Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol.
Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol.
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DOI：
10.1186/s43058-023-00479-3
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发表时间：
2023-10-05
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涉及儿童福利的儿童和青少年中，有一半符合至少一项精神健康诊断标准。本项目建议通过调整和测试行动后回顾(AAR)团队有效性干预来加强儿童和家庭团队(CFT)服务的干预，以改善儿童福利服务(CWS)中成功的心理健康服务联系。尽管服务规划既是必需的，也是一种协作方法，但CFT会议的实施保真度和一致性令人怀疑，很少像预期的那样包括儿童和家庭的声音。本研究采用平行分组试验设计，采用非等价对照组，采用定性和定量相结合的方法，对AAR在提高CFT结果方面的影响进行量身定制和评估。作者将针对在一个大型的、公共资助的CWS系统中正在实施的CFT服务干预进行定性的需求评估。由与关键利益攸关方的访谈和焦点小组组成的定性调查将导致制定一项行动计划，以解决当前和预期的CFT服务干预结果之间的差距。AAR实施战略将进行调整和调整，以满足CFT服务的干预需求。为了测试自动评估在改善与社区卫生服务干预相关的结果方面的有效性，我们将采用随机整组抽样的方法，将来自两个社区卫生服务系统区域的四名社区卫生工作人员随机分配到干预条件(社区卫生服务 + )或标准实施(社区卫生服务照常进行)。作者将通过基于网络的调查从CWS社会工作者和其他CFT成员那里收集数据。将评估AAR团队对CFT实施的有效性干预机制。通过纳入儿童和家庭的声音，AAR增强的CFT应导致对CFT干预的保真度提高，父母对服务和共同决策的满意度更高，从而加强服务计划的后续行动，并与儿童心理健康治疗服务建立联系。通过这项随机临床试验获得的知识有可能为CWS领导人、个案工作者、正式和非正式的CFT成员支持人员、父母/照顾者以及有开放病例的儿童提供服务和整合。在系统和家庭两级提高干预效果，对于提高实践效率和改善儿童和家庭结果至关重要。NCT05629013。批准日期：2022年11月28日(版本1)。加州大学圣地亚哥分校。丹妮尔·费特斯。
Half of child-welfare-involved children and adolescents meet the criteria for at least one mental health diagnosis. This project proposes to improve successful mental health service linkage in child welfare services (CWS) by adapting and testing the after-action review (AAR) team effectiveness intervention to augment the child and family team (CFT) services’ intervention. Despite being both required and a collaborative approach to service planning, CFT meetings are implemented with questionable fidelity and consistency, rarely including the voice of children and families as intended. Using a parallel group trial design, with non-equivalent comparison groups, and qualitative and quantitative methodology, this study will tailor and assess the impact of the AAR on enhancing CFT outcomes. The authors will conduct a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention in a large, publicly funded, CWS system. A qualitative inquiry consisting of interviews and focus groups with key stakeholders will result in the preparation of an action plan to address identified gaps between the current and desired CFT services intervention outcomes. The AAR implementation strategy will be adapted and tailored to address the CFT services’ intervention needs. To test the effectiveness of the AAR on improving outcomes associated with the CFT services intervention, we will utilize blocked randomization of four CWS caseworkers from two CWS system regions to either the intervention condition (CFT + AAR) or standard implementation (CFT as usual). The authors will collect data from the CWS caseworkers and additional CFT members via web-based surveys. Mechanisms of the AAR team effectiveness intervention for CFT implementation will be assessed. By inclusion of child and family voice, the AAR-enhanced CFT should lead to increased fidelity to the CFT intervention and greater levels of parental satisfaction with the service and shared decision-making, thus resulting in enhanced follow-through with service plans and linkage to mental health treatment services for children. The knowledge gained by this randomized clinical trial has the potential to benefit service delivery and integration for CWS leaders, caseworkers, formal and informal CFT member support persons, parents/caregivers, and children with open cases. Improving intervention effectiveness, both at the system and family levels, is crucial for practice efficiencies and improved child and family outcomes. NCT05629013. Approval date: November 28, 2022 (version 1). University of California, San Diego. Danielle Fettes.