Refining and Pilot Testing a Decision Support Intervention to Facilitate Adoption of Evidence-Based Programs to Improve Parent and Child Mental Health

项目摘要 在2019财政年度，尽管美国存在寄养家庭，但仍有超过26.8万名儿童进入寄养家庭。 循证方案（EBP），可以成功地防止虐待儿童。实证依据 决策（EIDM）可以导致采用可能成功实施的EBP， 产生预期的影响。尽管存在防止虐待儿童的EBP， 未充分利用儿童福利。在这个职业发展奖建议的研究活动响应NIMH 目标4.2.c：制定、完善和试行一项执行战略，在下列情况下增加EIDM： 决策者正在采用循证保健方案，以改善心理健康和儿童福利服务。活动利用 前所未有的联邦政策机会，以防止虐待儿童和测试执行决定 真实的世界中的支助战略：《家庭第一预防服务法》。FFPSA旨在预防 通过向各州提供联邦资金，实施EBP， 支持儿童和父母的心理健康，减少父母滥用药物，提高为人父母的技能。这 该项目吸引了来自四个实施FFPSA的州的决策者，以扩展候选人先前的工作 开发创新的EIDM工具以支持EBP的采用：通过协作优化响应 评估（ORCA）。ORCA基于多准则决策分析，提供了一种结构化的方法 以达成高质量的、有证据依据的群体决策。考虑到使用ORCA等工具的群体决策 从促进中受益，本研究将开发和测试两种促进模式，以伴随ORCA： 自动化（ORCA-A）和实时（ORCA-L）。此外，一个基于网络的平台，用于托管ORCA工具和 将在决策者的投入下制定ORCA-A促进战略（目标1）。ORCA-A的影响， 然后将测试ORCA-L对决策经验、过程和结果的质量（目标2）。 将监测ORCA-A和ORCA-L采用的每个EBP的实施过程质量（目标3）。到 增强她在实施，决策和系统科学的坚实基础，候选人，博士。 Gracelyn Cruden将利用这些研究活动和培训活动来扩展她的技能，包括： 在服务系统中领导实施研究，采用连续的方法， 社区成员，利用跨学科的方法来引出成员的偏好， 先进的模拟模型测试，并使用先进的统计多层次，纵向研究。Cruden 将由一个由初级导师丽莎索尔达娜博士领导的优秀团队指导， 导师：Jason Chapman博士、Lindsey齐默尔曼博士、R.克里斯托弗·谢尔德里克，乔纳森·珀特尔博士， 顾问大卫凡尼斯博士和克莱尔安德森女士。完成这些活动后，Cruden将 配备领导一个跨学科的研究团队，将支持高质量的心理健康和儿童福利 通过增加决策者对EIDM的使用来提供服务。

PROJECT SUMMARY Over 268,000 children entered foster care in the United States during fiscal year 2019 despite the existence of evidence-based programs (EBPs) that can successfully prevent child maltreatment. Evidence-informed decision-making (EIDM) can lead to the adoption of EBPs that are likely to be successfully implemented and result in the intended impacts. Despite the existence of EBPs to prevent child maltreatment, EBPs are underutilized in child welfare. Proposed study activities in this career development award respond to NIMH Objective 4.2.c by developing, refining, and piloting an implementation strategy to increase EIDM when decision makers are adopting EBPs to improve mental health and child welfare services. Activities leverage an unprecedented federal policy opportunity to prevent child maltreatment and test implementation decision support strategies in the real world: The Family First Prevention Services Act (FFPSA). FFPSA aims to prevent child maltreatment and foster care entries by providing federal funding to states for implementing EBPs that support child and parent mental health, reduce parental substance misuse, and improve parenting skills. This project engages decision makers from four states implementing FFPSA to extend the candidate’s prior work developing an innovative EIDM tool to support EBP adoption: Optimizing Responses through Collaborative Assessments (ORCA). ORCA is based in multi-criteria decision analysis, which provides a structured approach to reach quality, evidence-informed group decisions. Given that group decisions with tools such as ORCA benefit from facilitation, this study will develop and test two facilitation modalities to accompany ORCA: automated (ORCA-A) and live (ORCA-L). In addition, a web-based platform to host the ORCA tool and the ORCA-A facilitation strategy will be developed with decision makers’ input (Aim 1). The impact of ORCA-A and ORCA-L on quality of decision experiences, processes, and outcomes then will be tested (Aim 2). Implementation process quality for each EBP adopted with ORCA-A and ORCA-L will be monitored (Aim 3). To enhance her strong foundation in the implementation, decision, and systems sciences, the candidate, Dr. Gracelyn Cruden, will leverage these research activities and training activities to expand her skillset to include: leading implementation studies in service systems, employing a continuum of methods for engaging community members, leveraging interdisciplinary approaches for eliciting members’ preferences, conducting advanced simulation model testing, and using advanced statistics for multilevel, longitudinal studies. Cruden will be mentored by an outstanding team led by Primary Mentor Dr. Lisa Saldana, who is accompanied by Mentors Dr. Jason Chapman, Dr. Lindsey Zimmerman, Dr. R. Christopher Sheldrick, Dr. Jonathan Purtle, and Consultants Dr. David Vanness, and Ms. Clare Anderson. Upon completion of these activities, Cruden will be equipped to lead an interdisciplinary research team that will support quality mental health and child welfare services by increasing decision makers’ use of EIDM.