Outcomes of the Wraparound Service Model

描述（由申请人提供）：在过去的几年里，已经开始出现共识的原则，程序和实施措施的环绕服务模式（WSM），一个流行的个性化和团队为基础的护理管理过程中的儿童严重情绪障碍（SED）和他们的家庭。 拟议的研究将使用随机设计，对内华达州克拉克县护理系统内经历SED并接受服务的儿童和青少年进行明确规定和手动WSM的初步测试。标准化WSM的探索性研究将作为一个重要的第一个试点测试，尽管在全国数百个社区实施，WSM的影响潜力的确定已受到阻碍的干预程序和开发不佳的研究基础规范不足。 利用一个机会，通过立法授权的行为医疗保健服务重新设计在内华达州，与国家的SAMHSA资助的系统的护理补助金，并支持国家最近收到的SAMHSA国家基础设施补助金（SIG），拟议的研究将实现三个主要目标。首先，它将确定在内华达州使用手动和标准化的质量保证方法实施WSM是否比随机分配到非概括性病例管理项目（典型病例管理或TCM）的儿童更符合概括性原则。其次，它将确定儿童和青少年经历SED和随机WSM经验上级的行为和功能的结果比儿童随机中医条件，并确定忠实于WSM过程中的作用，作为一个调解人的临床和功能的结果。第三，在保持与研究的探索性，数据将进行分析，以扩大目前的理解心理测量的WSM忠诚度的措施，在研究中，检查儿童和青少年的亚群的结果，并探讨两个研究组所收到的服务的差异。鉴于在全国护理系统中广泛关注和实施“概括”型过程，研究结果将立即产生政策影响，并为进一步的大规模功效和有效性研究奠定基础。

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.