visualize mitochondrial dynamics in excitatory and inhibitory neurons in response to psilocybin alone and with nicotinamide mononucleotide (NMN). NMN is a safe precursor for nicotinamide adenine dinucleotide (NAD+), a coenzyme critical for many metabolic and signaling reactions. [Adequate NAD+ levels might prime the brain for psychedelic assisted therapy, enabling optimal brain energetics during extinction. We will determine whether enhanced mitochondrial dynamics are necessary for psilocbyin’s effects using genetic manipulations of NAD+dependent pathways in specific neuronal subtypes. Quantitative histology, behavioral outcomes, and ex vivo electrophysiology will determine whether administration of NMN can promote the effectiveness of psilocybin and enhance extinction of fear.] Significance and Impact to Veterans’ Health: PTSD is the most common mental health issue among Veterans served by the VA. Prolonged exposure therapy accounts for half of the treatment hours for Veterans in VA outpatient treatment clinics and dropout rates are high. Salient, traumatic memories permit neutral events, like a smell or place, to become associated with the trauma, thereby triggering traumatic memories. Individuals with PTSD fail to use contextual cues to modulate retrieval of fear memories regardless of whether the context is threatening or safe. These results suggest that the ability to control retrieval and suppress traumatic memories is disrupted. Dysregulated mitochondrial dynamics have been identified in individuals with PTSD. Mitochondrial dysfunction is an overlooked aspect of mood disorders that might pose an obstacle to therapeutic intervention, making reappraisal of traumatic memories inefficient. Using the translationally relevant fear-potentiated startle preparation, the proposed experiments will determine the effects of psilocybin with and without NMN and determine whether mitochondria-focused combination therapies enhance psychedelic assisted therapy. Pathway to Translation and Implementation: This proposal is focused on the development of safe adjuvants to facilitate psychedelic-assisted psychotherapies.[ Mitochondrial adaptation to experience is necessary for new learning to occur.] Supplements that modulate mitochondrial health and activity are currently used by millions of people to enhance longevity and metabolic efficiency. We will determine whether this class of supplements can prepare the brain to inhibit fear across contexts. We predict that these compounds can improve psilocybin assisted therapy, and potentially reduce the dose of psilocybin needed to facilitate exposure therapy. Current treatment protocols require a hallucinogenic dose that lasts 8 hours or more, making treatment less accessible, requiring long supervised therapy sessions. If successful, our results will make psychedelic assisted therapies more available to and successful for Veterans.

Public Health Agency of Canada | Agence de la santé publique du Canada

Family violence, including child maltreatment, intimate partner violence (IPV) and children's exposure to IPV, can have serious and lasting impacts on physical and mental health. The Public Health Agency of Canada's Family Violence Prevention Investment is a national grants and contributions program focused on preventing and reducing the health impacts of family violence.

NIMH - National Institute of Mental Health

Project Summary / Abstract Suicide is a leading cause of death among adolescents, and early identification of risk for suicidal behavior among youth remains a challenge. Novel approaches to identify earlier developmental indicators of risk for later psychiatric problems, including risk for suicidal behavior, are needed. Children who exhibit gender nonconformity (GNC) have higher risk for experiencing childhood abuse and rejection from parents and peers. Early psychosocial stressors related to GNC could dysregulate stress responses, leading to biological dysregulation in the hypothalamic-pituitary-adrenal axis and inflammatory pathways. Biological dysregulation in these pathways is associated with psychiatric symptoms and risk for suicidal behavior. Furthermore, psychosocial stressors and biological dysregulation have the potential to augment neurocognitive correlates of suicidal behavior among youth exhibiting GNC, including increased impulsivity and reactive aggression. Thus, psychosocial stress and biological dysregulation during childhood could contribute to psychiatric symptoms prior to adolescence among youth exhibiting GNC. While GNC could have utility in identifying children who will have future elevated risk for engaging in suicidal behavior, the existing literature examining associations between GNC and risk for suicidal behavior among children is critically limited. The proposed longitudinal feasibility study is designed to examine how GNC is associated with early indicators of risk for suicidal behavior among children ages 7–10, including psychosocial stressors, biological dysregulation, psychiatric diagnoses and symptoms, neurocognitive correlates of risk for suicidal behavior, and suicidal ideation. The aims of the proposed study are to accrue feasibility data by enrolling a sample of children enriched for GNC, collecting data on all variables of interest (clinical interview and self-report data from children and parents as well as biological and neurocognitive behavioral task data from children), and retaining participants in the longitudinal study at follow-ups over 9 months. We will develop a testable conceptual model for a future R01 study by examining associations between GNC, psychosocial stressors, biological dysregulation, psychiatric symptoms, suicidal ideation, and neurocognitive correlates of suicidal behavior. Results from the proposed study will facilitate the design of a future R01 proposal to conduct a long-term prospective study to enroll a large sample of children enriched for GNC and follow them into adolescence to assess developmental trajectories of GNC, psychosocial stress, and risk for suicidal behavior. This line of work has the potential to provide critical information to facilitate early identification of youth at risk for suicidal behavior, providing the information and time necessary to intervene prior to the development of risk for suicidal behavior among adolescents.

