A Mobile Text Approach to Measurement and Feedback for Wraparound Care Coordination

摘要 美国有1500万儿童和青少年患有可诊断的心理健康（MH）障碍， 大约一半（600万至800万）被认为经历了严重的情绪障碍（SED）。集成、多功能 协调多个帮助者和提供多种干预措施的模式社区系统， 确定了解决青年人面临的复杂和多方面的问题与SED。其中一个模型是 环绕式服务模式（WSM），已被引用在多个主要的审查有效的社区治疗， 并被列入卫生部长关于青少年心理健康和暴力的报告。与其他情况一样， 循证实践，数据被一致地测量和用于告知护理的程度，即， “测量为基础的护理”或MBC-占很大比例的变化，在结果的总结。 这个SBIR项目的目标是开发和测试短消息辅助响应治疗， 环绕式（SMART-环绕式）应用程序，以克服当前在测量和使用数据方面的障碍， 日常服务设置。SMART-Wrap将通过SMS系统促进MBC，从而告知和改进 服务和临床结果。在第一阶段，我们将实现四个具体目标。首先，我们将与一个 多元化的专家顾问团队，在开发心理健康应用程序和管理WSM方面经验丰富 服务，以创建原型评估项目，并编制一个基于网络的“后端”系统， 通过定制的SMS评估项目。第二，我们会评估这个青年原型系统的可行性， SED和他们的照顾者，以及确定基于SMS的项目的心理测量特性。三是 将设计和程序原型WSM护理团队仪表板功能，以提供一个可行的和可接受的 在线系统，用于跟踪收集的数据，确定关键调查结果，并促进MBC。最后，我们将进行 初步试点测试，以评估智能包裹在典型的包裹式服务中对SED青少年的可行性， 让家庭和Wraparound护理团队成员在2个月的时间内使用原型。一期 定量和定性数据将用于为第二阶段研发计划提供信息。建议的SMART Wrap 该产品将利用短信的简单性和可访问性优势， 总结服务并将当前总结实践转向MBC。最终的结果将是一个严格的 测试了新的移动的常规结果监测（ROM）解决方案，以帮助改善服务和临床结果 为美国超过六百万的年轻人提供服务。

Abstract Fifteen million children and adolescents in the U.S. experience a diagnosable mental health (MH) disorder, with approximately half (6 to 8 million) considered to experience a serious emotional disorder (SED). Integrated, multi- modal community systems to coordinate multiple helpers and provision of multiple interventions have been identified to address the complex and multifaceted problems faced by youth with SED. One such model, the Wraparound service model (WSM), has been cited in multiple major reviews of effective community treatments, and is listed in the Surgeon General's Reports on youth mental health and violence. As is the case for other evidence-based practices, the degree to which data are consistently measured and used to inform care—i.e., “measurement-based care” or MBC—accounts for a large proportion of variance in outcomes for Wraparound. The goal of this SBIR project is to develop and test the Short Message Assisted Responsive Treatment for Wraparound (SMART-Wrap) application to overcome the current barriers to measuring and using data in everyday service settings. SMART-Wrap will facilitate MBC with an SMS system and thus inform and improve both service and clinical outcomes. In Phase I, we will accomplish four specific aims. First, we will work with a diverse group of expert advisors, experienced in developing mental health applications and administering WSM services, to create prototype assessment items and program a web-based `back-end' system for deploying assessment items via customized SMS. Second, we will assess feasibility of this prototype system for youth with SED and their caregivers, as well as determine the psychometric properties of the SMS-based items. Third, we will design and program prototype WSM care team dashboard functions to provide a feasible and acceptable online system for tracking collected data, identifying key findings, and facilitating MBC. Lastly, we will conduct an initial pilot test to evaluate feasibility of SMART-Wrap in typical Wraparound service for youth with SED by having both families and Wraparound care team members use the prototype over a 2-month period. Phase I quantitative and qualitative data will be used to inform the Phase II R&D plan. The proposed SMART-Wrap product will harness the simplicity and accessibility benefits of SMS to significantly improve engagement in Wraparound services and shift current Wraparound practice toward MBC. The end result will be a rigorously tested new mobile Routine Outcome Monitoring (ROM) solution to help improve service and clinical outcomes for the over six million youth in the U.S. with SED.