Brief Precision Behavioral Health Screening and Early Intervention for Rural Youth

青少年的行为健康求助近年来急剧上升，导致与 尊重未得到满足的行为健康，特别是在农村地区。这场危机因资源问题而加剧 服务提供商所经历的压力。可悲的是，社区青年服务提供者为青年和家庭提供服务 (YSP)，包括儿童、青年和家庭服务、卫生服务、儿童福利、青少年部门 司法服务、学校卫生诊所、寄养护理和管理型护理组织承包行为 有州的服务是最不可能获得服务的人之一，特别是那些有质量的服务。在农村 在社区，情况更糟；为青年服务的治疗方案供不应求，训练有素的工作人员很少。 而且为最严重的问题青年保留的治疗是外包的，而且费用很高。服务包括 种族/少数族裔青年明显较难接触到。这一现实因频繁的同时发生而变得更加复杂 问题行为(CP)，如药物滥用、抑郁、创伤相关问题和破坏性 并强调迫切需要协调一致、具有参与性和适应性的服务。 社区迫切需要更具创新性、以证据为基础、完全集成的交付模式， 接触到大量没有得到所需服务的有社区合作伙伴的青年。对青年的早期干预 开始体验在青少年发展为更慢性的心理健康之前交付的CPS 疾病提供了最好的机会来降低与这些疾病相关的经济和医疗成本。这个 拟议的SBIR第一阶段研究的目标是开发和试运行一个原型，以实现“e-Health早期治疗” 青年资源“(TRITE)，这是一种基于网络的干预措施，允许以低成本进行广泛的交付以扩大规模 YSP为因距离等障碍而受到限制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。《试镜》将包括一个多屏幕和 一套简短的行为改变咨询模块，指导青少年和工作人员解决吸毒和其他问题 通过筛选过程通知的问题行为。拟议研究的具体目标是：(1)进行 由10名YSP工作人员组成的焦点小组，为州和社区计划内的测试实施以及 与20名参与YSP的青少年和10名家长一起指导测试的内容、结构和 它的四个当前模块的交付方法。反馈将迭代地整合到测试开发中。(2) 为四个测试模块之一的原型和材料创建和评估软件，包括 包含文本、图形和交互功能的基本基本元素的在线框架。(3) 使用参与YSP的青年(n=20)的独立样本对单个模块进行可用性测试 检查功能(例如，技术错误)、可行性(例如，完成率)、可用性(例如，可接受性， 吸引力)，以及该技术原型的潜在影响。我们还将与国家、州、 和社区层面，为实施提供信息，并参与商业化规划。

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.