Aligning Organizational Priorities With ARC to Improve Youth Mental Health Service Outcomes
Aligning Organizational Priorities With ARC to Improve Youth Mental Health Service Outcomes
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DOI：
10.1037/ccp0000107
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发表时间：
2016-08-01
影响因子：
5.9
通讯作者：
Green, Philip
中科院分区：
文献类型：
--
作者：
Glisson, Charles;Williams, Nathaniel J.;Green, Philip
目的：可用性，响应性和连续性（ARC）组织干预旨在通过将组织优先事项与有效服务组织的5项原则（即，使命驱动、结果导向、改进导向、关系为中心、参与为基础）。本研究评估了ARC干预对青年成果的影响，以及组织优先事项作为将ARC干预与成果联系起来的机制的中介作用。方法：14个社区为基础的精神卫生机构在中西部大都会沿着与475名临床医生和605名青年（5-18岁）由这些机构服务，被随机分配到3年ARC干预或控制条件。在干预结束时，由临床医生完成ARC原则问卷（APQ）来衡量机构的优先事项。青少年的结果是衡量的心理社会功能的总问题，他们的照顾者描述使用儿童简表评估（SAC）在6个月的时间间隔。结果如下：青少年的心理社会功能的改善率在机构分配到ARC条件是1.6倍的机构分配到控制条件的改善率，创造了一个标准化的差异，在6个月的后续行动之间的功能d = 0.23。对青年成果的影响完全由ARC 5项原则中所述的组织优先事项的一致性所介导（d = .21）。结论：ARC的组织干预改善青年的成果，调整组织的优先事项与ARC的5个原则。研究结果表明，组织的优先事项解释了为什么一些社区精神卫生机构比其他机构更有效。
Objective: The Availability, Responsiveness, and Continuity (ARC) organizational intervention is designed to improve community-based youth mental health services by aligning organizational priorities with 5 principles of effective service organizations (i.e., mission driven, results oriented, improvement directed, relationship centered, participation based). This study assessed the effect of the ARC intervention on youth outcomes and the mediating role of organizational priorities as a mechanism linking the ARC intervention to outcomes. Method: Fourteen community-based mental health agencies in a midwestern metropolis along with 475 clinicians and 605 youth (ages 5-18) served by those agencies were randomly assigned to the 3-year ARC intervention or control condition. The agencies' priorities were measured with the ARC Principles Questionnaire (APQ) completed by clinicians at the end of the intervention. Youth outcomes were measured as total problems in psychosocial functioning described by their caregivers using the Shortform Assessment for Children (SAC) at 6 monthly intervals. Results: The rate of improvement in youths' psychosocial functioning in agencies assigned to the ARC condition was 1.6 times the rate of improvement in agencies assigned to the control condition, creating a standardized difference in functioning of d = .23 between the 2 groups at the 6-month follow-up. The effect on youth outcomes was fully mediated by the alignment of organizational priorities described in the 5 ARC principles (d = .21). Conclusion: The ARC organizational intervention improves youth outcomes by aligning organizational priorities with the 5 ARC principles. The findings suggest that organizational priorities explain why some community mental health agencies are more effective than others.