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Vela JC, Ramos N, Fielding C, Elizondo D. Exploring Latine Parent Leaders' and a Program Coordinator's Lived Experiences with a Culturally Adapted Parent-Directed Training Program. J Autism Dev Disord 2024:10.1007/s10803-024-06270-0. [PMID: 38443658 DOI: 10.1007/s10803-024-06270-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/07/2024]
Abstract
The purpose of the current study was to explore the lived experiences among parent leaders and a program coordinator who participated in a parent-directed training program to support other Latine parents of children with autism spectrum disorder. We used qualitative methods to explore 4 Latine parent leaders' and 1 program coordinator's experiences with a parent-directed training program to support other Latine parents who have children with autism spectrum disorder. We interviewed parent leaders and a program coordinator to learn about their lived experiences as leaders in a parent-directed training program. The following themes emerged from Interpretative Phenomenological Analysis data analysis: (a) personal growth, (b) leadership development, (c) sense of connection and community, (d) contributing to a larger and meaningful purpose, and (e) applying knowledge and skills to help other parents. A culturally adapted parent-directed training program has the potential to positively influence Latine parent leaders who are prepared to support parents of children with ASD. There were positive program impacts on parent leaders regarding personal growth, leadership development, connection and community, contribution to a larger purpose, and use of knowledge and skills to help other parents. We also discovered the importance of building a safe community for Latine parent leaders and other parents who have children with ASD in a parent-directed training program.
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Affiliation(s)
- Javier Cavazos Vela
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA.
| | - Noe Ramos
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
| | - Cheryl Fielding
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
| | - Denisse Elizondo
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
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Training of Lived Experience Workforces: A Rapid Review of Content and Outcomes. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:177-211. [PMID: 36357820 PMCID: PMC9648875 DOI: 10.1007/s10488-022-01232-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/12/2022]
Abstract
Recently, the lived and living experience (LLE) workforce in mental health and alcohol and other drugs (AOD) sectors has expanded. Despite widespread benefit of this inclusion, some LLE practitioners have encountered personal and professional challenges in their workforce roles. An essential avenue to address these challenges is through provision of training to ensure adequate LLE role preparation, and to support integration of LLE workforces within mental health and AOD settings. We aim to understand the primary components applied in LLE training programs (i.e., content and methods), the outcomes from program participation, and to summarize observed patterns between training components and outcomes. This rapid review utilized a systematic methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize existing literature on training programs for service users or carers/family in lived experience roles, in the mental health and AOD workforce. We searched CINAHL, PsycINFO, Medline, and Web of Science databases. We identified 36 relevant studies. Findings indicate short- and long-term impacts of training participation for this emerging workforce, with the most promising outcomes being increased professional knowledge and skills and improved personal psychosocial wellbeing and trauma recovery. Other positive training outcomes included high trainee satisfaction, increased application of training skills, and employment/education opportunities following training completion. Gaps and training limitations were noted in relation to the training content/delivery, trainee reservations, and personal barriers to training participation or completion. In response to program benefits and limitations investigated, we present recommendations for improving training processes for this workforce.
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Alvarez K, Cervantes PE, Nelson KL, Seag DEM, Horwitz SM, Hoagwood KE. Review: Structural Racism, Children's Mental Health Service Systems, and Recommendations for Policy and Practice Change. J Am Acad Child Adolesc Psychiatry 2022; 61:1087-1105. [PMID: 34971730 PMCID: PMC9237180 DOI: 10.1016/j.jaac.2021.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Racism is a public health crisis that impacts on children's mental health, yet mental health service systems are insufficiently focused on addressing racism. Moreover, a focus on interpersonal racism and on individual coping with the impacts of racism has been prioritized over addressing structural racism at the level of the service system and associated institutions. In this paper, we examine strategies to address structural racism via policies affecting children's mental health services. METHOD First, we identify and analyze federal and state policies focused on racism and mental health equity. Second, we evaluate areas of focus in these policies and discuss the evidence base informing their implementation. Finally, we provide recommendations for what states, counties, cities, and mental health systems can do to promote antiracist evidence-based practices in children's mental health. RESULTS Our analysis highlights gaps and opportunities in the evidence base for policy implementation strategies, including the following: mental health services for youth of color, interventions addressing interpersonal racism and bias in the mental health service system, interventions addressing structural racism, changes to provider licensure and license renewal, and development of the community health workforce. CONCLUSION Recommendations are provided both within and across systems to catalyze broader systems transformation.
