Improving Transition Outcomes for Youth with Autism Spectrum Disorder from within a Medicaid Accountable Care Organization

在医疗补助责任护理组织内改善患有自闭症谱系障碍的青少年的过渡结果

• 批准号: 10571426
• 负责人: Michael Silverstein
• 金额: $ 15.08万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10571426
• 关键词: Improving; Transition; Outcomes; Youth; Autism

PROJECT SUMMARY Despite an increasing number of American children with autism spectrum disorder (ASD), fragmentation across child and adult service systems results in poor education, employment and health outcomes for transition-age youth. Whereas much research is being conducted among young children with ASD, there has been less work that addresses the topic of care transitions for older youth. The purpose of this K18 Career Enhancement Award is to equip an experienced clinical trial investigator, Michael Silverstein, MD, MPH, with new skills and knowledge in the area of ASD transition research, so that he can expand his research portfolio in this direction. To date, Dr. Silverstein has conducted mental health services research among disparity populations, primarily in the field of depression prevention. This K18 outlines a two-year plan, whereby Dr. Silverstein will work with new mentors to augment his content and methodologic expertise, expand his mentoring capacity in ASD transitions research, and conduct a randomized pilot study to optimize a problem- solving based transition intervention that supports youth's autonomy, but addresses the variable functional abilities of the ASD population by including other family members as intervention participants. The premise of the K18 research plan is that successful transition to adulthood for the ASD population depends on a mixture of systems- and family-level strategies. The proposed intervention, therefore, will be embedded in a series of broader, systems-level transition strategies currently being deployed in a large Medicaid accountable care organization. The primary aim of the pilot trial is to optimize a prototype problem solving intervention model. Model refinements will focus on new components specific to youth with ASD and on determining the optimal degree of parental involvement in the intervention for youth with varying functional abilities. Concurrent qualitative work aims to generate hypotheses concerning testable intervention targets for how problem solving strategies could impact ASD transition outcomes. To support this research, Dr. Silverstein's K18 career development activities include structured mentor meetings that emphasize learning intervention design for youth with ASD and becoming familiar with service systems in education, vocational training and housing. Other activities include a 2-month internship at the Riverview School (which specializes in children with ASD) to learn educational strategies that could be incorporated into intervention design; and group mentoring experiences to develop the careers of junior investigators interested in studying ASD services for transition-age youth. The K18 is designed to set the stage for a clinical trial of a new intervention model to promote successful care transition and for a sustained shift in Dr. Silverstein's research focus.

项目摘要 尽管有自闭症谱系障碍（ASD）的美国儿童数量越来越多 整个儿童和成人服务系统导致教育，就业和健康成果不佳 过渡时代青年。尽管在ASD的幼儿中正在进行许多研究，但 较少的工作解决了年长青年的护理过渡主题。这个K18职业的目的 增强奖是为了配备经验丰富的临床试验研究员Michael Silverstein，MD，MPH， 在ASD过渡研究领域的新技能和知识，以便他可以扩大研究组合 朝这个方向。迄今为止，Silverstein博士已经进行了心理健康服务研究 人口主要在预防抑郁症领域。该K18概述了一项为期两年的计划，并概述了博士。 Silverstein将与新导师合作，以扩大他的内容和方法论专业知识，扩大他的内容 指导ASD过渡研究中的能力，并进行一项随机试验研究以优化问题 - 基于解决的基于支持青年自治的过渡干预措施，但可以解决可变功能 ASD人口的能力通过将其他家庭成员包括在干预参与者中。 K18研究计划的前提是，为ASD人群成功过渡到成年 取决于系统和家庭级策略的混合。因此，拟议的干预将是 嵌入了一系列更广泛的系统级过渡策略中，目前正在大规模部署 医疗补助责任组织。试验试验的主要目的是优化原型问题 解决干预模型。模型改进将重点关注ASD和ASD和ASD青年的新组件 确定父母在功能不同的年轻人干预中的最佳程度 能力。同时定性工作旨在产生有关可检验的干预目标的假设 解决问题的策略如何影响ASD过渡结果。为了支持这项研究，博士 Silverstein的K18职业发展活动包括强调学习的结构化导师会议 ASD青年的干预设计并熟悉教育中的服务系统，职业 培训和住房。其他活动包括在河景学校实习2个月（专门 在ASD的儿童中）学习可以纳入干预设计的教育策略；和 小组指导经验，以发展有兴趣研究ASD服务的初级调查人员的职业 对于过渡时代的青年。 K18旨在为新干预模型的临床试验奠定基础 促进成功的护理过渡，并持续改变Silverstein博士的研究重点。