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

改善农村青年获得心理健康服务的机会：利用多学科团队加强农村儿童宣传中心筛查和转诊方案的实施

• 批准号: 10371161
• 负责人: Elizabeth Ann McGuier
• 金额: $ 17.08万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10371161
• 关键词: Adoption; Advisory Committees; Advocate; Affect; Affective; Behavior; Behavioral; Behavioral Sciences; Businesses; California; Caregivers; Caring; Child; Child Abuse and Neglect; Child Advocacy; Child Mental Health; Child Welfare; Clinical; Clinical Sciences; Committee Members; Communication; Communities; Competence; Conflict (Psychology); Data; Development; Dissemination and Implementation; Education; Effectiveness; Eligibility Determination; Ensure; Evidence based practice; Evidence based treatment; Goals; Health Personnel; Hybrids; Impairment; Improve Access; Intervention; Interview; Law Enforcement; Mental Health; Mental Health Services; Mentors; Mentorship; Methods; Modeling; National Institute of Mental Health; Outcome; Partnership Practice; Pediatrics; Penetration; Pennsylvania; Performance; Play; Positioning Attribute; Primary Health Care; Process; Protocols documentation; Psyche structure; Psychiatry; Psychology; Public Health; Randomized; Replicating Effective Programs; Research; Research Personnel; Resources; Rice; Risk; Role; Rural; Rural Health Services; Schools; Screening procedure; Service setting; Speed; Standardization; Structure; Suicide; Surveys; System; Testing; Training; Translational Research; Universities; Utah; Vulnerable Populations; Washington; Youth; base; cognitive process; cohesion; community based research; effectiveness implementation study; evidence base; experience; health care settings; hybrid type 2 trial; implementation efforts; implementation facilitation; implementation outcomes; implementation process; implementation science; implementation strategy; improved; improved outcome; maltreatment; member; multidisciplinary; patient safety; peer; pilot trial; post implementation; professor; response; routine practice; rural area; screening; skills; stress symptom; suicide rate; theories; tool; traumatic stress

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).

项目总结/摘要 农村地区的儿童遭受虐待的风险较高， 健康需求。儿童倡导中心（CAC）为虐待提供协调的机构间反应 儿童基金会能够很好地识别有心理健康需求的儿童， 循证治疗。这项K23研究将研究多学科团队在CAC中的运作方式， 与筛查和转诊协议的实施相关，以及是否改善了团队运作 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， 在农村社区行动中心和其他提供团队护理的环境中的做法。这项研究将使用一个利益相关者- 参与的方法，有三个目标：1）使用混合方法来检查多学科团队如何 相互依存和运作与实施筛查和转诊协议有关， 2）制定以团队为中心的战略，以促进在农村社区行动中心的实施; 3）开展试点 在农村CAC中进行的随机对照有效性-实施II型混合试验。为确保其成功 执行和建立调查员的独立研究能力，以下培训目标是 建议：1）发展能力，进行业主参与，以社区为基础的研究， 弱势群体，2）发展团队理论应用于实施的专业知识， 提供团队护理的多学科环境，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大卫科尔科博士（精神病学教授， 匹兹堡大学心理学、儿科学、临床和转化科学）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）， 咨询委员会成员劳里温加特博士（组织行为学和理论教授，泰珀 卡耐基梅隆大学商学院），爱德华多·萨拉斯博士（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）。