NIMH - National Institute of Mental Health

PROJECT SUMMARY/ABSTRACT Autistic youth are far more likely to experience depression and suicidal thoughts and behaviors than their non- autistic peers, yet few autistic youth receive appropriate treatment. Untreated depression is associated with adverse short- (e.g., school refusal) and long-term outcomes (e.g., poor physical health) that impair quality of life. Families of autistic youth with depression encounter barriers to care including significant clinician shortages and high clinician uncertainty in treating this population. Clinicians frequently decline referrals due to limited autism training and few evidence-based treatments. Though Cognitive-Behavioral Therapy (CBT) is a leading intervention for depression in non-autistic youth, it has not been rigorously studied in autism. Given that autism- adapted CBT consistently outperforms standard CBT for anxiety and obsessive-compulsive disorder, it is likely that autism-adapted CBT for depression may be effective in treating symptoms; however, this remains largely underdeveloped and untested. To being to address this gap, we partnered with autistic stakeholders to develop Cognitive Behavioral Therapy for Depression in Autistic Youth (CBT-DAY) and tested the preliminary feasibility and acceptability of CBT-DAY in a pilot nonrandomized trial, with promising initial findings. CBT-DAY targets emotional reactivity, negative self-esteem, and autism self-knowledge in youth to improve depressive symptom severity. However, CBT-DAY has not been evaluated in a larger randomized controlled trial and when delivered by clinicians with limited autism training. Therefore, in this study, we seek to examine the feasibility, acceptability, and initial effectiveness of CBT-DAY and its associated clinician training model for verbally-fluent (Verbal IQ≥70) autistic youth with depression (11-17 years old) served in outpatient clinics. In the first phase of the study, we aim to develop a CBT-DAY clinician training model for clinicians with limited autism training based on feedback from 35 stakeholders including autistic youth with depression and their parents, clinicians, and clinic leaders. In the second phase, we will conduct a hybrid type 1 effectiveness-implementation trial with 60 autistic youth (11- 17 years old) with depression, 60 of their parents, and 20 clinicians with limited autism training in clinical settings, comparing CBT-DAY versus treatment-as-usual (TAU). We will test the initial feasibility, acceptability, and effectiveness of CBT-DAY in improving youth depressive symptom severity. In the final phase of the study, we will collect mixed methods data (i.e., interviews, surveys) on implementation outcomes (i.e., feasibility, acceptability, fidelity) and contextual factors influencing CBT-DAY implementation and sustainment from the recruited families, clinicians, and organizational leaders. Findings will inform future studies that scale up CBT- DAY and improve its implementation and sustainability in clinical settings. This R34 project has important clinical implications, as findings may support the testing and implementation of CBT-DAY and its associated clinician training model to improve outcomes for autistic youth with depression and increase the service workforce.

Mental Health

Fellowship Training Program in Child Psychiatry

Mental Health

Fellowship Training Program in Child Psychiatry

NIMH - National Institute of Mental Health

Financial Tools Access and Navigation (FinTAN) for Supported Financial Decision Making – Project Summary Financial hardship and mental illness intersect in ways that have devastating consequences for millions of Americans. People with serious mental illness (SMI) are more likely to run out of money, fall behind on rent and bills, be indebted, and experience financial stress, all of which impact mental health outcomes; people from low socioeconomic status backgrounds, particularly people of color, are more likely to experience financial hardship, given historical and ongoing structural discrimination. Financial hardship among people with SMI arises partly from meagre disability benefits and/or low wages but is exacerbated when people have difficulty managing money due to their illness. Currently, money management support is limited to ad hoc budgeting advice or, more commonly, removal of financial control through a representative payee or conservator; currently, 26% of people receiving disability benefits – mostly those with SMI - have a payee. Having a payee can reduce hospitalization, homelessness and substance use and increase likelihood of treatment adherence and paying essential bills. However, there is little evidence of positive impact on mental health outcomes, and some significant downsides; some people have their autonomy unnecessarily curtailed, the arrangement can damage important relationships and hinder recovery, and others do not get needed assistance due to the understandable reluctance of some people to relinquish financial control, and shortage of payees. This raises the risk of eviction, utility disconnection, hunger, and financial abuse among people with SMI. Work is underway to develop more person-centered models and to explore guidance that does not involve removal of financial control. An area that remains underexplored is the potential for financial tools and services such as bank accounts, payment cards, and digital apps to expand and improve money management support options for people with SMI; there is compelling evidence that these are crucial in shaping people’s financial management. This project will test an intervention that will guide people to use of financial tools and services that may allow people to more effectively manage their own finances, receive assistance from another person in a way that maximizes the autonomy of the owner of the funds, and that offer pathways towards greater autonomy over time, so improving mental health and quality of life. The specific aims of this study are to: i) collaboratively create a Financial Tools Access and Navigation (FinTAN) guide to assist persons and care providers to identify the potential utility of relevant financial products, and guide them in their use; ii) pilot test the feasibility and impact of using the FinTAN guide and the associated financial tools and services among 15 people with SMI and those who assist them with their money management; iii) prepare for a future full-scale clinical trial of the FinTAN guide and relevant financial tools and services. We will use a Community Based Participatory Research approach, deploying primarily qualitative methods to assess feasibility and impact of the intervention, as well as testing various quantitative measures to be used in a future larger clinical trial.

