GATEWAYS AND PATHWAYS PROJECT (GAPP)

门户和途径项目 (GAPP)

• 批准号: 2675577
• 负责人: Arlene Rubin Stiffman
• 金额: $ 10.83万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-04-01 至 2000-03-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2675577
• 关键词: adolescence (12-20); behavioral /social science research tag; child mental health service; clinical research; health care cost /financing; health care referral /consultation; health care service availability; health care service utilization; human subject; urban area

DESCRIPTION (Adapted from Applicant's Abstract): Previous research is surprisingly uninformative about why the majority of adolescents with mental health problems fail to receive mental health services, even when adults recognize they have a problem and could provide a "gateway" to care. Initial studies by Dr. Stiffman reveal that gateway providers are unable to help the youths, and frustrated with their level of knowledge, and the structural constraints (organization, management, financing) in which they must operate. To understand the pathway to mental health services, we are building upon the currently funded Youth Services Project (YSP) (R24 MH50857). We explore a model of mental health services use which includes the moderating effect of gateway providers' perceptions and structural, organizational factors on the relationship between adolescents' use of mental health services and need, predisposing characteristics, and enabling characteristics (availability, accessibility, acceptability, and affordability). We examine this service model with four separate but linked sets of data: 1) Secondary data from the Youth Services Project which contains: a) 796 youths' reports of predisposing and need characteristics, service use, and pathways to care, and b) census data concerning youths' neighborhoods; 2) Primary data from interviews with the youths' "gateway" providers concerning: a) providers; assessments of the youths' predisposing and need characteristics, and b) providers; perceptions of enabling characteristics and the structure of the service system; 3) Primary data from case record reviews; and 4) Primary data from public records concerning the structure, organization and financing of providers' "gateway" sectors. This study provides the first opportunity to test an extensive model of pathways to service use from both provider and client perspectives. We will characterize 1) differences in the perception of need and knowledge of services between gateway providers who link mentally ill youth to mental health services and those who do not; 2) differences in the availability, accessibility, affordability, acceptability, and to the structural characteristics of mental health services that explain providers' actions in linking youths to mental health services; and 3) differences in the organizational structure (support, flexibility, resources) of gateway providers that explain providers; actions in linking youths to services.

描述(改编自申请者摘要)：以前的研究是 令人惊讶的是，对于为什么大多数患有精神疾病的青少年 健康问题得不到心理健康服务，即使成年人 认识到他们有一个问题，可以提供一个关心的“门户”。 斯蒂夫曼博士的初步研究表明，网关提供商无法 帮助年轻人，并对他们的知识水平感到沮丧，以及 结构性限制(组织、管理、融资) 必须动手术。 为了了解获得精神健康服务的途径，我们正在 目前资助的青年服务项目(YSP)(R24 MH50857)。我们探索 一种包含调节效应的心理健康服务使用模式 关于网关提供商的看法和结构、组织因素 青少年对心理健康服务的利用与心理健康的关系 需要、易患特征和使能特征 (可获得性、可及性、可接受性和可负担性)。 我们使用四个独立但相互关联的数据集来检查此服务模型： 1)青年服务项目的次要数据，其中包括：a)796 青少年的易患倾向和需要特征、服务使用和 关怀途径，以及b)关于青少年邻里关系的人口普查数据；2) 与青少年“门户”提供者面谈的主要数据 涉及：a)提供者；对青少年的倾向和需要进行评估 特征，以及b)提供者；对有利特征的看法 以及服务系统的结构；3)病案原始数据 审查；以及4)来自关于该结构的公共记录的主要数据， 组织和资助提供者的“门户”部门。本研究 为测试广泛的路径模型提供了第一个机会 从提供商和客户的角度来看服务使用情况。 我们将描述人们对需求和知识认知的不同 在将精神病青少年与精神病患者联系起来的网关提供者之间提供服务 卫生服务和不提供卫生服务的人；2)在可获得性方面的差异， 可获得性、可负担性、可接受性和结构性 心理健康服务的特点，解释了提供者在 将青少年与心理健康服务联系起来；以及3)在 网关的组织结构(支持、灵活性、资源) 解释提供者的提供者；将青年与服务联系起来的行动。