Outcomes of the Wraparound Service Model

环绕式服务模式的成果

• 批准号: 7047999
• 负责人: ERIC J. BRUNS
• 金额: $ 18.36万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7047999
• 关键词: adolescence (12-20); behavioral /social science research tag; caregivers; child mental health service; clinical research; community mental health services; data collection methodology /evaluation; governmental health /scientific organization; health care model; health care policy; health care quality; health care service evaluation; health related legal; health services research tag; human subject; interview; middle childhood (6-11); mood disorders; outcomes research; patient care management; psychometrics

DESCRIPTION (provided by applicant): Over the past several years, consensus has begun to emerge on the principles, procedures, and implementation measures for the wraparound service model (WSM), a popular individualized and team based care management process for children with serious emotional disturbance (SED) and their families. The proposed study will use a randomized design to pilot test a well-specified and manualized WSM for children and adolescents experiencing SED and being served within the Clark County, Nevada, system of care. This exploratory study of a standardized WSM will serve as an important first pilot test; despite being implemented in hundreds of communities nationally, determination of WSM's potential for impact has been hampered by inadequate specification of the intervention procedures and a poorly-developed research base. Capitalizing on an opportunity presented through a legislatively mandated behavioral health care services redesign in Nevada, associated with the state's SAMHSA-funded system-of-care grant, and supported by the state's recent receipt of a SAMHSA state infrastructure grant (SIG), the proposed study will accomplish three primary aims. First, it will determine if implementation of WSM in Nevada using manualized and standardized quality assurance methods results in greater adherence to wraparound principles than for children randomized to a non-wraparound case management program (typical case management or TCM). Second, it will determine if children and adolescents experiencing SED and randomized to WSM experience superior behavioral and functional outcomes than children randomized to the TCM condition and determine the role of fidelity to the WSM process as a moderator of clinical and functional outcomes. Third, in keeping with the study's exploratory nature, data will be analyzed to extend the current understanding of psychometrics of the WSM fidelity measures employed in the study, examine outcomes for subpopulations of children and youth, and explore differences in services received by the two study groups. Given the widespread interest and implementation of "wraparound" type processes in systems of care nationwide, results of the study will have immediate policy implications, as well as set the stage for further large scale efficacy and effectiveness studies.

描述（申请人提供）：在过去的几年里，围绕式服务模式（WSM）的原则、程序和实施措施已经开始形成共识，这是一种流行的针对严重情绪障碍儿童（SED）及其家庭的个性化和基于团队的护理管理流程。 拟议的研究将采用随机设计，针对经历 SED 并在内华达州克拉克县护理系统中接受服务的儿童和青少年，对一种详细说明和手动的 WSM 进行试点测试。这项标准化 WSM 的探索性研究将作为重要的首次试点；尽管WSM在全国数百个社区得到实施，但由于干预程序规范不充分和研究基础不完善，WSM影响潜力的确定受到了阻碍。 利用内华达州立法授权的行为健康护理服务重新设计所提供的机会，与该州 SAMHSA 资助的护理系统拨款相关的机会，以及该州最近收到的 SAMHSA 州基础设施拨款 (SIG) 的支持，拟议的研究将实现三个主要目标。首先，它将确定内华达州使用手动和标准化质量保证方法实施 WSM 是否会比随机分配到非环绕病例管理计划（典型病例管理或 TCM）的儿童更好地遵守环绕原则。其次，它将确定经历 SED 并随机接受 WSM 的儿童和青少年是否比随机接受 TCM 条件的儿童表现出更好的行为和功能结果，并确定对 WSM 过程的忠诚度作为临床和功能结果的调节者的作用。第三，为了保持研究的探索性，将对数据进行分析，以扩展当前对研究中使用的 WSM 忠诚度测量的心理测量学的理解，检查儿童和青少年亚人群的结果，并探讨两个研究组所接受的服务的差异。鉴于全国护理系统中“环绕式”流程的广泛关注和实施，该研究的结果将产生直接的政策影响，并为进一步大规模的功效和效果研究奠定基础。