NIAAA - National Institute on Alcohol Abuse and Alcoholism

PROJECT SUMMARY Alcohol use and hazardous drinking are ubiquitous among firefighters in the United states and is associated with significant physical and mental health risks for this population. Due to the nature of their work, firefighters experience substantially higher rates of trauma exposure and are subsequently at greater risk of developing specific mental health conditions compared to the general population, particularly trauma-related psychopathology (e.g., posttraumatic stress). Hazardous drinking and posttraumatic stress frequently co-occur among firefighters, leading to poorer health outcomes compared to either condition alone. Despite this elevated risk, firefighters often lack access to tailored, empirically supported interventions, and no existing mental health interventions address hazardous drinking in a trauma-informed framework for this at-risk population. Personalized feedback interventions (PFIs) are a promising approach that could address this gap. By delivering brief, patient-centered feedback on drinking behaviors and perceptions within the context of trauma and occupational stress, PFIs aim to reduce problematic drinking behaviors and stigma related to coping-orientated drinking and improve stress management strategies. PFIs can be brief, cost-effective, and easily disseminated in a format accessible to large groups, making them a strong candidate for use with firefighters who face critical barriers to engaging in traditional mental health programs. This innovative study aims to develop a single-session, trauma-informed, online PFI tailored specifically for firefighters, using a comprehensive, three-phase approach to address three primary aims. The Development Phase involves developing, adapting, and enhancing a trauma-informed PFI by gathering qualitative feedback from firefighters (N = 45) and using an iterative, rapid user-centered design approach to ensure the intervention is engaging for firefighters as well as relevant and aligned with fire service culture. The Evaluation Phase will assess the feasibility, acceptability, and preliminary impact of the PFI in a mixed-methods longitudinal open trial with firefighters (N = 50), with a focus on the intervention's usability, delivery, and influence on drinking behaviors. The Implementation Planning Phase will involve qualitative and quantitative assessments with fire service leaders (N = 15) to identify implementation barriers and shape future research testing the implementation process for the intervention and inform future strategies for resource integration and fostering sustainable community partnerships. This proposal will equip Dr. Lebeaut with essential training for an independent research career, including training in (1) qualitative methodologies, (2) user-centered design, (3) developing, adapting, and enhancing trauma-informed alcohol interventions, and (4) developing collaborative relationships with community partners in the fire service. The proposed study will directly inform a future R01 to evaluate the intervention’s efficacy and scalability and support the development of a firefighter-focused research program.

First Nations Health Authority

FNHA provides funding for health promotion, disease prevention, and mental wellness programs for First Nations communities in British Columbia.

Substance Abuse and Mental Health Services Adminis

First Responders-Comprehensive Addiction and Recovery Act

Health and Human Services Department

This notice is to inform the public that the Substance Abuse and Mental Health Services Administration (SAMHSA) is supporting administrative supplements in scope of the parent award for the 58 eligible grant recipients funded in FY 2025 under the State Opioid Response (SOR), Notice of Funding Opportunity (NOFO) TI-24-008. The SOR formula will be used to calculate the award amounts for all 50 states, District of Columbia and Puerto Rico with a minimum award constraint of $500,000. The following six territories: American Samoa, Guam, Micronesia, Northern Mariana Islands, Palau, and Virgin Islands may receive $100,000 each, for a total of $43,196,037 across the program. If any grantee declines the supplement, the remaining balance will be redistributed to the states that accept the supplement, including the District of Columbia and Puerto Rico, using the SOR formula. Recipients have a project end date for use of these supplemental funds of September 29, 2026. The supplements will be used to develop and/or expand recovery housing for young adults (ages 18-24) with opioid and/ or stimulant use disorders. Grant recipients will also be allowed to provide other treatment and recovery support services.

