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

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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).