Foster Care Mental Health Family Navigator

寄养心理健康家庭导航

• 批准号: 10382292
• 负责人: MARINA TOLOU-SHAMS
• 金额: $ 24.13万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-20 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10382292
• 关键词: Address; Adherence; Adolescent; Age; Area; Behavioral trial; Biological; California; Caregivers; Case Management; Child Welfare; Clinical; Collaborations; Complex; Continuity of Patient Care; Data; Decision Making; Dependence; Development; Ethnic Origin; Family; Family health status; Feedback; Focus Groups; Fostering; Future; Health; Health Personnel; Health Services; Health Services Accessibility; Health Services Needs; Health Technology; Healthcare; Improve Access; Individual; Intervention; Interview; Justice; Laws; Lawyers; Legal; Malignant Neoplasms; Mediator of activation protein; Mental Health; Mental Health Services; Methods; Modeling; Monitor; Motivation; Outcome; Parents; Participant; Pattern; Personal Satisfaction; Phase; Process; Protocols documentation; Psyche structure; Quality of Care; Race; Research; Role; Safety; Schools; Services; Symptoms; System; Testing; Text Messaging; Time; Training; Waiting Lists; Youth; acceptability and feasibility; barrier to care; base; behavioral health; care coordination; child mental health service; cohort; contextual factors; court; design; digital health; effectiveness trial; efficacy trial; experience; foster care; health care availability; health knowledge; improved; informant; mHealth; meetings; model design; navigator intervention; pilot test; prevent; primary outcome; racial and ethnic; remote monitoring; satisfaction; screening; services as usual; sex; substance use; success; therapy development; tv watching

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.

项目摘要 儿童福利系统中的青年记录了很高的心理健康症状和经历。 与非儿童青少年相比，在获得和参与精神卫生保健服务方面存在重大差距 福利制度。医疗保健领域已经开发了导航器模型，以应对 影响护理质量的服务获取、碎片化和连续性，但目前还没有经验证明 支持心理健康导航器模型，以满足儿童独特而复杂的心理健康需求 福利参与(CWI)青年。这项发展研究将分三个阶段进行，符合 研究目的。这项研究将采取混合方法、多信息者参与的研究方法 开发、迭代改进和试点测试寄养护理家庭导航器(FCFN)模型以改进 参与儿童福利制度的青少年(12-17岁)的心理健康服务结果。这个 导航者模式将利用数字医疗技术参与并改进护理协调、跟踪 以及监测这些青少年和家庭的心理健康服务需求。这项研究将使JJ- 试验行为健康服务级联框架，支持数据驱动的决策方法 改进对精神卫生服务需求和结果的识别。这项研究将首先利用一个组合 机构间协作会议、青年和家庭焦点小组以及定性的个人访谈 多系统利益攸关方指导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反复改进方案。 研究的最后阶段将侧重于对FCFN干预措施进行修改后的推广设计，75 儿童福利涉及青年。三组各25名青年和照顾者将接受FCFN服务，费用为6 几个月后，将对50名青年和 照常接受服务的护理员。我们将探索调解人(例如，对导航员、青年的满意度 治疗动机、感知的护理障碍)和干预的调节因素(例如种族、民族、性别) 向干预机制通报变化的影响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的离职访谈，并 导航员更深入地了解对飞行员结果的影响，这些影响可以为未来更大的效果提供信息 和有效性试验。