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Affiliation(s)
- Kiara Alvarez
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | | | - Katherine L Nelson
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Merck & Co., Inc., Kenilworth, New Jersey
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Homophily Effect in Trauma-Informed Classroom Training for School Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127104. [PMID: 35742350 PMCID: PMC9222887 DOI: 10.3390/ijerph19127104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 02/05/2023]
Abstract
A national shortage of youth mental health professionals necessitates training others (e.g., school staff) to help youth with behavioral and mental health issues. Professional training in trauma-informed classroom (TIC) practices could increase school staff’s awareness of adverse childhood experiences (ACEs). The purpose was to determine the effect of homophily on participants’ perceptions or knowledge of TIC training. Mental Health America of Greater Houston (MHAGH) offered TIC training from 2019 to 2020 to Texas educators (N ≈ 29,900) from nine school districts that experienced significant natural and human-made traumatic events. Proportional stratified random samples were selected based on trainer type (experts vs. peer trainers). Perception was measured with close-ended items on five-point scales. Knowledge was measured with content-specific questions. Independent t-tests and two-way ANOVA revealed no significant interaction effects (i.e., trainer and test type) and no differences existed in perception or knowledge by trainer type. TIC training can be equally effective when delivered by homophilous peers (i.e., school staff) and heterophilous experts (i.e., mental health experts). COVID-19 worsened the effects of ACEs and youth mental health issues. High-quality training will increase school staff’s use of TIC practices. MHAGH’s train-the-trainer model helps educators supporting youth affected by ACEs and other life stressors.
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De Nadai AS, Quast T, Little TB, Westerberg K, Patyk KC, Monahan MF, Storch EA, Gregory ST. Intervention cost-effectiveness for pediatric anxiety and OCD: A systematic review and integrated database model. J Affect Disord 2022; 298:110-118. [PMID: 34728286 DOI: 10.1016/j.jad.2021.10.127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND While multiple treatments for pediatric anxiety and obsessive compulsive disorder (OCD) are efficacious, little is known about their cost-effectiveness. In response, we sought to provide relevant information through systematic review and cost-effectiveness simulation. METHODS We evaluated the cost-effectiveness of treatment for pediatric anxiety and OCD in two ways. First, we conducted a systematic review following PRISMA guidelines. Second, we evaluated cost-effectiveness for antidepressant medication, cognitive behavioral therapy, and their combination via a simulation that integrated information from the Truven MarketScan database and the NIMH National Database for Clinical Trials Related to Mental Illness. RESULTS Both systematic review and simulation found antidepressant medication and cognitive behavioral therapy to be cost-effective for pediatric anxiety and OCD. Antidepressant medication was the least costly approach, and cognitive behavioral therapy provided additional cost-effectiveness, especially for OCD. LIMITATIONS During systematic review, relatively few articles provided information about both costs and effectiveness. While there was a notable margin of error to support multiple interventions as cost-effective, limited prior research decreased precision of point estimates and comparisons between interventions. CONCLUSIONS Both antidepressant medication and cognitive behavioral therapy were found to be cost-effective for pediatric anxiety and OCD. Results supported investment from third party payers, who serve as critical gatekeepers that can increase treatment dissemination. However, more precise information would better inform the exact amount of investment needed, especially with regard to selection decisions between active interventions. Cost-effectiveness research would benefit from systematic collection of data on treatment costs and quality of life in future clinical trials.
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Affiliation(s)
| | - Troy Quast
- University of South Florida, 13201 Bruce B. Downs Blvd., Tampa, FL 33620, USA
| | - Tara B Little
- Texas State University, 601 University Drive, UAC 253L, San Marcos, TX 78666, USA
| | - Kaitlyn Westerberg
- Texas State University, 601 University Drive, UAC 253L, San Marcos, TX 78666, USA
| | - Kevin C Patyk
- Texas State University, 601 University Drive, UAC 253L, San Marcos, TX 78666, USA
| | - Maureen F Monahan
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Eric A Storch
- Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA
| | - Sean T Gregory
- Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA; Magellan Health, 6303 Cowboys Way, Frisco, TX 75034, USA
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Barnett ML, Luis Sanchez BE, Green Rosas Y, Broder-Fingert S. Future Directions in Lay Health Worker Involvement in Children's Mental Health Services in the U.S. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:966-978. [PMID: 34554014 PMCID: PMC8633058 DOI: 10.1080/15374416.2021.1969655] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Nearly half of children meeting criteria for a mental health disorder in the United States (U.S.) do not receive the treatment they need. Unfortunately, lack of access to and engagement in mental health services can be seen at even higher rates for historically marginalized groups, including low-income, racial, and ethnic minority youth. Lay Health Workers (LHWs) represent a valuable workforce that has been identified as a promising solution to address mental health disparities. LHWs are individuals without formal mental health training who oftentimes share lived experiences with the communities that they serve. A growing body of research has supported the mobilization of LHWs to address service disparities around the globe; however, challenges persist in how to scale-up and sustain LHW models of care, with specific barriers in the U.S. In this paper, we describe LHWs' different roles and involvement in the mental health field as well as the current state of the literature around LHW implementation. We integrate the RE-AIM Framework with a conceptual model of how LHWs address disparities to outline future directions in research and practice to enhance equity in the reach, effectiveness, adoption, implementation, and maintenance of LHW models of care and evidence-based practices for historically marginalized communities within the U.S.
