Leveraging Health Information Technology to Improve School-Based Mental Health

利用健康信息技术改善校本心理健康

• 批准号: 9407463
• 负责人: Corey Fagan
• 金额: $ 22.28万
• 依托单位: MENTAL HEALTH DATA SERVICES, INC.
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-18 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9407463
• 关键词: Adolescent; Adult; Area; Assessment tool; Behavior; Benchmarking; Caregivers; Caring; Child; Client; Clinic; Collection; Country; County; Data; Data Reporting; Detection; Deterioration; Development; Devices; Disease remission; Dropout; Education; Educational Intervention; Effectiveness; Ensure; Evaluation; Evidence based practice; Evidence based treatment; Family; Feedback; Fees; Future Teacher; Goals; Graph; Health Insurance Portability and Accountability Act; Healthcare; Interruption; Intervention; Interview; Libraries; Literature; Measurement; Measures; Mental Health; Mental Health Services; Methodology; Modeling; Monitor; National Institute of Mental Health; Outcome; Parents; Patients; Phase; Procedures; Process; Public Health; Publishing; Recovery; Research; Resources; Respondent; Schools; Series; Services; Small Business Technology Transfer Research; Special Education; Structure; Students; System; Technology; Testing; Time; Training; Treatment outcome; Universities; Validation; Washington; Work; Youth; base; behavioral health; clinical decision-making; cloud based; comparative; design; digital; evidence base; experience; field study; health care quality; health information technology; improved; in vivo; infancy; innovation; medical specialties; novel; preference; premature; randomized trial; response; school district; teacher; treatment as usual; uptake; usability; user centered design; web-accessible

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.

项目摘要 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- 高质量的循证治疗本项目的目标是提高校本心理咨询的质量 通过利用卫生信息技术促进基于测量的护理， （MBC）-一种基于证据的做法，利用客户或护理人员报告的数据来监测治疗 并为临床决策提供信息。MBC一直被证明可以改善心理健康 青年和成年人的治疗结果，导致更快的恢复。虽然MBC不常用于 学校，我们以前的工作已经发现，数字测量反馈系统，收集客户生成的 治疗结果数据并将结果传递给临床医生，可以促进MBC。尽管越来越普遍 在专业心理健康环境中使用时，还没有市售的测量反馈系统 开发或调整以供学校使用。鉴于有令人信服的证据表明， MBC，SMH的广泛影响，以及目前缺乏针对 学校，我们建议适应和市场的测量反馈系统称为OwlOutcomes ™ (or Owl）为SMH。使用情境化技术适应过程，该过程详细介绍了 使现有的卫生信息技术适应新的环境， 设计方法，强调迭代开发的简约和引人注目的产品， 目前的提案将最大限度地提高一种创新产品--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《最低限度教育公约》。在目标1中，（a）评价 实现上下文（即，SMH）和（B）通过基于实验室的可用性评估未适应的Owl SMH临床医生的测试将告知Owl对SMH的适应;（c）可用性的评估， 通过体内现场测试，改良Owl（Owl-S）的兼容性和实用性将确定其他适应性 needed.在目标2中，对完全适应的Owl-S进行的试点随机试验将评估（a）获得 Owl-S对SMH临床医生使用基于测量的护理的影响，以及（B）Owl-S在SMH中的实施容易性。 学校临床医生对其可用性、兼容性和实用性的评级表明SMH。完成这些 目标将产生一个适合SMH使用的测量反馈系统，该系统易于实施（目标 2b）并有效增加MBC的使用（目标2a），从而提高SMH护理质量。14,000所学校 根据SaaS模式和 每名临床医生的年度订阅费为250美元（每个地区约5名）。该STTR将支持产品适应性， Owl-S的验证，并在这样做的过程中创建一个创新的产品，将填补一个非常大的，目前 这是一个尚未开发的市场，最终目标是改善学校心理健康对公共卫生的影响。