Examining the Potential of Shared Decision Making to Improve the Effectiveness of Youth Mental Health Treatment in Community Mental Health Centers

检验共同决策在提高社区心理健康中心青少年心理健康治疗有效性方面的潜力

• 批准号: 10623190
• 负责人: Jennifer Lynn Cecilione Herbst
• 金额: $ 0.81万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-16 至 2023-06-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10623190
• 关键词: 13 year old; Address; Adult; Affect; Age; Agreement; American; Anxiety; Archives; Caregivers; Child; Client; Clinical; Clinical Trials; Code; Community Mental Health Centers; Consensus; Data; Development; Effectiveness; Evaluation; Evidence based program; Feedback; Foundations; Generations; Goals; Health; Knowledge; Link; Literature; Manuals; Measurement; Measures; Medical; Mental Health; Mental Health Services; Mental disorders; Methods; National Institute of Mental Health; Outcome; Participant; Patients; Population; Process; Provider; Psyche structure; Psychometrics; Quality of Care; Reporter; Research; Research Personnel; Review Literature; Sampling; Science; Tape Recording; Techniques; Training; Validity and Reliability; Youth; career; cultural values; design; effectiveness trial; improved; male; multilevel analysis; preference; secondary analysis; shared decision making; skills; trait; treatment as usual; trial comparing

PROJECT SUMMARY Up to one third of American youth struggle with a mental health (MH) disorder, which are associated with negative short- and long-term outcomes. Fortunately, evidence-based programs (EBPs) have demonstrated positive effects for youth MH disorders in clinical trials. However, the effectiveness of these EBPs in community MH centers (CMHCs), where most youth receive MH services, has been disappointing. Thus, improving the effectiveness of EBPs for youth in CMHCs is critical to health outcomes for these youth. One method by which clinicians can potentially achieve this goal is by implementing shared decision making (SDM) practices in conjunction with EBPs. SDM is a process by which clinicians and clients collaboratively make treatment decisions. Evidence from the medical and adult MH treatment fields suggests that SDM can improve the patient-provider relationship as well as improve clinical outcomes. By implementing SDM practices (e.g., discussing treatment options with youth and caregivers), clinicians may be better suited to adapt EBPs to fit client preferences, ideals, and cultural values. However, SDM in youth MH treatment is understudied, and thus clinicians may not know the ideal methods for implementing SDM practices with their youth clients. A critical gap this field is the paucity of measures designed to assess SDM practices in youth MH treatment. This project fills this gap with a reliable and valid observer-rated measure of SDM practices designed for youth MH treatment (i.e., the Shared Decision Making in Youth Mental Health Treatment Scale or SDM-YMH) and thus addresses NIMH’s research Objective 4.1 by contributing to research aimed at improving the effectiveness of EBPs in CMHCs. This project’s overarching goal will be addressed via two specific aims: 1) develop and evaluate the initial reliability and validity of SDM-YMH item and subscale scores, and 2) examine the predictive validity of SDM-YMH subscale scores. These aims will be realized by the secondary analysis of therapy tapes recorded as part of an effectiveness trial as well as accompanying treatment integrity and alliance data. The 38 youth participants (52.6% male, 60.5% White) in these therapy sessions ranged in age from 8 to 13 years old (M = 9.84, SD = 1.65). The SDM-YMH will be developed and evaluated via an iterative process: 1) SDM literature review, 2) generation of items, with the incorporation of expert consensus, 3) pilot coding and generation of an accompanying SDM-YMH coding manual, 4) training of coders, 5) coding of treatment sessions, and 6) examination of interrater reliability, construct validity, and predictive validity. This project will result in a new observer-rated measure of SDM practices specific to youth MH treatment, thereby filling a critical gap in the literature. It is expected that study findings will help inform future research regarding the development and evaluation of clinician practices that can increase the effectiveness of EBPs in CMHCs with youth clients.

项目摘要 多达三分之一的美国青年患有心理健康（MH）障碍，这与以下因素有关： 短期和长期的负面结果。幸运的是，循证医学项目（EBP）已经证明， 在临床试验中对青少年精神分裂症有积极作用。然而，这些EBPs在社区中的有效性 MH中心（CMHC），大多数年轻人接受MH服务，一直令人失望。因此，改善 CMHC中的青年EBP的有效性对这些青年的健康结果至关重要。的一种方法 临床医生可以通过实施共享决策（SDM）实践来实现这一目标， 与EBP结合。SDM是临床医生和客户合作进行治疗的过程 决策来自医学和成人MH治疗领域的证据表明，SDM可以改善 医患关系以及改善临床结果。通过实施可持续发展管理做法（例如， 与青少年和护理人员讨论治疗方案），临床医生可能更适合调整EBP以适应 客户偏好、理想和文化价值观。然而，SDM在青年MH治疗中的研究不足，因此 临床医生可能不知道对他们的青少年客户实施SDM实践的理想方法。一个关键 这一领域的差距是缺乏旨在评估SDM在青年MH治疗中的做法的措施。这个项目 填补了这一空白与一个可靠的和有效的评级衡量SDM的做法，专为青年MH 处理（即，青少年心理健康治疗量表（SDM-YMH） 通过促进旨在提高 CMHC中的EBP。该项目的总体目标将通过两个具体目标来实现：1）开发和 评估SDM-YMH项目和子量表得分的初步信度和效度; 2）检验SDM-YMH项目和子量表得分的预测性 SDM-YMH子量表评分的有效性。这些目标将通过对治疗磁带的二次分析来实现 记录为有效性试验的一部分，以及伴随的治疗完整性和联盟数据。的38 在这些治疗过程中，青少年参与者（52.6%男性，60.5%白色）的年龄范围为8至13岁 （M = 9.84，SD = 1.65）。SDM-YMH将通过迭代过程进行开发和评估： 文献综述，2）生成项目，纳入专家共识，3）试点编码， 生成随附的SDM-YMH编码手册，4）编码人员培训，5）治疗编码 6）评定者间信度、结构效度和预测效度的检验。该项目将 导致一个新的衡量SDM的做法，具体到青年MH治疗，从而填补了一个 文学中的关键空白。预计研究结果将有助于为未来的研究提供信息， 开发和评估临床医生的做法，可以提高有效性的EBP在CMHC， 青年客户。