Brief Precision Behavioral Health Screening and Early Intervention for Rural Youth

近年来，青少年行为健康求助急剧增加，引发了一场危机 尊重未得到满足的行为健康，特别是在农村地区。资源匮乏加剧了这场危机 服务提供商所经历的压力。可悲的是，社区青年服务提供商为青年和家庭提供服务 (YSP)，包括儿童、青少年和家庭服务部门、卫生服务部门、儿童福利部门、青少年部门 司法服务、学校保健诊所、寄养和管理式护理组织承包行为 与国家合作的服务是最不可能获得服务的群体之一，尤其是那些高质量的服务。在农村 社区，情况更糟；为青年服务的治疗方案供应不足，受过培训的工作人员很少 专为问题最严重的青少年提供的治疗是外包的，而且费用昂贵。服务有 对于少数族裔/族裔青年来说尤其难以获得。这种现实因频繁同时发生而变得更加复杂 问题行为 (CP)，例如药物滥用、抑郁、创伤相关问题和破坏性行为 行为，并强调迫切需要协调、有吸引力和适应性的服务。 社区迫切需要更具创新性、基于证据的、完全集成的交付模式 接触大量未获得所需服务的 CP 青少年。对青少年的早期干预 在青少年出现更慢性的心理健康之前开始体验 CP 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)，一种基于网络的干预措施，可以以低成本进行大规模交付以扩大规模 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。 eTRY 将涉及多屏幕和 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 筛查过程中发现的问题行为。本研究的具体目标是： (1) 进行 由 10 名 YSP 工作人员组成的焦点小组，为州和社区计划中的 eTRY 实施情况以及 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 其四个当前模块的交付方式。反馈将迭代地集成到 eTRY 开发中。 (2) 创建并评估四个 eTRY 模块之一的原型软件和材料，包括 在线框架包含文本、图形和交互功能等基本要素。 (3) 使用 YSP 参与的青少年的独立样本（n = 20）对单个模块进行可用性测试，以 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。我们还将让国家、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.