Brief Precision Behavioral Health Screening and Early Intervention for Rural Youth

农村青少年简明精准行为健康筛查与早期干预

• 批准号: 10384508
• 负责人: Ken C WINTERS
• 金额: $ 30.11万
• 依托单位: OREGON RES BEHAVIORAL INTERVENTION STRAT
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2023-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10384508
• 关键词: Address; Adolescent; Advocate; Area; Behavior; Behavioral; Caring; Child; Child Welfare; Chronic; Clinic; Communities; Computer software; Contracts; Counseling; Development; Disease; Drug usage; Early Intervention; Early treatment; Effectiveness; Elements; Emotions; Ensure; Evidence based treatment; Family; Feedback; Focus Groups; Goals; Health; Health Care Costs; Health Personnel; Health Services; Health Services Accessibility; Healthcare; Human Resources; Intervention; Justice; Literature; Managed Care; Mental Depression; Mental disorders; Methods; Minority; Modeling; Motivation; Online Systems; Outcome; Parents; Phase; Preparation; Primary Health Care; Problem behavior; Procedures; Process; Provider; Research; Resources; Risk; Rural; Rural Community; Rural Health; Rural Population; Sampling; Schools; Self-Direction; Services; Small Business Innovation Research Grant; Social Work; Structure; Substance abuse problem; System; Testing; Text; Time; Training; Trauma; Waiting Lists; Youth; base; behavior change; behavioral health; commercialization; cost; digital health; eHealth; economic cost; ethnic minority population; evidence base; experience; foster care; health care availability; health care settings; help-seeking behavior; innovation; intervention cost; pediatrician; personalized approach; programs; prototype; racial and ethnic; rural area; school health; screening; service delivery; service intervention; service providers; software development; substance use; suburb; telehealth; tool; treatment program; usability; user-friendly; web-based intervention

Behavioral health help-seeking among adolescents has risen sharply in recent years, resulting in a crisis with respect to unmet behavioral health, particularly in rural regions. This crisis has been exacerbated by resource strains experienced by service providers. Sadly, youth and families served by community youth service providers (YSPs), including departments for children, youth, and family services, health services, child welfare, juvenile justice services, school health clinics, foster care, and managed care organizations contracting behavioral services with states, are among those least likely to receive services, especially those of quality. In rural communities, the situation is worse; youth-serving treatment programs are in short supply, few trained staff are available and treatment, reserved for the most severe problem youth, is outsourced and expensive. Services are notably less accessible for racial/ethnic minority youth. This reality is compounded by the frequent co-occurrence of problem behaviors (CPs) such as substance abuse, depression, trauma-related problems, and disruptive behavior and underscores the urgent need for services that are coordinated, engaging and adaptive. Communities desperately need more innovative, evidence-based, fully integrated delivery models that can access the large number of youth with CPs who are not receiving needed services. Early interventions for youth beginning to experience CPs that are delivered before adolescents develop a more chronic mental health disorder offer the best opportunity to reduce the economic and health costs associated with these disorders. The goal of the proposed SBIR Phase I research is to develop and pilot test a prototype for “e-Health Early Treatment Resource for Youth” (eTRY), a web-based intervention to allow for broad-scale delivery at low-cost to expand YSPs’ early intervention services for adolescents whose access is limited due to barriers such as distance from providers, lack of trained clinicians, and agencies with long waiting lists. eTRY will involve a multi-screener and a set of brief behavior change counseling modules to guide the youth and staff to address drug use and other problem behaviors informed by the screening process. The specific aims of the proposed study are: (1) Conduct focus groups with 10 YSP staff to inform eTRY implementation within state and community programs as well as with 20 YSP-involved adolescents and 10 parents to guide the development of eTRY content, structure and delivery methods for its four current modules. Feedback will be integrated iteratively in eTRY development. (2) Create and evaluate the software for a prototype and materials for one of the four eTRY modules, including the online framework that contains the basic essential elements of text, graphics, and interactive features. (3) Conduct a usability test of the single module with an independent sample of YSP-involved youth (n=20) to examine functionality (e.g., technical errors), feasibility (e.g., percent completions), usability (e.g., acceptability, appeal), and potential impact of the eTRY prototype. We will also engage stakeholders at the national, state, and community levels to inform implementation and engage in commercialization planning.

近年来，青少年的行为健康求助急剧上升，导致了一场危机， 关注未得到满足的行为健康，特别是在农村地区。这场危机因资源短缺而加剧 服务提供商经历的压力。可悲的是，由社区青年服务提供者服务的青年和家庭 （YSP），包括儿童，青年和家庭服务，卫生服务，儿童福利，青少年 司法服务，学校卫生诊所，寄养和管理式护理组织承包行为 与国家合作提供服务的人是最不可能获得服务的人，特别是那些高质量的服务。农村 社区，情况更糟;青年服务的治疗方案供不应求，很少有训练有素的工作人员 只有最严重的问题青年才能得到治疗，这种治疗是外包的，而且费用昂贵。服务 特别是少数种族/族裔青年更难获得。这一现实因经常同时发生 的问题行为（CP），如药物滥用，抑郁症，创伤相关的问题，和破坏性 行为，并强调迫切需要协调，参与和适应性的服务。 社区迫切需要更多创新的、基于证据的、完全整合的交付模式， 接触大量没有得到所需服务的有社区保护方案的青年。青年早期干预 在青少年发展出更慢性的心理健康之前， 这些疾病提供了减少与这些疾病相关的经济和健康成本的最佳机会。的 拟议的SBIR第一阶段研究的目标是开发和试点测试“电子健康早期治疗”的原型 青年资源”（eTRY），这是一项基于网络的干预措施，可以低成本广泛提供， 青年服务计划为因距离远等障碍而难以获得服务的青少年提供早期干预服务。 提供者，缺乏训练有素的临床医生，以及等待名单很长的机构。eTRY将涉及多筛选器， 一套简短的行为改变咨询模块，指导青年和工作人员解决吸毒和其他问题 通过筛选过程发现的问题行为。拟议研究的具体目标是：（1）开展 由10名YSP工作人员组成的焦点小组，为州和社区项目中的eTRY实施提供信息， 与20名参与YSP的青少年和10名家长一起指导eTRY内容，结构和 目前四个模块的交付方法。将在eTRY开发中迭代整合反馈。（二） 为四个eTRY模块之一创建和评估原型和材料的软件，包括 在线框架，包含文本、图形和交互功能的基本要素。（三） 对参与青年服务计划的青少年（n=20）的独立样本进行单一模块的可用性测试， 检查功能（例如，技术错误），可行性（例如，完成百分比），可用性（例如，可接受性， 上诉），以及eTRY原型的潜在影响。我们还将与国家、州、 和社区一级，为实施提供信息，并参与商业化规划。