From Court to the Community: Improving Access to Evidence-Based Treatment for Underserved Justice-Involved Youth At-Risk for Suicide

从法院到社区:改善有自杀风险、司法服务不足的青少年获得循证治疗的机会

基本信息

  • 批准号:
    10609530
  • 负责人:
  • 金额:
    $ 61.68万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2022
  • 资助国家:
    美国
  • 起止时间:
    2022-04-15 至 2027-02-28
  • 项目状态:
    未结题

项目摘要

PROJECT SUMMARY Justice-involved youth (JIY) living in the community experience disproportionately high rates of suicidal thoughts and behavior (STB) and non-suicidal self-injury (NSSI) compared to adolescents in the general population. Many JIY lack access to evidence-based treatment specifically designed to treat NNSI and STB, thereby increasing the overall risk of suicide in this population. Further, even when JIY do have access to evidence-based treatment, treatment initiation in this population is low. The current proposal aims to reduce STB and NSSI among JIY, and thus reduce mental health disparities in this vulnerable and underserved youth population. Our primary aim is to implement a systems-level intervention designed to increase access to evidence-based treatment strategies specifically designed to treat STB and NSSI behaviors for JIY referred to outpatient care by the Rhode Island Family Court. We will conduct a cluster randomized stepped wedge trial in which 9 distinct community mental health agencies (CMHA) who serve JIY in the state of Rhode Island will be randomized to receive a standardized training program. A select number of CHMA administrators and providers will complete semi-structured qualitative interviews pre-implementation to assess agency/system-level and provider-level factors that may promote or hinder the uptake of evidenced-based treatment strategies for STB and NSSI in CMHAs serving JIY living in the community. Quantitative data will assess organizational, provider, and youth characteristics and will be collected through questionnaires CMHA providers complete and from the electronic medical record pre- implementation, immediately post-implementation, and 9-months into sustainment. It is hypothesized that at the systems level, the training program will be sustained for at least one year and up to 3 years by CMHA administrators. At the provider level, it is hypothesized that training in the use of evidence-based treatment strategies for STB and NSSI will significantly increase both the use of these strategies and the quality of their delivery over a year’s follow-up period. At the patient level, we hypothesize that the training program will improve parental adherence to outpatient treatment and reduce rates of adolescent STB and NSSI that require emergency medical/psychiatric care in our healthcare system. Our secondary aim is to examine factors that influence treatment initiation among JIY living in the community. We will enroll 180 caregivers of JIY youth who screen positive for recent NSSI/STB to test the hypothesis that JIY whose caregivers are randomized to the psychoeducation/action plan condition, compared to an educational video, will be significantly more likely to initiate treatment at a CMHA. Caregivers will complete follow-up assessments at 3- and 6-months post-baseline to assess whether their adolescent initiated treatment and how many sessions the adolescent attended. This application has strongly aligns with NIMH’s Strategic Objective 3.3: “Test interventions for effectiveness in community practice settings,” and the goals of the RFA-MH-21-187 to test effective “systems-level strategies for the detection and prevention of SIB and/or NSSI specifically among underserved children and adolescents.”
项目摘要 生活在社区中的正义参与青年(JIY)的自杀想法比例过高 和行为(STB)和非自杀性自伤(NSSI)相比,在一般人群中的青少年。许多 JIY缺乏专门用于治疗NNSI和STB的循证治疗,从而增加了 这一人群的总体自杀风险此外,即使JIY确实获得了循证治疗, 该人群的治疗起始率较低。目前的建议旨在减少JIY中的STB和NSSI, 从而减少这一弱势和得不到充分服务的青年人口的心理健康差距。我们的主要目标是 实施系统一级的干预措施,以增加获得循证治疗战略的机会 专门设计用于治疗由罗得岛转诊至门诊的JIY的STB和NSSI行为 家事法庭。我们将进行一项整群随机阶梯楔形试验, 在罗得岛州为JIY服务的卫生机构(CMHA)将被随机接受标准化的 培训计划。一些选定的CHMA管理员和供应商将完成半结构化 实施前的定性访谈,以评估可能 促进或阻碍在为JIY服务的CMHA中采用基于证据的STB和NSSI治疗策略 生活在社区里。定量数据将评估组织,供应商和青年的特点, 通过CMHA提供者完成的问卷调查和从电子病历中收集, 实施、实施后立即和维持后9个月。据推测, 系统级,培训计划将持续至少一年,CMHA将持续3年 管理员。在提供者一级,假设使用循证治疗的培训 STB和NSSI的战略将大大增加这些战略的使用和它们的质量。 在一年的随访期内交付。在患者层面,我们假设培训计划将改善 父母坚持门诊治疗,降低青少年STB和NSSI的发生率, 紧急医疗/精神病护理。我们的第二个目标是检查 影响JIY在社区中的治疗开始。我们将招募180名JIY青少年的照顾者, 最近的NSSI/STB筛查呈阳性,以检验其护理者被随机分配到 与教育视频相比,心理教育/行动计划条件更有可能 在CMHA开始治疗。护理人员将在基线后3个月和6个月完成随访评估 评估他们的青少年是否开始治疗,以及青少年参加了多少次治疗。这 应用程序与NIMH的战略目标3.3非常一致:“测试干预措施的有效性, 社区实践环境”和RFA-MH-21-187的目标,以测试有效的“系统级战略, 检测和预防SIB和/或NSSI,特别是在服务不足的儿童和青少年中。

项目成果

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Kathleen Kemp其他文献

Kathleen Kemp的其他文献

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{{ truncateString('Kathleen Kemp', 18)}}的其他基金

From Court to the Community: Improving Access to Evidence-Based Treatment for Underserved Justice-Involved Youth At-Risk for Suicide
从法院到社区:改善有自杀风险、司法服务不足的青少年获得循证治疗的机会
  • 批准号:
    10804858
  • 财政年份:
    2023
  • 资助金额:
    $ 61.68万
  • 项目类别:
From Court to the Community: Improving Access to Evidence-Based Treatment for Underserved Justice-Involved Youth At-Risk for Suicide
从法院到社区:改善有自杀风险、司法服务不足的青少年获得循证治疗的机会
  • 批准号:
    10440040
  • 财政年份:
    2022
  • 资助金额:
    $ 61.68万
  • 项目类别:
Screening and Brief Intervention for Suicidality and Nonsuicidal Self-Injury Among Youth in the Juvenile Justice System
少年司法系统中青少年自杀和非自杀自残的筛查和短期干预
  • 批准号:
    9923764
  • 财政年份:
    2018
  • 资助金额:
    $ 61.68万
  • 项目类别:
Implementing a Brief Suicide Intervention for High Risk Youth with Front-Line Juvenile Justice Staff
与一线少年司法人员一起对高危青少年实施短暂的自杀干预
  • 批准号:
    9215146
  • 财政年份:
    2016
  • 资助金额:
    $ 61.68万
  • 项目类别:
Implementing a Brief Suicide Intervention for High Risk Youth with Front-Line Juvenile Justice Staff
与一线少年司法人员一起对高危青少年实施短暂的自杀干预
  • 批准号:
    9350393
  • 财政年份:
    2016
  • 资助金额:
    $ 61.68万
  • 项目类别:

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