Foster Care Mental Health Family Navigator

项目摘要 儿童福利系统中的青少年记录了高比例的心理健康症状和经历 与非儿童青少年相比，精神卫生保健服务的获得和参与存在显著差异 福利制度。导航器模型已经在医疗保健领域中开发，以应对以下挑战： 服务的可及性、分散性和连续性会影响护理质量，但目前还没有经验证明 支持心理健康导航模型，以解决儿童独特而复杂的心理健康需求 福利参与（CWI）青年。本开发研究将分三个阶段进行， 研究目的。本研究将采用混合方法、多信息人参与的研究方法， 开发，反复完善和试点测试寄养家庭导航（FCFN）模型，以改善 参与儿童福利系统的青少年（12-17岁）的心理健康服务成果。的 导航器模型将利用数字健康技术参与并改善护理协调、跟踪 以及监察这些青少年及其家庭的精神健康服务需要。该研究将调整JJ- TRIALS行为健康服务级联框架，以支持数据驱动的决策方法， 改善对精神卫生服务需求和结果的确认。这项研究将首先利用一种组合， 机构间协作会议、青年和家庭重点小组以及与 多系统利益相关者指导FCFN协议的开发。接下来是为期6个月的公开审判 将进行FCFN干预，并通过直接参与者反馈迭代完善方案。 研究的最后阶段将侧重于对FCFN干预措施进行修改后的推出设计， 儿童福利涉及青年。三组25名青年和照顾者将接受FCFN服务， 个月，并将对50名青年和 像往常一样接受服务的护理人员。我们将探讨调解人（例如，对领航员的满意度，青年 治疗动机，感知的护理障碍）和调节者（例如，种族、族裔、性别）的干预 影响，使干预机制了解变化以及关键的人口和其他背景因素 与试验结果相关。最后，我们还将对试验参与者进行定性离职面谈， 导航员更深入地了解对试点结果的影响，从而为未来更大的功效提供信息 有效性试验。

Project Summary Youth in the child welfare system have documented high rates of mental health symptoms and experience significant disparities in mental health care services access and engagement relative to youth not in the child welfare system. Navigator models have been developed in the healthcare field to address challenges of service access, fragmentation and continuity that impact quality of care, but at present there is no empirically supported mental health navigator model to address the unique and complex mental health needs of child welfare involved (CWI) youth. This developmental study will be conducted in three phases consistent with study aims. The study will take a mixed-methods, multi-informant participatory research approach to developing, iteratively refining and pilot testing a Foster Care Family Navigator (FCFN) model to improve mental health service outcomes for adolescents (ages 12-17) involved in the child welfare system. The navigator model will leverage digital health technology to engage with and improve care coordination, tracking and monitoring of mental health service needs for these youth and families. The study will adapt the JJ- TRIALS Behavioral Health Services Cascade framework to support a data-driven decision-making approach to improving identification of mental health service needs and outcomes. The study will first utilize a combination of interagency collaborative meetings, youth and family focus groups and qualitative individual interviews with multisystem stakeholders to guide the development of the FCFN protocol. Next an open trial of the 6-month FCFN intervention will be conducted and the protocol iteratively refined through direct participant feedback. The last phase of the study will focus on conducting a modified roll-out design of the FCFN intervention with 75 child welfare involved youth. Three cohorts of 25 youth and caregivers each will receive FCFN services for 6 months and will be compared on primary outcomes of mental health initiation and engagement to 50 youth and caregivers who receive services as usual. We will explore mediators (e.g., satisfaction with navigator, youth treatment motivation, perceived barriers to care) and moderators (e.g., race, ethnicity, sex) of intervention impact to inform intervention mechanisms of change and key demographic and other contextual factors associated with trial outcomes. Finally, we will also conduct qualitative exit interviews with trial participants and navigators to gain a deeper understanding of influences on pilot outcomes that can inform future larger efficacy and effectiveness trials.