Randomized Trial of the Availability, Responsiveness and Continuity (ARC) Organizational Intervention for Improving Youth Outcomes in Community Mental Health Programs
Randomized Trial of the Availability, Responsiveness and Continuity (ARC) Organizational Intervention for Improving Youth Outcomes in Community Mental Health Programs
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DOI：
10.1016/j.jaac.2013.02.005
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发表时间：
2013-05-01
影响因子：
13.3
通讯作者：
Williams, Nathaniel J.
中科院分区：
文献类型：
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作者：
Glisson, Charles;Hemmelgarn, Anthony;Williams, Nathaniel J.
目的：这项研究的主要目的是评估是否可用性，响应性和连续性（ARC）的组织干预改善社区为基础的心理健康计划的青年成果。第二个目标是评估在18个月的ARC干预后，组织社会环境得到更多改善的项目是否比社会环境改善较少的项目有更好的青年成果。方法：18个社区心理健康项目，服务于5至18岁的青少年被随机分配到ARC或控制条件。参与项目的临床医生（n = 154）在基线和18个月ARC组织干预后完成了组织社会背景（OSC）测量。由18个方案（9个在ARC，9个在控制）服务的393名青年的照顾者完成了儿童短期评估（SAC），每月一次，为期六个月，从入学开始。结果如下：分层线性模型（HLM）分析表明，在完成18个月ARC干预的项目中，青年的结果明显更好。HLM分析还表明，青少年的结果是最好的，在18个月的ARC干预后，组织的社会环境改善最多的方案。结论：青少年在社区心理健康项目的成果可以改善与ARC的组织干预和成果是最好的方案，使组织的社会背景下最大的改善。ARC，组织的社会背景，和青年的成果之间的关系表明，服务改进的努力将是更成功的，如果这些努力包括战略，以改善组织的社会背景中的服务嵌入。J. Am. Acad.儿童青少年精神病学，2013;52（5）：493-500。
Objectives: The primary objective of the study was to assess whether the Availability, Responsiveness and Continuity (ARC) organizational intervention improved youth outcomes in community based mental health programs. The second objective was to assess whether programs with more improved organizational social contexts following the 18-month ARC intervention had better youth outcomes than programs with less improved social contexts. Method: Eighteen community mental health programs that serve youth between the ages of 5 and 18 were randomly assigned to ARC or control conditions. Clinicians (n = 154) in the participating programs completed the Organizational Social Context (OSC) measure at baseline and following the 18-month ARC organizational intervention. Caregivers of 393 youth who were served by the 18 programs (9 in ARC and 9 in control) completed the Shortforrn Assessment for Children (SAC) once a month for six months beginning at intake. Results: Hierarchical linear models (HLM) analyses indicated that youth outcomes were significantly better in the programs that completed the 18 month ARC intervention. HLM analyses also showed that youth outcomes were best in the programs with the most improved organizational social contexts following the 18 month ARC intervention. Conclusions: Youth outcomes in community mental health programs can be improved with the ARC organizational intervention and outcomes are best in programs that make the most improvements in organizational social context. The relationships linking ARC, organizational social context, and youth outcomes suggest that service improvement efforts will be more successful if those efforts include strategies to improve the organizational social contexts in which the services are embedded. J. Am. Acad. Child Adolesc. Psychiatry, 2013;52(5):493-500.