Improving access to mental health services for rural youth: Leveraging multidisciplinary teams to enhance implementation of a screening and referral protocol in rural Child Advocacy Centers

项目摘要/摘要 农村地区的儿童虐待儿童的风险更高，精神疾病得不到满足的比率也很高 健康需求。儿童倡导中心(CACs)为虐待行为提供协调的机构间反应 并处于有利地位，能够识别有心理健康需求的儿童，并便利获得 循证治疗。这项K23研究将检验多学科团队在CAC中的运作情况 与实施筛查和转诊方案有关，以及是否改善团队运作 可以加强执行工作。了解多学科团队如何促进或阻碍 实施和制定以团队为重点的战略可以加强实施循证战略的努力 在农村社区康复中心和其他提供基于团队的护理的环境中的做法。这项研究将使用一个利益相关者- 参与式方法，有三个目标：1)使用混合方法来检查多学科团队 相互依存和发挥作用与#年实施筛查和转诊议定书有关。 CACs；2)制定以团队为重点的战略，以促进农村CACs的实施；以及3)开展试点 随机对照有效性--在农村社区开展II型混合试验。以确保其成功 执行和培养调查员的独立研究能力，培训目标如下 建议：1)培养开展利益相关者参与的、基于社区的研究的能力 弱势群体，2)发展将团队理论应用于实施的专门知识 提供以团队为基础的护理的多学科环境，以及3)获得实施方法方面的技能 科学。培训和研究将由共同导师David Kolko博士(精神病学教授， 匹兹堡大学心理学、儿科学、临床和转化学)和格雷戈里博士 Aarons(加州大学圣地亚哥分校精神病学教授)。将通过以下方式提供额外的指导 社区合作伙伴Teresa Smith博士(东北地区儿童倡导中心项目主任)和 咨询委员会成员Laurie Weingart博士(Tepper组织行为学和理论学教授 卡内基梅隆大学商学院)，Eduardo Salas博士(莱斯大学心理学教授 )、伊丽莎白·米勒博士(匹兹堡大学儿科学教授)和约翰·福特尼博士 (华盛顿大学精神病学和行为科学教授)

Project Summary/Abstract Children in rural areas are at elevated risk for child maltreatment and have high rates of unmet mental health needs. Child Advocacy Centers (CACs) provide coordinated interagency responses to maltreatment allegations and are well-positioned to identify children with mental health needs and facilitate access to evidence-based treatments. This K23 study will examine how multidisciplinary team functioning in CACs is associated with implementation of a screening and referral protocol and whether improving team functioning can enhance implementation efforts. Understanding how multidisciplinary teams facilitate or hinder implementation and developing team-focused strategies can enhance efforts to implement evidence-based practices in rural CACs and other settings providing team-based care. This study will use a stakeholder- engaged approach and has three aims: 1) Use mixed methods to examine how multidisciplinary team interdependence and functioning are associated with implementation of a screening and referral protocol in CACs; 2) Develop team-focused strategies to facilitate implementation in rural CACs; and 3) Conduct a pilot randomized controlled effectiveness-implementation Type II hybrid trial in rural CACs. To ensure its successful execution and build the investigator’s capacity for independent research, the following training aims are proposed: 1) Develop competence in conducting stakeholder-engaged, community-based research with vulnerable populations, 2) Develop expertise in the application of team theories to implementation in multidisciplinary settings providing team-based care, and 3) Acquire skills in methods for implementation science. Training and research will be overseen by co-mentors Dr. David Kolko (Professor of Psychiatry, Psychology, Pediatrics, and Clinical and Translational Science, University of Pittsburgh) and Dr. Gregory Aarons (Professor of Psychiatry, University of California-San Diego). Additional mentorship will be provided by community partner Dr. Teresa Smith (Project Director, Northeast Regional Children’s Advocacy Center) and advisory committee members Dr. Laurie Weingart (Professor of Organizational Behavior and Theory, Tepper School of Business at Carnegie Mellon University), Dr. Eduardo Salas (Professor of Psychology, Rice University), Dr. Elizabeth Miller (Professor of Pediatrics, University of Pittsburgh), and Dr. John Fortney (Professor of Psychiatry and Behavioral Sciences, University of Washington).