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Affiliation(s)
- Miya L Barnett
- Department of Counseling, University of California Santa Barbara
| | | | | | - Sarabeth Broder-Fingert
- Department of Pediatrics, University of Massachusetts Medical School
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School
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Hogue A, Becker SJ, Wenzel K, Henderson CE, Bobek M, Levy S, Fishman M. Family involvement in treatment and recovery for substance use disorders among transition-age youth: Research bedrocks and opportunities. J Subst Abuse Treat 2021; 129:108402. [PMID: 34080559 PMCID: PMC8380649 DOI: 10.1016/j.jsat.2021.108402] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/30/2022]
Abstract
This article presents a narrative review and conceptual framework for research on family involvement across the continuum of substance use disorder (SUD) services for transition-age youth (ages 15-26). Though families are powerful resources for enhancing treatment and recovery success among youth with SUDs, they are not routinely included in clinical practice. This article summarizes youth SUD prevalence and service utilization rates and presents developmental and empirical rationale for increasing family involvement in services. It then describes key research issues on family involvement across the SUD services continuum: Problem Identification, Treatment Engagement, Active Treatment, Recovery Support. Within each phase, it highlights bedrock research findings and suggests promising opportunities for advancing the scientific knowledge base on family involvement. The main goals are to endorse family-oriented practices for immediate adoption in routine care and identify areas of research innovation that could significantly enhance the quality of youth SUD services.
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Affiliation(s)
- Aaron Hogue
- Partnership to End Addiction, United States of America.
| | - Sara J Becker
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, United States of America
| | - Kevin Wenzel
- Maryland Treatment Centers, United States of America
| | | | - Molly Bobek
- Partnership to End Addiction, United States of America
| | - Sharon Levy
- Boston Children's Hospital, Harvard Medical School, United States of America
| | - Marc Fishman
- Maryland Treatment Centers, United States of America
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McGuier EA, Rothenberger SD, Friedman A, Kolko DJ. An equivalence analysis of provider education in youth mental health care. Health Serv Res 2021; 56:440-452. [PMID: 33844276 PMCID: PMC8143690 DOI: 10.1111/1475-6773.13659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To test for equivalence between providers with and without advanced degrees in multiple domains related to delivery of evidence-based treatment. DATA SOURCE Provider and client data from an effectiveness trial of Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT) in a major metropolitan area in the United States. STUDY DESIGN We tested for equivalence between providers (N = 182) with and without advanced degrees in treatment-related knowledge, practices, and attitudes; job demands and stress; and training engagement and trainer-rated competence in AF-CBT. We also conducted exploratory analyses to test for equivalence in family clinical outcomes. DATA COLLECTION Providers completed measures prior to randomization and at 6-month follow-up, after completion of training and consultation in AF-CBT. Children and caregivers completed assessments at 0, 6, 12, and 18 months. PRINCIPAL FINDINGS Providers without advanced degrees were largely non-inferior to those with advanced degrees in treatment-related knowledge, practices, and attitudes, while findings for job demands and stress were mixed. Providers without advanced degrees were non-inferior to providers with advanced degrees in consultation attendance (B = -1.42; confidence interval (CI) = -3.01-0.16; margin of equivalence (Δ) = 2), number of case presentations (B = 0.64; CI = -0.49-1.76; Δ = 2), total training hours (B = -4.57; CI = -10.52-1.37; Δ = 3), and trainer-rated competence in AF-CBT (B = -0.04; CI = -3.04-2.96; Δ = 4), and they were significantly more likely to complete training (odds ratio = 0.66; CI = 0.10-0.96; Δ = 30%). Results for clinical outcomes were largely inconclusive. CONCLUSIONS Provider-level outcomes for those with and without advanced degrees were generally comparable. Additional research is needed to examine equivalence in clinical outcomes. Expanding evidence-based treatment training to individuals without advanced degrees may help to reduce workforce shortages and improve reach of evidence-based treatments.
