E-Connect: Linking probation youth at risk for suicide to behavioral health services.
E-Connect: Linking probation youth at risk for suicide to behavioral health services.
复制标题
E-Connect：将有自杀风险的缓刑青少年与行为健康服务联系起来。
DOI：
10.1037/ccp0000824
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发表时间：
2023
影响因子：
5.9
通讯作者：
Taxman,FayeS
中科院分区：
文献类型：
--
作者：
Elkington,KatherineS;Wasserman,GailA;Ryan,MargaretE;Sichel,CoriannaE;Sarapas,Casey;Dennis,MichaelL;Taxman,FayeS
参与司法系统的青年（YIJ）有较高的自杀想法和行为（STB）以及相关的行为健康（BH）问题，但与普通人群中的青年相比，服务使用水平较低。本研究探讨了电子连接，数字化临床决策支持系统（CDSS），在改善STB风险识别，转介，并链接到BH服务的缓刑官员的有效性。由于干预跨越了COVID-19关闭前后的时期，我们还研究了公共机构提供服务对研究结果的影响。（1，488名青年，年龄10-18岁，56%男性，56%白色）允许检查常规护理（基线）和电子连接在筛选，STB和BH问题的识别，转诊和治疗启动。使用e-Connect的缓刑监督官将YIJ与STB联系起来的可能性超过五倍（调整后的比值比[aOR]= 5.86; 95%置信区间，CI [3.24，11.7]），需要BH服务的YIJ转诊治疗的可能性超过11倍（aOR= 11.04; 95% CI [6.54，19.43]）。反过来，通过e-Connect转诊治疗的青少年启动治疗的可能性几乎高出17倍（aOR= 16.92; 95% CI [9.17，32.60]）。在COVID-19关闭前后，结果保持不变。Conclusione-Connect是首个数字STB筛查、转介和链接到服务系统之一，该系统使用CDSS技术成功协助缓刑监督官将青少年与治疗联系起来。这种方法可以支持在其他青年服务组织，如学校，越来越多地管理青年BH问题，最低限度的临床支持的STB和跨系统的联系的识别。
ObjectiveYouth involved in the justice system (YIJ) have higher rates of suicidal thoughts and behaviors (STB) and associated behavioral health (BH) problems, yet lower levels of service use compared to youth in the general population. This study examined the efficacy of e-Connect, a digital clinical decision support system (CDSS), at improving STB risk identification, referral, and linkage to BH services by probation officers. As the intervention spanned pre-and post-COVID-19 shutdown periods, we also examined the disruption in public agencies’ service provision on study outcomes.MethodAdministrative record data (1,488 youth, ages 10–18 years, 56% male, 56% White) allowed examination of differences between care-as-usual (baseline) and e-Connect in screening, identification of STB and BH problems, referral, and treatment initiation.ResultsCompared to care-as-usual, probation officers using e-Connect were over five times as likely to identify YIJ with STB (adjusted odds ratio [aOR]= 5.86; 95% confidence interval, CI [3.24, 11.7]) and over 11 times more likely to refer YIJ in need of BH services to treatment (aOR= 11.04; 95% CI [6.54, 19.43]). In turn, youth referred to treatment via e-Connect were nearly 17 times more likely to initiate (aOR= 16.92; 95% CI [9.17, 32.60]). Results remained unchanged during the pre-and post-COVID-19 shutdown periods.Conclusione-Connect is one of the first digital STB screening, referral, and linkage-to-service systems that use CDSS technology to successfully assist probation officers in linking youth on their caseload to treatment. Such an approach may support identification of STB and cross-systems linkage in other youth-serving organizations, such as schools, that increasingly manage youth BH problems with minimal clinical support.