By Youth, For Youth: Digital Supported Peer Navigation for Addressing Child Mental Health Inequities

项目摘要 尽管在过去几十年里，在研究、实践和政策方面取得了重大进展，但许多儿童和 青年继续经历基于他们的社会经济劣势，种族， 或少数民族身份，或移民身份。非洲裔美国人和拉丁裔青年的几率要高出1.5-3倍 比他们的白色同行经历未满足的心理健康需求， 与贫困有关的心理健康社会决定因素的负面影响。凭借他们无与伦比的能力 覆盖青年、学校和儿科初级保健服务是提供心理健康的理想中心， 卫生保健，社会服务和预防，以学生和家庭谁否则面临的障碍，照顾。使用 参与设计和社区合作参与研究（CPPR），加州大学洛杉矶分校和加州大学旧金山分校 洛杉矶儿童健康信托基金会和旧金山弗朗西斯科健康网络的精神病学研究中心 建议：（1）充分共同设计（与青年，护理人员，临床医生和其他利益相关者）一个创新的精神 健康数字工具，称为4 Youth，以实现算法支持的心理健康和社会决定因素 筛查和分诊、弹性应用程序和导航活动，并帮助支持初级护理-临床 学校中心和儿科服务中的劳动力;（2）研究两项心理健康计划的实施情况 单独的导航模型（家庭导航+4Youth和青少年导航+4Youth）及其组合 提高青年与适当水平的护理和支持的联系和匹配的有效性。这个项目 将在10个洛杉矶统一区的11-24岁青年、家庭和社区成员中发起 学区（LAUSD）健康中心和10个旧金山弗朗西斯科健康网络儿科初级保健 中心，主要为黑人，拉丁美洲和亚洲儿童服务。移动的技术方法正在获得 经验支持，并具有增强心理健康导航模型的巨大潜力。结合 可扩展的数字健康工具和统计评估算法，以帮助导航过程，如 筛查，分类，跟踪，连接到护理，和多层次的沟通，将有助于确保青年 接受导航员、提供者和其他相关系统可以衡量的最佳护理。一个成功 该项目的成果是CPPR开发的开源干预措施，可在学校实施， 儿科初级保健服务，以改善少数群体青年获得心理健康服务的机会。

PROJECT SUMMARY Despite significant progress in research, practice, and policy over the past few decades, many children and youth continue to experience poor mental health outcomes based on their socioeconomic disadvantage, ethnic or racial minority status, or immigrant status. African American and Latino youth have 1.5–3 times greater odds of experiencing an unmet mental health need than do their white counterparts and are more likely to be negatively impacted by social determinants of mental health related to poverty. With their unrivaled ability to reach youth, school-based and pediatric primary care services are ideal hubs to provide mental health, healthcare, social services, and prevention to students and families who otherwise face barriers to care. Using Participatory Design and Community Partnered Participatory Research (CPPR), UCLA and UCSF psychiatry research centers with Los Angeles Trust for Children’s Health and San Francisco Health Network propose to: (1) Fully co-design (with youth, caregivers, clinicians and other stakeholders) an innovative mental health digital tool, called 4Youth, to implement algorithmically supported mental health and social determinants screening and triage, resiliency apps and navigation activities AND help support the primary care-clinical workforce within school centers and pediatric services; (2) Study the implementation of two mental health navigation models separately (family navigaton+4Youth and youth navigation+4Youth), and their combined effectiveness for improving connecting and matching youth to the right level of care and supports. This project will be initiated with youth 11-24 years old and family and community members across 10 Los Angeles Unified School District (LAUSD) Wellness Centers and 10 San Francisco Health Network pediatric primary care centers, which serve mostly Black, Latino, and Asian children. Mobile technology approaches are gaining empirical support and hold great potential for enhancing mental health navigator models. Incorporating scalable digital health tools, and statistically evaluated algorithms to aid the navigation process, such as screening, triage, tracking, connecting to care, and multi-level communication, will help ensure youth are receiving optimal care that navigators, providers and other relevant systems can measure. A successful outcome of the project is a CPPR developed open-source intervention implementable in school-based and pediatric primary care services, for improving mental health services access for minoritized youth.