Health and Human Services Department

This notice is to inform the public that the Substance Abuse and Mental Health Services Administration (SAMHSA) is supporting an administrative supplement in scope of the parent award for an eligible grant recipient funded under the FY 2022 Certified Community Behavioral Health Clinic (CCBHC) Planning, Development and Implementation Grants Notice of Funding Opportunity (NOFO) SM-22-002. The total available funding is $2,000,000. This supplemental funding will be used to expand CCBHC services to the Kensington area in Philadelphia, PA, which is currently experiencing one of the highest overdose mortality rates in the nation. The proliferation of new medetomidine-linked overdoses and associated medical complications, along with the emergence of a homeless encampment in April and May of 2024, meets the threshold of a novel, unanticipated public health event and provides a compelling rationale for targeted action through a non-competitive supplement to an existing CCBHC to provide comprehensive mental health and substance use services in Kensington.

Florida Veterans Commission

State grants for veteran service programs in Florida including housing, employment, education, and mental health support.

National Institutes of Health

This Funding Opportunity Announcement (FOA) is intended to encourage research on 1) the development and/or pilot testing of new or adapted interventions; 2) pilot testing interventions with demonstrated efficacy in broader scale effectiveness trials; or 3) innovative services research directions that require preliminary testing or development. This FOA will utilize the R34 grant mechanism This FOA provides resources for evaluating the feasibility, tolerability, acceptability and safety of novel approaches to improving mental health and modifying health risk behavior, and for obtaining the preliminary data needed as a pre-requisite to a larger-scale (efficacy or effectiveness) intervention or services study. The total amount awarded and the number of awards will depend upon the mechanism numbers, quality, duration, and costs of the applications received.

National Institutes of Health

Full-Scale Hybrid Effectiveness-Implementation Trials for Mental Health Interventions (R01 - Clinical Trial Required)

National Institutes of Health

Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01 Clinical Trial Required). This NOFO is a key element of NIMHs set of NOFOs to support clinical trials research across the intervention development and testing pipeline. The NOFO supports (1) clinical trials to test the effectiveness of optimized therapeutic and preventive interventions for use in community and practice settings; and (2) clinical trials to evaluate the effectiveness of patient-, provider-, organizational-, or systems-level services interventions to improve access, continuity, quality, equity, and/or value of mental health services. This NOFO is intended to support trials that: address a significant problem, such that the findings have potential to inform practice; are adequately powered to definitively answer the primary research question(s), with well-justified hypotheses supported by pilot data; and are designed to examine questions regarding mediators and moderators of effects. Consistent with the NIMH experimental therapeutics approach, this NOFO is intended to support effectiveness trials that explicitly address whether the intervention engages the target(s)/mechanism(s) presumed to underlie the intervention effects (i.e., the mechanism(s) that accounts for changes in clinical/functional outcomes, changes in provider behavior, improved access or continuity of services, etc.). The collaborative R01 mechanism provides support for multisite trials when two or more sites are necessary for completion of the trial (e.g., to increase sample size, accelerate recruitment, or increase sample diversity and representation).

NIMH - National Institute of Mental Health

PROJECT SUMMARY/ABSTRACT The transition from adolescence to adulthood is a critical stage of development characterized by significant changes in social-emotional behavior. One of the central brain structures modulating this transition is the amygdala. The development of the amygdala continues through adolescence, undergoing an expansion in size and neuron number into early adulthood. These changes enable healthy social and emotional development, and perturbations in amygdala development and maturation are linked a host of mental health disorders, most notably autism spectrum disorders (ASD) and the long-term behavioral consequences as a result of early life stress (ELS). However, the amygdala neuronal and circuit substrates underlying changes coincident with this major life transition remain little understood. In our published studies in humans and mice, we identified and characterized a unique population of immature neurons in the paralaminar nucleus of the amygdala (PL). While these neurons are born embryonically, they interestingly delay their maturation until adolescence when they differentiate into excitatory neurons. Thus, our discovery and characterization of PL neurons that undergo maturation coincident with adolescence revealed a novel mechanism of brain plasticity during a critical stage of post-natal development. Using the mouse as a model, the goal of our proposed studies is to understand the function of amygdala late-maturing neurons from adolescence to early adulthood and what drives their maturation. To test this, we will examine how PL neuronal responses change over time (Aim 1), the necessity and sufficiency of PL neurons in this transition (Aim 2), and the role inhibitory neurotransmission plays in their maturation and later function (Aim 3). Our proposed studies are also an essential step to understanding the role late maturing PL neurons play in neuro-atypical brain function associated with disorders of social cognition to which the PL has previously been linked, such as ASD and the long-term consequences of ELS.