Coordination of Sustainable Financing for EBTs in Youth Mental Health Services: A Fiscal Mapping Process

青年心理健康服务中 EBT 可持续融资的协调：财政规划过程

• 批准号: 10356110
• 负责人: Alex Richard Dopp
• 金额: $ 26.21万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-19 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10356110
• 关键词: Address; Behavioral; Case Management; Case Study; Characteristics; Clinical Treatment; Cognitive; Cognitive Therapy; Communities; Concept Formation; Consensus; Consultations; Cost Sharing; Data; Evaluation; Evidence based treatment; Exercise; Exploratory/Developmental Grant; Fee-for-Service Reimbursements; Feedback; Focus Groups; Foundations; Funding; Funding Agency; Future; Goals; Government Agencies; Insurance; Knowledge; Lead; Leadership; Link; Mental Health; Mental Health Services; Methods; Modeling; National Institute of Mental Health; Outcome; Parent-Child Relations; Participant; Privatization; Problem behavior; Process; Public Health; Research; Resources; Sampling; Secure; Services; Strategic Planning; Stream; Structure; Testing; Training; Trauma; United States National Institutes of Health; Work; Youth; base; comparative; cost; cost effective; economic impact; effectiveness implementation trial; experience; implementation research; innovation; intervention mapping; novel; pilot test; prospective; recruit; sustainability framework; tool; traumatic stress

PROJECT SUMMARY/ABSTRACT Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, as recognized by NIMH’s Strategic Objective 4.2: to develop and validate strategies for sustaining EBTs in partnership with key stakeholders. There remains a particularly significant need for strategic planning tools that can guide coordination of sustainable funding for EBTs among youth mental health service agencies, various public and private funding sources, and purveyor/intermediary organizations (which provide guidance and support on the delivery of specific EBTs). The Specific Aims of the proposed R21 project are to (1) develop and (2) evaluate, with stakeholder input, a fiscal mapping process that will guide strategic planning efforts to finance sustainment of EBTs in youth mental health services. The interdisciplinary project team will employ a mixed method approach – with input from a sample of N = 40 stakeholder participants with expertise in the administration and financing of EBTs – to accomplish these aims. All of the proposed research will focus on two widely-disseminated exemplar EBTs (Parent-Child Interaction Therapy and Trauma-Focused Cognitive-Behavioral Therapy) to maximize generalizability of results within the available resources. Aim 1 of the project is to develop the fiscal mapping process: a multi-step, structured process that guides youth mental health service agencies and their partners in selecting the optimal combination of strategies for financing their EBT sustainment efforts. We will adapt an established intervention mapping process and incorporate a compilation of 23 financing strategies developed by our team. We will engage our stakeholder participants in a modified Delphi exercise to achieve consensus on the key steps of the fiscal mapping process and gather information that can inform selection of financing strategies. Aim 2 of the project, which will proceed concurrently with Aim 1, is to evaluate preliminary impact of the fiscal mapping process on EBT sustainment capacities (i.e., structures and processes that support strategic planning) and outcomes (e.g., intentions to sustain) in youth mental health service agencies. Each participating agency will lead a pilot test of the fiscal mapping process, involving their intermediary and funding agency partners. We will evaluate how the fiscal mapping process impacts capacities and outcomes linked to EBT sustainment using a comparative case study approach, incorporating data from stakeholder focus groups and document review. After pilot testing, the participants will conceptualize the process and outcomes of fiscal mapping in a participatory modeling exercise to help inform future evaluations of the fiscal mapping process. Ultimately, the proposed research will generate a fiscal mapping process that will facilitate the coordination of sustained funding for EBTs in youth mental health services. Consistent with the exploratory objectives of the R21 mechanism, the results of this novel project will directly inform a planned large-scale R01 effectiveness- implementation trial to test the impact of the fiscal mapping process on sustainability of a wide variety of EBTs.

项目摘要/摘要 持续提供循证治疗(EBTS)对于解决公共卫生和 NIMH的战略目标4.2认识到青年心理健康问题的经济影响： 与主要利益相关者合作，制定和验证维持EBTS的战略。那里仍然有一个 尤其需要能够指导协调可持续筹资的战略规划工具 在青少年精神健康服务机构、各种公共和私人资金来源之间开展EBTS，以及 供应商/中介组织(就具体的电子商务服务的交付提供指导和支持)。 拟议的R21项目的具体目标是(1)制定和(2)在利益攸关方的参与下评价一个 财政规划进程，将指导战略规划工作，为青年精神中EBTS的维持提供资金 医疗服务。跨学科项目团队将采用一种混合方法--来自 N=40名在EBTS管理和融资方面具有专业知识的利益攸关方参与者的样本-TO 实现这些目标。所有拟议的研究都将集中在两个广泛传播的样本EBT (亲子互动疗法和关注创伤的认知-行为疗法)以最大限度地 在现有资源范围内成果的概括性。该项目的目标1是制定财政规划 流程：一个多步骤、结构化的流程，指导青少年心理健康服务机构及其合作伙伴 选择最佳战略组合，为其EBT持续努力提供资金。我们将调整 建立干预绘图程序，并汇编已制定的23项筹资战略 被我们的团队。我们将让我们的利益相关者参与修改后的Delphi练习，以达成共识 关于财政规划过程的关键步骤，并收集可以为融资选择提供信息的信息 战略。该项目的目标2将与目标1同时进行，目的是评估以下项目的初步影响 关于EBT维持能力的财政映射进程(即，支持 战略规划)和结果(例如，维持意图)在青年心理健康服务机构。每个人 参与机构将领导财政规划过程的试点测试，涉及他们的中介机构和资金 代理合伙人。我们将评估财政规划进程如何影响以下方面的能力和成果 使用比较案例研究方法，结合利益相关者焦点小组的数据，进行EBT维持 和文件审查。在试点测试之后，参与者将对财政的过程和结果进行概念化 在参与性建模工作中绘制地图，以帮助为今后对财政地图绘制进程的评价提供信息。 最终，拟议的研究将产生一个财政规划进程，这将促进协调 为青少年心理健康服务中的循证医学提供持续资金。符合项目的探索性目标 R21机制，这个新项目的结果将直接通知计划中的大规模R01成效- 执行试验，以测试财政摸底过程对各种增值税可持续性的影响。