# Engaging Mental Health Services for Preschoolers at Risk

> **NIH NIH R34** · CINCINNATI CHILDRENS HOSP MED CTR · 2024 · $240,750

## Abstract

PROJECT SUMMARY/ABSTRACT
Most mental health (MH) disorders develop in early childhood but are not clinically identified or treated until
later—delaying treatment services that could prevent the enduring effects of long-term MH problems.
Moreover, low income, ethno-racial minoritized children who exhibit higher rates of persistent MH disorders,
are at greater risk for lags in identification and treatment. Head Start (HStart) has shown early school success
for low-income children, aged 3-5 years, who are disproportionately Black or Latinx. HStart monitors for early
childhood MH symptoms, yet studies have found that when detected, only those most impaired are referred for
treatment. In our research, we learned that systemic and individual level barriers preclude early treatment
among HStart preschoolers with developmental concern. We showed that caregivers encountered system
barriers of HStart teachers and primary care providers (PCPs) falling behind in referrals for intervention, and
caregiver beliefs about stigma, their limited knowledge and distrust of healthcare hindered early engagement in
services. Studies on MH treatment obstacles for low-income, ethno-racial minoritized people illustrate similar
barriers to those found among HStart preschoolers with developmental concern. Our team developed and
tested an ethno-racially matched, peer-based family navigator program for HStart preschoolers with
developmental concern. Navigators used trust and empowerment to increase caregiver advocacy thereby
leading to improved professional alliances and treatment. A navigator program for those with primary MH
concern has not been trialed. In this R34 pilot effectiveness trial, we propose to take this next critical step by
tailoring and preliminary testing in a case series the Navigate-Train-Referral-Intervention Mental Health (NTRI-
MH) intervention to promote access, engagement, coordination, and optimization of services for preschoolers
with MH symptoms. In Aim 1, we will use focus group feedback from caregiver, navigator, HStart teacher, and
PCP stakeholders (n=30) to adapt NTRI-MH and create a web-based dashboard to monitor outcomes. Then,
conduct a feasibility study for caregivers of HStart preschoolers with MH symptoms, guided by ethno-racially
matched family navigators and referrals by HStart teachers and PCPs (n=20). In Aim 2, we will pilot test NTRI-
MH for caregivers of preschoolers with MH symptoms compared to an active control group of caregivers who
receive child behavior training (n=86). We will trial the effectiveness of the NTRI-MH mechanisms of caregiver
beliefs on MH, empowerment, and professional alliances on family functioning and child emotion regulation. If
the aims of the project are achieved, this study would have a large impact on early MH service use for low
income ethno-racial minoritized young children with the potential to improve child MH outcomes.

## Key facts

- **NIH application ID:** 10951843
- **Project number:** 1R34MH137224-01
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Karen Burkett
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $240,750
- **Award type:** 1
- **Project period:** 2024-08-12 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10951843

## Citation

> US National Institutes of Health, RePORTER application 10951843, Engaging Mental Health Services for Preschoolers at Risk (1R34MH137224-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10951843. Licensed CC0.

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