A Mobile Text Approach to Measurement and Feedback for Wraparound Care Coordination

摘要 在美国，有1500万儿童和青少年经历了可诊断的精神健康(MH)障碍， 大约一半(600万到800万)被认为经历了严重的情绪障碍(SED)。集成化、多功能化 协调多名帮助者和提供多项干预的模式社区系统 被确定为解决患有SED的青年面临的复杂和多方面的问题。一款这样的车型， 环绕式服务模式(WSM)在有效的社区治疗的多个主要综述中被引用， 并被列入卫生局局长关于青少年心理健康和暴力的报告中。就像其他人一样 以证据为基础的实践，数据被一致测量和用于为护理提供信息的程度--即， “基于测量的护理”或MBC--在WARPARED的结果差异中占很大比例。 该SBIR项目的目标是开发和测试短消息辅助应答治疗 环绕(SMART-Wrap)应用程序，以克服当前测量和使用数据的障碍 日常服务设置。Smart-Wrap将通过短信系统促进MBC，从而通知和改进 无论是服务还是临床结果。在第一阶段，我们将实现四个具体目标。首先，我们将使用一个 不同的专家顾问团队，在开发心理健康应用程序和管理WSM方面经验丰富 服务，以创建原型评估项目并编程基于Web的后端系统以进行部署 通过自定义短信进行考核项目。第二，我们将评估这一原型系统在青年中的可行性 SED和他们的照顾者，以及确定基于短信的项目的心理测量特性。第三，我们 将设计和规划原型WSM关怀团队仪表板功能，以提供可行和可接受的 用于跟踪收集的数据、确定关键发现和促进MBC的在线系统。最后，我们将进行 评估SMART-Wrap在青少年SED典型环绕式服务中的可行性的初步试点测试 让家庭和环绕式护理团队成员在两个月的时间内使用原型。第一阶段 将使用定量和定性数据为第二阶段研发计划提供信息。建议的智能包装 产品将利用短信的简单性和可访问性优势，显著提高 环绕式服务，并将当前的环绕式实践转向MBC。最终的结果将是一个严格的 测试了新的移动常规结果监测(ROM)解决方案，以帮助改善服务和临床结果 对于美国600多万患有自闭症的年轻人来说。

Abstract Fifteen million children and adolescents in the U.S. experience a diagnosable mental health (MH) disorder, with approximately half (6 to 8 million) considered to experience a serious emotional disorder (SED). Integrated, multi- modal community systems to coordinate multiple helpers and provision of multiple interventions have been identified to address the complex and multifaceted problems faced by youth with SED. One such model, the Wraparound service model (WSM), has been cited in multiple major reviews of effective community treatments, and is listed in the Surgeon General's Reports on youth mental health and violence. As is the case for other evidence-based practices, the degree to which data are consistently measured and used to inform care—i.e., “measurement-based care” or MBC—accounts for a large proportion of variance in outcomes for Wraparound. The goal of this SBIR project is to develop and test the Short Message Assisted Responsive Treatment for Wraparound (SMART-Wrap) application to overcome the current barriers to measuring and using data in everyday service settings. SMART-Wrap will facilitate MBC with an SMS system and thus inform and improve both service and clinical outcomes. In Phase I, we will accomplish four specific aims. First, we will work with a diverse group of expert advisors, experienced in developing mental health applications and administering WSM services, to create prototype assessment items and program a web-based `back-end' system for deploying assessment items via customized SMS. Second, we will assess feasibility of this prototype system for youth with SED and their caregivers, as well as determine the psychometric properties of the SMS-based items. Third, we will design and program prototype WSM care team dashboard functions to provide a feasible and acceptable online system for tracking collected data, identifying key findings, and facilitating MBC. Lastly, we will conduct an initial pilot test to evaluate feasibility of SMART-Wrap in typical Wraparound service for youth with SED by having both families and Wraparound care team members use the prototype over a 2-month period. Phase I quantitative and qualitative data will be used to inform the Phase II R&D plan. The proposed SMART-Wrap product will harness the simplicity and accessibility benefits of SMS to significantly improve engagement in Wraparound services and shift current Wraparound practice toward MBC. The end result will be a rigorously tested new mobile Routine Outcome Monitoring (ROM) solution to help improve service and clinical outcomes for the over six million youth in the U.S. with SED.