Examining the Potential of Shared Decision Making to Improve the Effectiveness of Youth Mental Health Treatment in Community Mental Health Centers

检验共同决策在提高社区心理健康中心青少年心理健康治疗有效性方面的潜力

• 批准号: 10623190
• 负责人: Jennifer Lynn Cecilione Herbst
• 金额: $ 0.81万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-16 至 2023-06-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10623190
• 关键词: 13 year old; Address; Adult; Affect; Age; Agreement; American; Anxiety; Archives; Caregivers; Child; Client; Clinical; Clinical Trials; Code; Community Mental Health Centers; Consensus; Data; Development; Effectiveness; Evaluation; Evidence based program; Feedback; Foundations; Generations; Goals; Health; Knowledge; Link; Literature; Manuals; Measurement; Measures; Medical; Mental Health; Mental Health Services; Mental disorders; Methods; National Institute of Mental Health; Outcome; Participant; Patients; Population; Process; Provider; Psyche structure; Psychometrics; Quality of Care; Reporter; Research; Research Personnel; Review Literature; Sampling; Science; Tape Recording; Techniques; Training; Validity and Reliability; Youth; career; cultural values; design; effectiveness trial; improved; male; multilevel analysis; preference; secondary analysis; shared decision making; skills; trait; treatment as usual; trial comparing

PROJECT SUMMARY Up to one third of American youth struggle with a mental health (MH) disorder, which are associated with negative short- and long-term outcomes. Fortunately, evidence-based programs (EBPs) have demonstrated positive effects for youth MH disorders in clinical trials. However, the effectiveness of these EBPs in community MH centers (CMHCs), where most youth receive MH services, has been disappointing. Thus, improving the effectiveness of EBPs for youth in CMHCs is critical to health outcomes for these youth. One method by which clinicians can potentially achieve this goal is by implementing shared decision making (SDM) practices in conjunction with EBPs. SDM is a process by which clinicians and clients collaboratively make treatment decisions. Evidence from the medical and adult MH treatment fields suggests that SDM can improve the patient-provider relationship as well as improve clinical outcomes. By implementing SDM practices (e.g., discussing treatment options with youth and caregivers), clinicians may be better suited to adapt EBPs to fit client preferences, ideals, and cultural values. However, SDM in youth MH treatment is understudied, and thus clinicians may not know the ideal methods for implementing SDM practices with their youth clients. A critical gap this field is the paucity of measures designed to assess SDM practices in youth MH treatment. This project fills this gap with a reliable and valid observer-rated measure of SDM practices designed for youth MH treatment (i.e., the Shared Decision Making in Youth Mental Health Treatment Scale or SDM-YMH) and thus addresses NIMH’s research Objective 4.1 by contributing to research aimed at improving the effectiveness of EBPs in CMHCs. This project’s overarching goal will be addressed via two specific aims: 1) develop and evaluate the initial reliability and validity of SDM-YMH item and subscale scores, and 2) examine the predictive validity of SDM-YMH subscale scores. These aims will be realized by the secondary analysis of therapy tapes recorded as part of an effectiveness trial as well as accompanying treatment integrity and alliance data. The 38 youth participants (52.6% male, 60.5% White) in these therapy sessions ranged in age from 8 to 13 years old (M = 9.84, SD = 1.65). The SDM-YMH will be developed and evaluated via an iterative process: 1) SDM literature review, 2) generation of items, with the incorporation of expert consensus, 3) pilot coding and generation of an accompanying SDM-YMH coding manual, 4) training of coders, 5) coding of treatment sessions, and 6) examination of interrater reliability, construct validity, and predictive validity. This project will result in a new observer-rated measure of SDM practices specific to youth MH treatment, thereby filling a critical gap in the literature. It is expected that study findings will help inform future research regarding the development and evaluation of clinician practices that can increase the effectiveness of EBPs in CMHCs with youth clients.

项目摘要 多达三分之一的美国青年与心理健康（MH）障碍斗争，这与 负短期和长期结果。幸运的是，循证计划（EBP）已证明 在临床试验中对青年MH疾病的积极影响。但是，这些EBP在社区中的有效性 大多数年轻人获得MH服务的MH中心（CMHC）令人失望。那，改善 EBP对CMHC中的EBP对这些年轻人的健康成果至关重要。一种方法 临床医生可以实现这一目标，是通过实施共享决策（SDM）实践 与EBP的连接。 SDM是临床医生和客户协作进行治疗的过程 决定。医疗和成人MH治疗领域的证据表明，SDM可以改善 患者支持者的关系以及改善的临床结果。通过实施SDM实践（例如， 与青年和看护者讨论治疗选择），临床医生可能更适合适应EBP 客户的偏好，思想和文化价值观。但是，了解青年MH治疗中的SDM，因此 临床医生可能不知道与青年客户实施SDM实践的理想方法。批判 差距这个领域是旨在评估青年MH治疗中SDM实践的措施的匮乏。这个项目 通过可靠且有效的观察者评价的SDM实践的测量来填补这一空白 治疗（即，在青年心理健康治疗量表或SDM-ymh中共享决策），因此 解决NIMH的研究目标4.1，旨在提高旨在提高有效性的研究 CMHC中的EBP。该项目的总体目标将通过两个具体目标来解决：1）开发和 评估SDM-YMH项目和子量表分数的初始可靠性和有效性，以及2）检查预测 SDM-YMH子量表得分的有效性。这些目的将通过二级治疗录像带实现 作为有效性试验的一部分以及参与治疗完整性和联盟数据的记录。 38 这些疗法课程的青年参与者（男性为52.6％，白色60.5％）在8至13岁之间 （M = 9.84，SD = 1.65）。 SDM-IMH将通过迭代过程开发和评估：1）SDM 文献综述，2）生成项目，使用专家共识，3）试点编码和 会议的SDM-YMH编码手册，4）编码器培训，5）治疗编码 会议和6）检查间可靠性，构建有效性和预测有效性。这个项目将 导致对特定于青年MH治疗的SDM实践进行新的观察者评分的测量 文献中的危险差距。预计研究结果将有助于告知未来的有关 对临床实践的开发和评估，可以提高CMHC中EBP的有效性 青年客户。