Collaborative Mental Health Services for Behavior Disorders in Primary Care

初级保健行为障碍的协作心理健康服务

基本信息

批准号：
7768423
负责人：
DAVID KOLKO
金额：
$ 60.3万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-09-30 至 2012-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7768423
关键词：
Address Adolescent Aftercare Analysis of Variance Anxiety Anxiety Disorders Attention Attention deficit hyperactivity disorder Attitude Behavior Behavior Disorders Behavior Therapy Behavioral Belief Caring Case Manager Child Child Welfare Childhood Client Clinical Clinical Services Collaborations Communication Community Health Comorbidity Consumer Satisfaction Data Development Diagnosis Disease Disease remission Disruptive Behavior Disorder Distress Effectiveness Effectiveness of Interventions Emergency Situation Emotional Family Feedback Goals Health Status Home environment Housing Impairment Improve Access Intake Intervention Intervention Studies Justice Knowledge Learning Light Linear Models Measures Medical Medical Records Medication Management Mental Health Mental Health Services Methodology Methods Modeling Monitor Nurses Oppositional Defiant Disorder Outcome Parents Patients Pharmaceutical Preparations Physicians Pilot Projects Population Positioning Attribute Primary Care Physician Primary Health Care Problem behavior Procedures Process Provider Qualifying Quality of Care Randomized Randomized Clinical Trials Recruitment Activity Refractory Relative (related person)Reporting Research Research Personnel Resources Role Sampling Schools Services Severities Site Special Education Symptoms System Testing Training Treatment outcome Work base care delivery chronic care model clinical care collaborative care design effective intervention emerging adult evidence base expectation experience flexibility follow-up functional outcomes functional status health care delivery health related quality of life improved informant intervention program medical specialties pediatrician physical conditioning practice-based research network primary care setting psychoeducation psychosocial skills theories treatment as usual treatment program

项目摘要

DESCRIPTION (provided by applicant): This competing continuation extends our parent study (Effectiveness of Therapy for Behavior Problems in Primary Care; MH63272) by seeking to more efficiently and effectively treat children with a disruptive behavior problem (DBP) in the pediatric primary-care setting. Our enhanced treatment program, Doctor- Office Collaborative Care (DOCC), reflects a care management approach that incorporates the child's pediatrician through integrated in-house services and resources coordinated by a clinical care manager. Physician clusters from six primary care offices will be randomized to either DOCC or Treatment-as-Usual (TAU). Patients of these PCPs will simply receive the intervention condition of their respective PCPs. Background information will be collected to examine group comparability on the same three covariates as used in the original parent study (ADHD, any other comorbid disorder, prior MH treatment). Based on the findings of our parent study and year-long pilot study, several developments are incorporated herein: 1) Adaptation of the chronic care model and participatory management theory to create an evidence-based collaborative care delivery system designed to enhance training, implementation, and sustainability, 2) revised clinical content that includes medication management for ADHD, brief anxiety management, and attention to parental distress/referral, 3) technological advances to facilitate efficient processes of care, monitoring, and communication, and 4) an improved methodology that includes new samples, measures, and settings. Both intervention process (implementation) and outcome (effectiveness) data will be assessed across four timepoints: 1) intake, 2) discharge, 3) 1-year follow-up, and 4) 2-year follow-up. Assessment will include a multi-method (e.g., individualized and standardized rating scales, office medical records, provider reports), multi-informant (child, parent, care manager, pediatrician) approach to evaluate effects on key child behavioral and emotional outcomes (symptom severity, diagnoses), and functional/health status (impairment). We will also explore the impact of DOCC on child services/systems use, parental functioning, and physician beliefs/practices supportive of collaborative care. Analyses will be conducted using Hierarchical Linear Modeling and Analyses of Variance. The ultimate goal for this research is to establish the viability of an integrated mental health service delivery system within the pediatric primary care setting.

描述（由申请人提供）：这种竞争性延续扩展了我们的父母研究（对初级保健行为问题的有效性； MH63272）通过寻求在儿科初级保健环境中更有效有效地治疗具有破坏性行为问题（DBP）的儿童。我们增强的治疗计划，医生办公室合作护理（DOCC），反映了一种护理管理方法，该方法通过临床护理经理协调的内部内部服务和资源结合了儿童的儿科医生。来自六个初级保健办公室的医师聚类将被随机分为DOCC或治疗态度（TAU）。这些PCP的患者将仅接受其各自的PCP的干预条件。将收集背景信息，以检查与原始家长研究（ADHD，任何其他合并症，先前MH治疗）相同三个协变量的群体可比性。根据我们的家长研究和为期一年的试点研究的发现，本文纳入了一些发展：1）适应慢性护理模型和参与式管理理论，以创建一个基于证据的协作护理交付系统，旨在增强培训，实施和可持续性，2）修订的临床内容，包括针对ADHD的焦虑症，及时的临床管理，以及对临时的临床管理，以及对父母的痛苦和效率的效果，3）技术，3），3），技术，3），3）技术，3）技术，3）技术，三）技术，3）技术，3）技术，3）技术，3）技术，3）技术，3）技术，3）技术，3）技术，3）。交流和4）改进的方法，包括新的样本，措施和设置。干预过程（实施）和结果（有效性）数据将在四个时间点上评估：1）摄入量，2）排放，3）1年随访和4）2年随访。评估将包括多方法（例如，个性化和标准化的评分量表，办公室病历，提供者报告），多信息（儿童，家长，护理经理，儿科医生）方法，以评估对关键儿童行为和情感结果的影响（症状，诊断）以及功能/健康状况（IMBAIRMENT）。我们还将探讨DOCC对儿童服务/系统使用，父母功能以及医师信念/实践的影响。分析将使用层次线性建模和方差分析进行。这项研究的最终目标是在小儿初级保健环境中建立综合心理健康服务提供系统的可行性。