Coordination of Sustainable Financing for EBTs in Youth Mental Health Services: A Fiscal Mapping Process

青年心理健康服务中 EBT 可持续融资的协调：财政规划过程

• 批准号: 10356110
• 负责人: Alex Richard Dopp
• 金额: $ 26.21万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-19 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10356110
• 关键词: Address; Behavioral; Case Management; Case Study; Characteristics; Clinical Treatment; Cognitive; Cognitive Therapy; Communities; Concept Formation; Consensus; Consultations; Cost Sharing; Data; Evaluation; Evidence based treatment; Exercise; Exploratory/Developmental Grant; Fee-for-Service Reimbursements; Feedback; Focus Groups; Foundations; Funding; Funding Agency; Future; Goals; Government Agencies; Insurance; Knowledge; Lead; Leadership; Link; Mental Health; Mental Health Services; Methods; Modeling; National Institute of Mental Health; Outcome; Parent-Child Relations; Participant; Privatization; Problem behavior; Process; Public Health; Research; Resources; Sampling; Secure; Services; Strategic Planning; Stream; Structure; Testing; Training; Trauma; United States National Institutes of Health; Work; Youth; base; comparative; cost; cost effective; economic impact; effectiveness implementation trial; experience; implementation research; innovation; intervention mapping; novel; pilot test; prospective; recruit; sustainability framework; tool; traumatic stress

PROJECT SUMMARY/ABSTRACT Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, as recognized by NIMH’s Strategic Objective 4.2: to develop and validate strategies for sustaining EBTs in partnership with key stakeholders. There remains a particularly significant need for strategic planning tools that can guide coordination of sustainable funding for EBTs among youth mental health service agencies, various public and private funding sources, and purveyor/intermediary organizations (which provide guidance and support on the delivery of specific EBTs). The Specific Aims of the proposed R21 project are to (1) develop and (2) evaluate, with stakeholder input, a fiscal mapping process that will guide strategic planning efforts to finance sustainment of EBTs in youth mental health services. The interdisciplinary project team will employ a mixed method approach – with input from a sample of N = 40 stakeholder participants with expertise in the administration and financing of EBTs – to accomplish these aims. All of the proposed research will focus on two widely-disseminated exemplar EBTs (Parent-Child Interaction Therapy and Trauma-Focused Cognitive-Behavioral Therapy) to maximize generalizability of results within the available resources. Aim 1 of the project is to develop the fiscal mapping process: a multi-step, structured process that guides youth mental health service agencies and their partners in selecting the optimal combination of strategies for financing their EBT sustainment efforts. We will adapt an established intervention mapping process and incorporate a compilation of 23 financing strategies developed by our team. We will engage our stakeholder participants in a modified Delphi exercise to achieve consensus on the key steps of the fiscal mapping process and gather information that can inform selection of financing strategies. Aim 2 of the project, which will proceed concurrently with Aim 1, is to evaluate preliminary impact of the fiscal mapping process on EBT sustainment capacities (i.e., structures and processes that support strategic planning) and outcomes (e.g., intentions to sustain) in youth mental health service agencies. Each participating agency will lead a pilot test of the fiscal mapping process, involving their intermediary and funding agency partners. We will evaluate how the fiscal mapping process impacts capacities and outcomes linked to EBT sustainment using a comparative case study approach, incorporating data from stakeholder focus groups and document review. After pilot testing, the participants will conceptualize the process and outcomes of fiscal mapping in a participatory modeling exercise to help inform future evaluations of the fiscal mapping process. Ultimately, the proposed research will generate a fiscal mapping process that will facilitate the coordination of sustained funding for EBTs in youth mental health services. Consistent with the exploratory objectives of the R21 mechanism, the results of this novel project will directly inform a planned large-scale R01 effectiveness- implementation trial to test the impact of the fiscal mapping process on sustainability of a wide variety of EBTs.

项目概要/摘要 持续提供循证治疗 (EBT) 对于解决公共卫生和公共卫生问题至关重要 正如 NIMH 战略目标 4.2 所认识到的，青少年心理健康问题的经济影响： 与主要利益相关者合作制定和验证维持 EBT 的战略。 尤其迫切需要能够指导协调可持续资金的战略规划工具 青少年心理健康服务机构、各种公共和私人资金来源之间的 EBT，以及 供应商/中介组织（为特定 EBT 的交付提供指导和支持）。 拟议 R21 项目的具体目标是 (1) 开发和 (2) 根据利益相关者的意见评估 财政规划流程将从战略上指导规划工作，以实现青年心理领域 EBT 的财务可持续性 跨学科项目团队将采用混合方法，并听取专家的意见。 N = 40 个在 EBT 管理和融资方面具有专业知识的利益相关者参与者的样本 – 所有拟议的研究都将集中于两个广泛传播的 EBT 范例。 （亲子互动疗法和以创伤为中心的认知行为疗法）最大化 该项目的目标 1 是制定财政规划。 流程：一个多步骤、结构化的流程，指导青少年心理健康服务机构及其合作伙伴 我们将选择最佳的策略组合来为其 EBT 可持续发展努力提供融资。 建立了干预规划流程并纳入了已制定的 23 项融资策略的汇编 我们将让利益相关者参与修改后的德尔菲练习，以达成共识。 了解财政规划过程的关键步骤并收集可为融资选择提供信息的信息 该项目的目标 2 将与目标 1 同时进行，是评估战略的初步影响。 关于 EBT 可持续性能力的财政规划流程（即支持的结构和流程） 青少年心理健康服务机构的战略规划）和成果（例如维持意图）。 参与机构将牵头进行财政规划流程的试点测试，其中涉及其中介机构和资金 我们将评估财政规划流程如何影响相关能力和成果。 使用比较案例研究方法并纳入利益相关者焦点小组的数据来维持 EBT 和文件审查后，将概念化财政的过程和结果。 在参与式建模活动中进行绘图，以帮助为未来对财政绘图过程的评估提供信息。 最终，拟议的研究将产生一个财政规划过程，该过程将促进协调 为青少年心理健康服务的 EBT 提供持续资助，这与该项目的探索性目标一致。 R21机制，这个新颖项目的结果将直接告知计划中的大规模R01有效性- 实施试验，以测试财政规划流程对各种 EBT 可持续性的影响。