Improving Family-to-Family Services in Childrens Mental Health

改善儿童心理健康方面的家庭对家庭服务

• 批准号: 8039652
• 负责人: KIMBERLY E. HOAGWOOD
• 金额: $ 75.47万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-28 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8039652
• 关键词: Improving; Family; Services; Childrens; Mental

DESCRIPTION (provided by applicant): Family Peer Advocates are a growing sector in the mental health workforce. In New York, Family Peer Advocates (FPA) work in approximately 400 Family-to-Family Support Programs (F2FS), providing a range of services (e.g., information and education, advocacy, etc) to parents/caregivers of youth with mental health issues. New York State has plans to double the number of FPA over the next two years, establish a credentialing process to professionalize the role of the FPA, and enable F2FS to become a billable service under state regulations. A quality improvement intervention to support the training of FPA (known as the Parent Empowerment and Engagement Program, or PEP) was developed by a collaborative board of key stakeholders. PEP was pilot-tested in an NIMH-funded study (R34MH071745). Results suggested that it led to improvements in FPA knowledge about effective MH practices, self-efficacy, professional skill development, and working alliances with parents. However, agency-level contextual factors within the work environment mitigated FPA effectiveness. Empirical studies of children's MH agency structure and climate suggest social contextual factors within work environments predict service effectiveness and child outcomes. Organizational interventions targeting agency social context have strong empirical support and can improve the quality of services in MH agencies. Therefore, the proposed study will: (1) Profile the infrastructure and social-organizational context of 20 agencies providing F2FS; (2) Examine the process and content of those services using an innovative Standardized Parent "Walkthrough" methodology; (3) Identify correlates of quality practices based on data from (1) and (2) and use these to guide the implementation of an agency-level organizational intervention for this new workforce; and (4) Conduct an experimental study among 20 agencies to examine the feasibility and impact of the agency-level intervention on agency context; FPA behavior, parent and youth outcomes. This two-phase study builds on the long-term collaborative work among Columbia University, OMH and community-based family advocacy organizations. It links two theory-based approaches (behavioral and social-organizational), which together suggest that family/consumer strategies to increase parental engagement and empowerment (via the work of FPA's) and strategies to change agency social contexts are complementary. If integrated within MH service agencies, these strategies are likely to improve integration of FPAs into mental health agencies, working alliances between providers and parents, and parent and youth outcomes. PUBLIC HEALTH RELEVANCE: This study, conducted within New York State Office of Mental Health, and its connection to a state-wide family advisory research board (FAR), will ensure that findings will be rapidly disseminated throughout the state. The goal is to improve the quality of clinical services for ethnically-diverse children and their families, using novel intervention targets and personalized service delivery, two of the priorities outlined in the NIMH Strategic Plan.

描述（由申请人提供）：家庭同侪倡导者是一个不断增长的部门在精神卫生工作队伍。在纽约，家庭同伴倡导者（FPA）在大约400个家庭对家庭支助方案（F2FS）中工作，提供一系列服务（例如，信息和教育、宣传等），向有心理健康问题的青少年的父母/照顾者提供服务。纽约州计划在未来两年内将FPA的数量增加一倍，建立一个认证过程，使FPA的作用专业化，并使F2FS成为州法规下的收费服务。一个由主要利益攸关方组成的协作委员会制定了一项质量改进干预措施，以支持FPA的培训（称为家长赋权和参与计划，或PEP）。PEP在NIMH资助的研究（R34 MH 071745）中进行了中试测试。结果表明，它导致FPA知识的有效MH的做法，自我效能，专业技能的发展，并与父母的工作联盟的改善。然而，工作环境中的机构一级背景因素降低了FPA的效力。对儿童MH机构结构和氛围的实证研究表明，工作环境中的社会背景因素可以预测服务效率和儿童结果。针对机构社会背景的组织干预措施有很强的经验支持，可以提高卫生保健机构的服务质量。因此，拟议的研究将：（1）轮廓的基础设施和社会组织背景的20个机构提供F2FS;（2）检查的过程和内容，这些服务使用一个创新的标准化的家长“走过场”的方法;（3）根据（1）和（2）中的数据识别质量实践的相关性，并使用这些数据来指导机构的实施-（4）在20个机构中进行一项实验研究，以检查机构层面干预对机构背景、FPA行为、父母和青年结果的可行性和影响。 这两个阶段的研究建立在哥伦比亚大学、OMH和社区家庭倡导组织之间的长期合作基础上。它连接两个理论为基础的方法（行为和社会组织），这两者共同表明，家庭/消费者的战略，以增加父母的参与和授权（通过FPA的工作）和战略，以改变机构的社会背景是相辅相成的。如果整合在精神卫生服务机构，这些战略可能会改善FPAs融入精神卫生机构，供应商和家长之间的工作联盟，以及家长和青年的成果。 公共卫生关系：这项研究在纽约州精神卫生办公室进行，并与全州家庭咨询研究委员会（FAR）建立了联系，将确保调查结果迅速在全州传播。其目标是利用新的干预目标和个性化的服务提供，提高对不同民族儿童及其家庭的临床服务质量，这是国家精神卫生战略计划中概述的两个优先事项。