E-CONNECT: A SERVICE SYSTEM INTERVENTION FOR JUSTICE YOUTH AT RISK FOR SUICIDE

E-CONNECT：针对有自杀风险的司法青少年的服务系统干预

• 批准号: 10223120
• 负责人: KATHERINE S ELKINGTON
• 金额: $ 59.22万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10223120
• 关键词: Acute; Address; Adolescent; Affect; Behavioral; Caring; Categories; Characteristics; Classification; Clinical; Collaborations; Communication; Communities; County; Data Collection; Decision Making; Detection; Development; Elements; Enrollment; Evidence based practice; Family; Firearms; Gatekeeping; Health; Health Services; Imprisonment; Intake; Intervention; Justice; Knowledge; Lifestyle-related condition; Link; Medical; Modeling; Moods; National Institute of Drug Abuse; National Institute of Mental Health; New York; Outcome; Participant; Phase; Policies; Prevalence; Procedures; Protocols documentation; Randomized; Research; Risk; Risk Behaviors; Secure; Self Efficacy; Service delivery model; Service provision; Services; Site; Standardization; Structure; Substance Use Disorder; Suicide; Supervision; System; Testing; Time; Training; Vulnerable Populations; Work; Youth; base; behavioral health; behavioral study; community setting; design; evidence base; health service use; healthcare community; high risk; improved; juvenile justice system; member; mobile application; mobile computing; offender; probation; programs; recidivism; referral services; scale up; screening; service delivery; service uptake; suicidal behavior; suicidal risk; system-level barriers; trauma exposure; uptake

While youth at all juvenile justice (JJ) processing points are at increased risk for suicidal behavior (SB) and associated behavioral health (BH) issues, those supervised in community settings (e.g., probation), may be at greatest risk: (a) protocols for identification and service referral are far more common in secure settings, (b) national policy increasingly favors community supervision/diversion over incarceration, (c) youth supervised in the community have far more access to means and opportunity than do those in secure settings, and (d) the multi- system coordination challenges to accessing BH care for community JJ youth are far greater than for those secure care. We propose to adapt and test the utility of a multi-level service delivery model that increases identification of SB and related BH problems, guides targeted referral, trains staff and structures interagency collaboration to increase uptake of BH services by youth on probation; and document the organizational elements required to widely-implement this model in juvenile probation and community treatment settings. The model is based on our earlier, evidence-based linkage protocols from Project Connect, and capitalizes on technological advances unavailable at Connect’s 2007 development, so as to address earlier implementation issues. Working in 9 NYS counties, project specific aims are (1) to develop a technologically advanced cross-system identification/linkage service model that trains staff, formalizes interagency collaboration and referral decision-making and uses a mobile application to seamlessly combine (a) screening for SB and related BH problems, (b) classification of clinical need and (c) county-specific streamlined referral plans for BH services; (2) to examine the degree to which, compared to Baseline, e- Connect improves (a) intermediary PO practice outcomes (service need identification, cross-system referral) and increasing (b) youth BH service use (access, engagement); and (3) to elucidate multi-level factors (e.g., staff, organizational, youth/family, community,) that influence implementation (feasibility, acceptability, sustainability) of e-Connect across various probation department processing categories (e.g. status offenders, diversion cases) to inform comprehensive scale-up. The theoretically based mechanisms (e.g., changes in staff knowledge and self-efficacy; agency structural characteristics) by which PO practice change affects BH service use will also be examined. Guided by the GPM and CFIR framework, this 5-year study will comprise 4 project phases: (1) Development, (2) Baseline data collection, (3) Implementation, and (4) Sustainment. After development, counties are randomized to one of 4 Waves to begin implementation of e-Connect at 4-month intervals in a stepped-wedge design. Implementation activities continue for 18m and sites’ use of e-Connect protocols after 18m will be an indication of sustainability. This initiative is one of the first to address SB and advance JJ youth enrollment in BH treatment. Because we propose addressing risk and acute SB, this study has the likelihood of identifying and linking to services high-risk, high need youth that are often overlooked.

虽然所有少年司法 (JJ) 处理点的青少年自杀行为 (SB) 和 相关的行为健康 (BH) 问题，那些在社区环境中受到监督的问题（例如缓刑）可能会在 最大的风险：(a) 身份识别和服务转介协议在安全环境中更为常见，(b) 国家政策越来越倾向于社区监督/转移而不是监禁，(c) 青少年在监狱中受到监督 与安全环境中的社区相比，社区拥有更多的手段和机会，并且 (d) 社区 JJ 青少年获得 BH 护理的多系统协调挑战远大于 那些安全的护理。我们建议调整和测试多层次服务交付模型的实用性 增加对 SB 和相关 BH 问题的识别，指导有针对性的转介，培训员工和结构 机构间合作，以增加缓刑青年对 BH 服务的利用；并记录 在青少年缓刑和社区广泛实施该模式所需的组织要素 治疗设置。该模型基于我们早期的 Project Connect 循证链接协议， 并利用 Connect 2007 年开发中无法实现的技术进步，以解决 较早的实施问题。在纽约州 9 个县开展工作，项目的具体目标是 (1) 开发 技术先进的跨系统识别/联动服务模式，培训员工、规范化 机构间协作和转介决策，并使用移动应用程序无缝结合 (a) 筛查 SB 和相关 BH 问题，(b) 临床需求分类，以及 (c) 县具体情况 简化 BH 服务转介计划； (2) 检查与基线相比，e- Connect 改善 (a) 中间 PO 实践成果（服务需求识别、跨系统转介） (b) 增加青年 BH 服务的使用（获取、参与）； (3) 阐明多层次因素（例如， 工作人员、组织、青年/家庭、社区）影响实施（可行性、可接受性、 跨缓刑部门处理类别（例如身份罪犯、 转移案例），为全面扩大规模提供信息。基于理论的机制（例如， 员工知识和自我效能； PO 实践变化影响 BH 的机构结构特征） 服务的使用情况也将受到审查。在 GPM 和 CFIR 框架的指导下，这项为期 5 年的研究将包括 4 项目阶段：(1) 开发，(2) 基线数据收集，(3) 实施，(4) 维持。后 发展，县被随机分配到 4 波之一，在 4 个月时开始实施 e-Connect 阶梯式楔形设计中的间隔。实施活动持续进行 18m，站点使用 e-Connect 18m之后的协议将是可持续性的标志。该倡议是第一个解决 SB 和 提前 JJ 青少年参加 BH 治疗。因为我们建议解决风险和急性 SB，所以本研究 有可能识别经常被忽视的高风险、高需求青年并为其提供服务。

项目成果

E-Connect: Linking probation youth at risk for suicide to behavioral health services.

E-Connect：将有自杀风险的缓刑青少年与行为健康服务联系起来。

• DOI: 10.1037/ccp0000824
• 发表时间: 2023
• 期刊: Journal of consulting and clinical psychology
• 影响因子: 5.9
• 作者: Elkington,KatherineS;Wasserman,GailA;Ryan,MargaretE;Sichel,CoriannaE;Sarapas,Casey;Dennis,MichaelL;Taxman,FayeS
• 通讯作者: Taxman,FayeS