Coordination of Sustainable Financing for EBTs in Youth Mental Health Services: A Fiscal Mapping Process

项目总结/摘要 持续提供循证治疗（EBT）对于解决公共卫生和 青年心理健康问题的经济影响，正如NIMH战略目标4.2所承认的那样： 与主要利益相关者合作，制定和验证维持EBT的战略。仍然 特别需要战略规划工具，以指导协调可持续供资， 青年心理健康服务机构、各种公共和私人资金来源之间的EBT，以及 承办商/中介组织（为特定EBT的交付提供指导和支持）。 建议的R21项目的具体目标是（1）制定和（2）评估，并与利益相关者的投入， 财政绘图过程，将指导战略规划工作，为青年心理健康教育的可持续性提供资金 保健服务跨学科项目小组将采用混合方法-从一个 样本为N = 40名具有EBT管理和融资专门知识的利益相关者参与者- 实现这些目标。所有拟议的研究将集中在两个广泛传播的范例EBT （亲子互动疗法和创伤集中认知行为疗法），以最大限度地提高 在现有资源范围内推广成果。该项目的目标1是绘制财政状况图 过程：一个多步骤，结构化的过程，指导青年心理健康服务机构及其合作伙伴， 选择最佳战略组合，为其EBT维持工作提供资金。我们将调整一个 建立了干预规划进程，并将23项已制定的筹资战略纳入其中 我们的团队。我们将让利益相关者参与修改后的德尔菲练习，以达成共识 了解财政规划过程的关键步骤，并收集可以为融资选择提供信息的信息 战略布局该项目的目标2将与目标1同时进行， 关于EBT维持能力的财政规划过程（即，结构和流程， 战略规划）和成果（例如，在青少年心理健康服务机构中，每个 参与机构将领导财政绘图过程的试点测试，涉及其中介和资金 机构合作伙伴。我们将评估财政规划过程如何影响与以下方面相关的能力和成果： 采用比较案例研究方法，纳入利益攸关方重点群体的数据， 和文件审查。试点测试后，参与者将概念化的过程和结果的财政 在参与性建模工作中进行绘图，以帮助为今后对财政绘图过程的评价提供信息。 最终，拟议的研究将产生一个财政绘图过程，将促进协调 为青年心理健康服务中的EBT提供持续资金。符合《公约》的探索性目标， R21机制，这个新项目的结果将直接告知计划的大规模R 01有效性- 实施试验，以测试财政绘图流程对各种EBT可持续性的影响。

PROJECT SUMMARY/ABSTRACT Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, as recognized by NIMH’s Strategic Objective 4.2: to develop and validate strategies for sustaining EBTs in partnership with key stakeholders. There remains a particularly significant need for strategic planning tools that can guide coordination of sustainable funding for EBTs among youth mental health service agencies, various public and private funding sources, and purveyor/intermediary organizations (which provide guidance and support on the delivery of specific EBTs). The Specific Aims of the proposed R21 project are to (1) develop and (2) evaluate, with stakeholder input, a fiscal mapping process that will guide strategic planning efforts to finance sustainment of EBTs in youth mental health services. The interdisciplinary project team will employ a mixed method approach – with input from a sample of N = 40 stakeholder participants with expertise in the administration and financing of EBTs – to accomplish these aims. All of the proposed research will focus on two widely-disseminated exemplar EBTs (Parent-Child Interaction Therapy and Trauma-Focused Cognitive-Behavioral Therapy) to maximize generalizability of results within the available resources. Aim 1 of the project is to develop the fiscal mapping process: a multi-step, structured process that guides youth mental health service agencies and their partners in selecting the optimal combination of strategies for financing their EBT sustainment efforts. We will adapt an established intervention mapping process and incorporate a compilation of 23 financing strategies developed by our team. We will engage our stakeholder participants in a modified Delphi exercise to achieve consensus on the key steps of the fiscal mapping process and gather information that can inform selection of financing strategies. Aim 2 of the project, which will proceed concurrently with Aim 1, is to evaluate preliminary impact of the fiscal mapping process on EBT sustainment capacities (i.e., structures and processes that support strategic planning) and outcomes (e.g., intentions to sustain) in youth mental health service agencies. Each participating agency will lead a pilot test of the fiscal mapping process, involving their intermediary and funding agency partners. We will evaluate how the fiscal mapping process impacts capacities and outcomes linked to EBT sustainment using a comparative case study approach, incorporating data from stakeholder focus groups and document review. After pilot testing, the participants will conceptualize the process and outcomes of fiscal mapping in a participatory modeling exercise to help inform future evaluations of the fiscal mapping process. Ultimately, the proposed research will generate a fiscal mapping process that will facilitate the coordination of sustained funding for EBTs in youth mental health services. Consistent with the exploratory objectives of the R21 mechanism, the results of this novel project will directly inform a planned large-scale R01 effectiveness- implementation trial to test the impact of the fiscal mapping process on sustainability of a wide variety of EBTs.