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Affiliation(s)
- Elizabeth A. McGuier
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Scott D. Rothenberger
- Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Abbey Friedman
- Western Psychiatric HospitalUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - David J. Kolko
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Western Psychiatric HospitalUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
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Implementation of an Abusive Head Trauma Prevention Program Through Interdisciplinary Collaboration: A Pilot Study. J Trauma Nurs 2020; 27:276-282. [PMID: 32890241 DOI: 10.1097/jtn.0000000000000529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Shaken baby syndrome/abusive head trauma (SBS/AHT) is the leading cause of child abuse death. Our institution piloted an evidence-based educational program to increase nurse and caregiver knowledge about SBS/AHT. METHODS Nurses participated in a pretest survey, completed online implementation training, and then were given a posttest survey to determine the change in SBS/AHT knowledge. Once trained, nurses disseminated information to caregivers with children younger than 6 months. Caregivers (N = 87) watched an educational video, reviewed information in a booklet with a nurse, and participated in teach-back related to key points of the intervention in both a hospital and the community setting. RESULTS Prior to the education, nurses (n = 115) scored 8.03 out of 10.00 on the SBS/AHT assessment. Following the intervention, nurses (n = 120) scored 9.00 out of 10.00 on the assessment, t(233) = -6.61, p < .001. During education, caregivers (n = 69) were able to recall 8.55 out of 12 key educational components. In the community setting, caregivers (n = 18) worked together to recall 12 out of the 12 key components. Caregivers were most likely to recall ways to comfort their crying baby (94%) and why shaking a baby is dangerous (93%). CONCLUSION This pilot study significantly increased nurses' knowledge of SBS/AHT and provided education to caregivers about SBS/AHT.
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Horwitz SM, Cervantes P, Kuppinger AD, Quintero PL, Burger S, Lane H, Bradbury D, Cleek AF, Hoagwood KE. Evaluation of a Web-Based Training Model for Family Peer Advocates in Children's Mental Health. Psychiatr Serv 2020; 71:502-505. [PMID: 31910753 PMCID: PMC8904137 DOI: 10.1176/appi.ps.201900365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to compare knowledge gains from a new online training program with gains from an existing in-person training program for family peer advocates. METHODS Data were used from a pre-post study of individuals who enrolled in the Web-based Parent Empowerment Program training; 144 participants completed the training and pre-post tests, and 140 were admitted to the analyses. Knowledge was assessed with 34 questions, 29 of which were common to the online and in-person trainings. Pre-post knowledge scores were available from the in-person training. RESULTS Statistically significant gains in knowledge were found with both the 34 questions and the 29 questions common to both trainings. Knowledge gains across the two training models did not differ. CONCLUSIONS Data on knowledge gains from this accessible, affordable online model show promise for training the growing and important workforce of family peer advocates.
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Affiliation(s)
- Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Paige Cervantes
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Anne D Kuppinger
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Patricia L Quintero
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Susan Burger
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Heather Lane
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Donna Bradbury
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Andrew F Cleek
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
| | - Kimberly Eaton Hoagwood
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury)
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Becan JE, Crawley RD, Knight DK. Using a Train-the-Trainer Model to Promote Practice Change among Agencies Serving Justice-Involved Youth. FEDERAL PROBATION 2019; 83:47-53. [PMID: 35095111 PMCID: PMC8794422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | | | - Danica K Knight
- Institute of Behavioral Research, Texas Christian University
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12
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Barnett M, Miranda J, Kia-Keating M, Saldana L, Landsverk J, Lau AS. Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol. BMJ Open 2019; 9:e028988. [PMID: 31324682 PMCID: PMC6661633 DOI: 10.1136/bmjopen-2019-028988] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Behavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successful implementation of evidence-based practices (EBPs) in community settings that serve low-income, ethnic minority families. Lay health workers (LHWs)-individuals without formal mental health training-represent an important workforce to increase engagement, as they are members of the communities they serve. However, the mobilisation of LHWs has not been well studied as an implementation strategy to extend the reach or effectiveness of EBPs in the USA. LHW-delivered implementation interventions that specifically support the engagement of Latinx parents in evidence-based BPT programmes have the potential to improve clinical and implementation outcomes. METHODS AND ANALYSIS A community-partnered approach will use the Quality Implementation Framework (QIF) to tailor and implement an LHW-delivered implementation intervention that aims to promote Latinx parent engagement in BPT programmes. Steps from the QIF will guide study activities to (1) conduct a mixed methods needs assessment to fit the implementation intervention to the local context, (2) adapt LHW-delivered implementation strategies to promote parent access to and engagement in Parent-Child Interaction Therapy and (3) conduct a hybrid effectiveness-implementation pilot trial to examine the feasibility, acceptability and preliminary effectiveness of the LHW implementation intervention at increasing engagement. ETHICS AND DISSEMINATION Study procedures have been approved by the Institutional Review Board at the University of California, Santa Barbara. Results will be shared with the community-advisory group, at community-based meetings for other stakeholders involved in the pilot project, and submitted for publication in peer-reviewed journals.
