Testing EBP and Organization Effects in Rural Appalachia

在阿巴拉契亚乡村测试 EBP 和组织效应

• 批准号: 6685780
• 负责人: CHARLES A GLISSON
• 金额: $ 76.08万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-03 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6685780
• 关键词: behavioral /social science research tag; children; clinical research; community mental health services; cost effectiveness; health care quality; health care service availability; health care service evaluation; health disparity; health services research tag; home health care; human subject; juvenile delinquency; legal /correctional; low socioeconomic status; medically underserved population; mental health services; outcomes research; patient oriented research; rural area; social behavior disorders

DESCRIPTION (provided by applicant): The proposed study examines a two-level strategy for overcoming barriers to the implementation of effective mental health treatments for youth in very rural, deeply impoverished communities. The two-level strategy includes (1) the implementation of an evidence-based practice (EBP) delivered in the homes of referred youth by therapists organized to provide treatment over large, rural, geographical areas and (2) an organizational-community intervention (entitled ARC) that changes the social context in which the service is provided and supports therapists' efforts to serve children in widely-dispersed, isolated communities. The study will be conducted in eight of the poorest, least populated counties in the rural Appalachian Mountains of East Tennessee. The sample will include 720 children referred to juvenile courts in those counties as a result of antisocial behavior. Half of the children selected in each county will receive an EBP, Multisystemic Therapy (MST), and half will receive the usual care provided to children referred to juvenile courts in the eight counties. In addition, an organizational-community intervention (ARC) will be administered in half (four) of the counties by change agents (Ph.D. industrial-organizational psychologists trained in organizational and community development). The change agents will work with treatment teams, judges, school administrators, and other community opinion leaders to address the barriers to mental health care in rural Appalachia and develop community and organizational support for the implementation of the EBP. Multisystemic Therapy (MST) will be provided by Youth Villages, the state's largest private children's mental health service organization. MST services will be funded by the Bureau of TennCare, the state's Medicaid-waiver health insurance program that covers children eligible for Medicaid as well as the children of the working poor who are ineligible for Medicaid. The services are being structured and funded in a way that will ensure they can be sustained in each county, if successful, after the completion of the study.

描述（由申请人提供）：拟议的研究研究了一项两级战略，以克服在非常农村，深深贫困的社区中为青年实施有效的心理健康治疗的障碍。两级策略包括（1）在治疗师的转介的年轻人中实施的基于证据的实践（EBP），该治疗师组织了在大型农村，地理领域提供治疗，以及（2）组织 - 社区干预（有价值的ARC），这些干预（有价值的ARC）可以为服务提供服务，并为治疗师提供服务的社会环境，以使治疗师的努力为儿童提供服务。该研究将在东田纳西州农村阿巴拉契亚山区的八个最贫穷，人口最少的县进行。该样本将包括720名因反社会行为而引用这些县的少年法院的儿童。每个县选出的一半的孩子将获得EBP，多系统疗法（MST），一半将接受给八个县的少年法院的儿童提供的通常护理。此外，变更代理人将在一半（四个）县（四个）中管理组织社区干预（ARC）（Ph.D.工业组织心理学家接受了组织和社区发展培训）。变革特工将与治疗团队，法官，学校管理员和其他社区意见领袖一起工作，以解决阿巴拉契亚农村地区心理保健的障碍，并为实施EBP提供社区和组织支持。多系统疗法（MST）将由该州最大的私人儿童心理健康服务组织青年村提供。 MST服务将由Tenncare局资助，该州的Medicaid-Waiver健康保险计划涵盖了有资格获得医疗补助的儿童以及不符合医疗补助的工作穷人的孩子。这些服务的结构和资助以确保在研究完成后成功地在每个县维持的方式。