A Family-Based Mental Health Navigator Intervention for Youth in the Child Welfare System: Protocol for a Randomized Controlled Trial.
A Family-Based Mental Health Navigator Intervention for Youth in the Child Welfare System: Protocol for a Randomized Controlled Trial.
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DOI：
10.2196/49999
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发表时间：
2023-09-12
影响因子：
1.7
通讯作者：
中科院分区：
文献类型：
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儿童福利系统中的青少年（参与儿童福利[CWI]青少年）有很高的心理健康症状率，并且在获得和参与精神卫生保健服务方面存在显著差异。青春期是一个发展阶段，出现精神健康症状和出现可能持续到成年的障碍的可能性增加。尽管CWI青少年对循证心理健康服务的需求很高，但儿童福利和心理健康服务系统之间的协调仍然不足，以增加获得护理的机会，并且参与心理健康服务的程度很低。在卫生保健领域为解决影响保健质量的服务获取、碎片化和连续性方面的挑战而开发的导航模型提供了一种很有希望的方法，可以加强CWI青年与精神卫生服务的联系和参与。然而，目前还没有经验支持的心理健康导航模型来解决CWI青年及其家庭独特而复杂的心理健康需求。本研究采用随机对照试验，旨在建立寄养家庭导航员（FCFN）模型，以改善12-17岁青少年的心理健康服务效果。导航员模型利用现场导航员和辅助数字健康技术，参与并改善CWI青年和家庭的护理协调、跟踪和监测心理健康服务需求。总共有80名护理人员-青年夫妇将被随机分配接受FCFN干预或标准护理（临床病例管理服务）：40人（50%）接受FCFN干预，40人（50%）接受对照组。定性离职面谈将告知6个月期间所接受服务的可行性和可接受性。主要试验结果是心理健康治疗的开始和参与。其他服务前和服务后的结果，如筛查比例和筛查时间，也将进行评估。我们假设接受FCFN干预的青少年比接受标准护理的青少年有更高的心理健康治疗启动和参与率。我们建议在2024年3月前招募80对夫妇，2024年9月前完成最终数据收集，2025年3月发表主要研究结果。在最终的数据分析和结果撰写后，最终的稿件将提交给期刊进行传播。这项研究将首次产生经验驱动的结论和建议，为长期存在且未解决的行为健康服务获取差异的CWI青年实施家庭心理健康导航模型。研究结果具有大规模试验适用性的潜力，并且在最终系统实施和采用方面是可行和可接受的。ClinicalTrials.gov NCT04506437;https://www.clinicaltrials.gov/study/NCT04506437 derr1 - 10.2196/49999
Youth in the child welfare system (child welfare–involved [CWI] youth) have high documented rates of mental health symptoms and experience significant disparities in mental health care services access and engagement. Adolescence is a developmental stage that confers increased likelihood of experiencing mental health symptoms and the emergence of disorders that can persist into adulthood. Despite a high documented need for evidence-based mental health services for CWI youth, coordination between child welfare and mental health service systems to increase access to care remains inadequate, and engagement in mental health services is low. Navigator models developed in the health care field to address challenges of service access, fragmentation, and continuity that affect the quality of care provide a promising approach to increase linkage to, and engagement in, mental health services for CWI youth. However, at present, there is no empirically supported mental health navigator model to address the unique and complex mental health needs of CWI youth and their families. Using a randomized controlled trial, this study aims to develop and test a foster care family navigator (FCFN) model to improve mental health service outcomes for CWI adolescents (aged 12-17 years). The navigator model leverages an in-person navigator and use of adjunctive digital health technology to engage with, and improve, care coordination, tracking, and monitoring of mental health service needs for CWI youth and families. In total, 80 caregiver-youth dyads will be randomized to receive either the FCFN intervention or standard of care (clinical case management services): 40 (50%) to FCFN and 40 (50%) to control. Qualitative exit interviews will inform the feasibility and acceptability of the services received during the 6-month period. The primary trial outcomes are mental health treatment initiation and engagement. Other pre- and postservice outcomes, such as proportion screened and time to screening, will also be evaluated. We hypothesize that youth receiving the FCFN intervention will have higher rates of mental health treatment initiation and engagement than youth receiving standard of care. We propose enrollment of 80 dyads by March 2024, final data collection by September 2024, and the publication of main findings in March 2025. After final data analysis and writing of the results, the resulting manuscripts will be submitted to journals for dissemination. This study will be the first to produce empirically driven conclusions and recommendations for implementing a family mental health navigation model for CWI youth with long-standing and unaddressed disparities in behavioral health services access. The study findings have potential to have large-scale trial applicability and be feasible and acceptable for eventual system implementation and adoption. ClinicalTrials.gov NCT04506437; https://www.clinicaltrials.gov/study/NCT04506437 DERR1-10.2196/49999
影响因子：
2.3
作者：
Smaldone A;Stockwell MS;Osborne JC;Cortes Y;Bekele E;Green NS
通讯作者：
Green NS