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Affiliation(s)
- Miya Barnett
- Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California, USA
| | - Jeanne Miranda
- Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Center for Health Services and Society, University of California Los Angeles, Los Angeles, California, USA
| | - Maryam Kia-Keating
- Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California, USA
| | - Lisa Saldana
- Oregon Social Learning Center, Eugene, Oregon, USA
| | | | - Anna S Lau
- Psychology, University of California Los Angeles, Los Angeles, California, USA
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Paton K, Hiscock H. Strengthening care for children with complex mental health conditions: Views of Australian clinicians. PLoS One 2019; 14:e0214821. [PMID: 30939168 PMCID: PMC6445417 DOI: 10.1371/journal.pone.0214821] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/20/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Improving mental health outcomes for children and young people has become a priority for policy makers in the developed world. In Australia, up to half of all children and adolescents meeting criteria for mental health disorders receive suboptimal levels of treatment (or no treatment at all) despite the availability of effective treatments. Children with complex mental health conditions are particularly at risk of inadequate treatment as optimal care requires coordination from medical, educational and social services. In Australia, clinicians including pediatricians, psychologists and child and adolescent psychiatrists deliver the bulk of mental health care for children with complex mental health conditions. We aimed to determine perspectives of these Australian clinicians on barriers and enablers within the current system and components of an optimal model of care. METHODS Inductive content analysis was used to analyse 30 semi-structured interviews with key clinicians managing the care of children with complex mental health conditions across Australia. Interviews were conducted using vignettes with Attention Deficit Hyperactivity Disorder (ADHD) and Autism as exemplars. FINDINGS Multiple barriers to optimal care exist at a systemic, clinician and family level. However, regional health systems provide an enabling environment from which metropolitan models could learn. Transitioning to adult services was highlighted as the most compromised area of care. Clinicians identified short (e.g. empowering parents to advocate for and deliver their child's care, case conferencing with schools) and long term (e.g. co-locating disciplines to deliver care, workforce training) solutions. CONCLUSIONS Whilst multiple barriers to optimal care for children with complex mental health conditions exist, clinicians identify several enablers including developing networks with other disciplines and empowering parents to advocate for and co-ordinate care. Systemic changes based on multidisciplinary, co-located and integrated care services should be developed as longer term solutions.
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Affiliation(s)
- Kate Paton
- Health Services, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Health Services, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Health Services Unit, The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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McLeod BD, Cox JR, Jensen-Doss A, Herschell A, Ehrenreich-May J, Wood JJ. Proposing a Mechanistic Model of Clinician Training and Consultation. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018; 25:e12260. [PMID: 30713369 PMCID: PMC6353552 DOI: 10.1111/cpsp.12260] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To make evidence-based treatments deliverable, effective, and scalable in community settings, it is critical to develop a workforce that can deliver evidence-based treatments as designed with skill. However, the science and practice of clinician training and consultation lags behind other areas of implementation science. In this paper, we present the Longitudinal Education for Advancing Practice (LEAP) model designed to help span this gap. The LEAP model is a mechanistic model of clinician training and consultation that details how training inputs, training and consultation strategies, and mechanisms of learning influence training outcomes. We first describe the LEAP model and then discuss how key implications of the model can be used to develop effective training and consultation strategies.
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Affiliation(s)
- Bryce D McLeod
- Virginia Commonwealth University, Department of Psychology
| | - Julia R Cox
- Virginia Commonwealth University, Department of Psychology
| | | | | | | | - Jeffrey J Wood
- Departments of Education and Psychiatry, University of California
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