Leveraging Health Information Technology to Improve School-Based Mental Health

项目总结 在美国，大约五分之一的儿童经历了严重到需要干预的心理健康问题； 其中70%-80%的人在教育部门接受治疗。然而，学校往往无法提供高质量的 高质量的循证治疗。本课题的目标是提高校本心理健康教育的质量 通过利用健康信息技术促进基于测量的护理来提供健康(SMH)服务 (MBC)-一种基于证据的实践，利用患者或照顾者报告的数据来监控治疗 取得进展并为临床决策提供信息。MBC一直被证明能改善心理健康 对青年和成人的治疗结果，导致更快的康复。尽管MBC不是常规使用在 学校，我们之前的工作已经发现，数字化测量反馈系统，其中收集客户生成 治疗结果数据并将结果提供给临床医生，可以促进MBC。尽管越来越普遍 在专门的心理健康环境中使用，还没有商业上可用的测量反馈系统 为学校环境而开发或改编的。鉴于有令人信服的证据证明 MBC，SMH的广泛影响，以及目前缺乏为以下方面设计的测量反馈系统 ，我们建议采用并推广一种名为OwlOutcome™的测量反馈系统 (或猫头鹰)用于SMH。使用情境化技术适应流程，该流程详细说明了 调整现有的卫生信息技术以适应新的环境，并纳入以用户为中心的阶段 设计方法论，强调迭代开发节俭而引人注目的产品， 目前的提案将最大限度地提高创新产品--学校猫头鹰的可用性、兼容性和实用性 (OWL-S)-以最佳方式支持在学校实施母婴健康教育。在目标1中，(A)对 实施环境(即SMH)和(B)通过基于实验室的可用性对未适应的OwL进行评估 与SMH临床医生的测试将为Owl适应SMH提供信息；(C)可用性评估， 通过体内田间试验，改良猫头鹰(猫头鹰-S)的兼容性和实用性将确定更多的适应 需要的。在目标2中，对完全适应的猫头鹰-S进行的试点随机试验将评估(A)获得 OWL-S关于SMH临床医生使用基于测量的护理的情况，以及(B)OWL-S在 学校临床医生对SMH的可用性、兼容性和实用性的评级表明SMH。这些项目的完成 AIMS将产生一个适用于SMH使用的测量反馈系统，该系统易于实现(AIM 2b)，并有效地增加MBC的使用(目标2a)，从而提高SMH的护理质量。~14,000所学校 基于SaaS模式和 每位临床医生每年的订阅费为250美元(每个区约5美元)。该STTR将支持产品适配和 猫头鹰-S的验证，并通过这样做创建了一个创新的产品，将满足一个非常大的和目前的需求 尚未开发的市场，最终目标是改善以学校为基础的心理健康对公共健康的影响。

PROJECT SUMMARY In the US, roughly 1 in 5 children experience a mental health problem severe enough to warrant intervention; 70-80% of them receive treatment in the education sector. However, schools are often unable to deliver high- quality evidence-based treatments. The goal of this project is to improve the quality of school-based mental health (SMH) services by leveraging health information technology to facilitate measurement-based care (MBC)—an evidence based practice that utilizes client or caregiver reported data to monitor treatment progress and inform clinical decision-making. MBC has consistently been shown to improve mental health treatment outcomes for youth and adults, leading to faster recovery. Although MBC is not routinely used in schools, our prior work has found that digital measurement feedback systems, which gather client-generated treatment outcome data and deliver results to clinicians, can facilitate MBC. Despite increasingly widespread use in specialty mental health settings, no commercially available measurement feedback systems have been developed or adapted for use in the school context. Given the compelling evidence for the effectiveness of MBC, the broad influence of SMH, and the current lack of measurement feedback systems designed for schools, we propose to adapt and market a measurement feedback system known as OwlOutcomes™ (or Owl) for SMH. Using the Contextualized Technology Adaption Process, which details a sequence of phases for adapting existing health information technology to novel settings, and incorporating user-centered design methodology, which emphasizes iterative development of parsimonious and compelling products, the current proposal will maximize the usability, compatibility, and utility of an innovative product—Owl for Schools (Owl-S)—to optimally support the implementation of MBC in schools. In Aim 1, (a) an evaluation of the implementation context (i.e., SMH) and (b) an assessment of the un-adapted Owl via lab-based usability testing with SMH clinicians will inform the adaption of Owl for SMH; (c) an evaluation of the usability, compatibility, and utility of the modified Owl (Owl-S) via in vivo field testing will identify additional adaptations needed. In Aim 2, a pilot randomized trial of the fully adapted Owl-S will assess (a) the impact of access to Owl-S on SMH clinicians’ use of measurement-based care, as well as (b) Owl-S’ ease of implementation in SMH as indicated by school clinicians’ rating of its usability, compatibility and utility. The completion of these Aims will result in a measurement feedback system adapted for SMH use, that is easily implementable (Aim 2b) and effective in increasing MBC use (Aim 2a) and thus improving SMH care quality. The ~14,000 school districts in the US represent a total addressable market of $17.5M per annum, based on a SaaS model and an annual subscription fee of $250/clinician (~5 per district). This STTR will support the product adaptation and validation of Owl-S and in so doing create an innovative product that will fill a need in a very large and currently untapped market, with the ultimate goal of improving the public health impact of school-based mental health.