A protocol for a multi-site case control study to evaluate child and adolescent mental health service transformation in England using the i-THRIVE model
A protocol for a multi-site case control study to evaluate child and adolescent mental health service transformation in England using the i-THRIVE model
复制标题
使用 i-THRIVE 模型评估英格兰儿童和青少年心理健康服务转型的多中心病例对照研究方案
DOI：
10.1101/2022.03.09.22272128
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Moore A
中科院分区：
文献类型：
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作者：
Moore A
国家i-THRIVE计划旨在评估NHS英格兰资助的整个系统转型对儿童和青少年心理健康服务的影响。本文报告了一个实施模式，已在CAMHS在英格兰70多个地区使用“繁荣”的需求为基础的护理原则的设计。报告了实施协议，其中该模型，“i-THRIVE”（实施-THRIVE），将用于评估THRIVE干预措施的有效性，以及实施过程的评估协议。为评估“智活”计划在改善儿童及青少年精神健康护理方面的成效，本研究将进行个案对照设计。将从NHS英格兰资助的CAMHS转型开始采用i-THRIVE模型的N = 10个CAMHS研究中心与在相同时间范围内选择使用不同转型方法的N = 10个“比较研究中心”进行比较。将根据人口规模、城市化程度、资金、贫困程度和精神卫生保健需求的预期普遍程度对各地点进行匹配。为了评估实施过程，将采用混合方法探讨背景、保真度、剂量、路径结构和范围对临床和服务水平结果的调节作用。这项研究提供了一个独特的机会，为正在进行的CAMHS国家转型提供有关提供儿童和青少年心理健康护理的流行新模式的证据，以及支持整个系统转型的新实施方法。如果结果反映了i-THRIVE的益处，则本研究有可能通过提供更综合的、以需求为导向的服务模式来指导CAMHS的显著改善，该模式增加了患者获得服务和接受护理的机会和参与。
The National i-THRIVE Programme seeks to evaluate the impact of the NHS England-funded whole system transformation on child and adolescent mental health services (CAMHS). This article reports on the design for a model of implementation that has been applied in CAMHS across over 70 areas in England using the ‘THRIVE’ needs-based principles of care. The implementation protocol in which this model, ‘i-THRIVE’ (implementing-THRIVE), will be used to evaluate the effectiveness of the THRIVE intervention is reported, together with the evaluation protocol for the process of implementation. To evaluate the effectiveness of i-THRIVE to improve care for children and young people’s mental health, a case-control design will be conducted. N = 10 CAMHS sites that adopt the i-THRIVE model from the start of the NHS England-funded CAMHS transformation will be compared to N = 10 ‘comparator sites’ that choose to use different transformation approaches within the same timeframe. Sites will be matched on population size, urbanicity, funding, level of deprivation and expected prevalence of mental health care needs. To evaluate the process of implementation, a mixed-methods approach will be conducted to explore the moderating effects of context, fidelity, dose, pathway structure and reach on clinical and service level outcomes. This study addresses a unique opportunity to inform the ongoing national transformation of CAMHS with evidence about a popular new model for delivering children and young people’s mental health care, as well as a new implementation approach to support whole system transformation. If the outcomes reflect benefit from i-THRIVE, this study has the potential to guide significant improvements in CAMHS by providing a more integrated, needs-led service model that increases access and involvement of patients with services and in the care they receive.