Rural Child/Adolescent Mental Health Service Use

根据PA-04-061（农村心理健康和药物滥用障碍研究），我们建议调查生活在田纳西州和密西西比州农村地区的有情绪和行为问题的医疗补助儿童和青少年的心理健康服务使用和结果。这个项目有两个主要目的。第一个目标是通过：a)描述农村和非农村参加医疗补助的儿童在倾向、促成和需求特征方面的差异，从而产生关于农村儿童使用心理健康服务的新知识；B)检验关于农村和非农村人口在获取、服务使用模式和临床结果方面差异的假设。第二个目标是为未来农村卫生服务研究细化“农村住所”的业务定义以及服务使用和结果的理论模型。该项目将使用先前收集的面谈和行政（即资格和遭遇/索赔）医疗补助数据。这种二级分析是检查农村环境中与行为健康问题作斗争的儿童和青少年的经验的有效方法。描述性和假设检验分析将解决以下问题：有情绪和行为障碍特别关注的参保农村儿童的儿童、家庭和社区特征是什么？2)。参加医疗补助的农村儿童使用哪些类型的精神卫生服务，他们使用服务的模式（包括获得服务的模式）是什么？3)。农村儿童的临床治疗效果如何？4)哪些因素可以预测农村儿童的服务使用和临床结果？对于每个问题，我们也会回答：这些儿童与非农村儿童有何不同？测试服务使用和结果差异的分析将纳入理论模型中描述的儿童、家庭、社区和服务系统因素。

In response to PA-04-061 (Research on Rural Mental Health and Drug Abuse Disorders), we propose to examine mental health service use and outcomes of Medicaid-enrolled children and adolescents with emotional and behavioral problems living in rural areas in Tennessee and Mississippi. This project has two primary aims. The first is to generate new knowledge on rural children's use of mental health services by: a) describing differences in predisposing, enabling, and need characteristics between rural and non-rural Medicaid-enrolled children; b) testing hypotheses about differences between rural and non-rural populations in access, service use patterns, and clinical outcomes. The second aim is to refine operational definitions of "rural residence" and theoretical models of service use and outcomes for future rural health services research. The project will use previously collected interview and administrative (i.e., eligibility and encounters/claims) Medicaid data. Such secondary analysis is an efficient method for examining the experiences of children and adolescents struggling with behavioral health problems in rural settings. Descriptive and hypothesis-testing analyses will address the following questions: 1.) What are the child, family, and community-level characteristics of Medicaid-enrolled rural children with special attention to emotional and behavioral disorders? 2.) What types of mental health services do Medicaid-enrolled rural children use, and what are their patterns of service use (including access)? 3.) What clinical outcomes of treatment do rural children experience? 4) What factors predict service use and clinical outcomes among rural children? For each question, we will also answer: How do these differ from non-rural children? Analyses to test service use and outcome differences will incorporate child, family, community, and service system factors as described in the theoretical model.