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Pryjmachuk S, Kirk S, Fraser C, Evans N, Lane R, Neill L, Camacho E, Bower P, Bee P, McDougall T. Service design for children and young people with common mental health problems: literature review, service mapping and collective case study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-181. [PMID: 38767587 DOI: 10.3310/dkrt6293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background The mental health of children/young people is a growing concern internationally. Numerous reports and reviews have consistently described United Kingdom children's mental health services as fragmented, variable, inaccessible and lacking an evidence base. Little is known about the effectiveness of, and implementation complexities associated with, service models for children/young people experiencing 'common' mental health problems like anxiety, depression, attention deficit hyperactivity disorder and self-harm. Aim To develop a model for high-quality service design for children/young people experiencing common mental health problems by identifying available services, barriers and enablers to access, and the effectiveness, cost effectiveness and acceptability of such services. Design Evidence syntheses with primary research, using a sequential, mixed-methods design. Inter-related scoping and integrative reviews were conducted alongside a map of relevant services across England and Wales, followed by a collective case study of English and Welsh services. Setting Global (systematic reviews); England and Wales (service map; case study). Data sources Literature reviews: relevant bibliographic databases and grey literature. Service map: online survey and offline desk research. Case study: 108 participants (41 children/young people, 26 parents, 41 staff) across nine case study sites. Methods A single literature search informed both reviews. The service map was obtained from an online survey and internet searches. Case study sites were sampled from the service map; because of coronavirus disease 2019, case study data were collected remotely. 'Young co-researchers' assisted with case study data collection. The integrative review and case study data were synthesised using the 'weaving' approach of 'integration through narrative'. Results A service model typology was derived from the scoping review. The integrative review found effectiveness evidence for collaborative care, outreach approaches, brief intervention services and the 'availability, responsiveness and continuity' framework. There was cost-effectiveness evidence only for collaborative care. No service model appeared to be more acceptable than others. The service map identified 154 English and Welsh services. Three themes emerged from the case study data: 'pathways to support'; 'service engagement'; and 'learning and understanding'. The integrative review and case study data were synthesised into a coproduced model of high-quality service provision for children/young people experiencing common mental health problems. Limitations Defining 'service model' was a challenge. Some service initiatives were too new to have filtered through into the literature or service map. Coronavirus disease 2019 brought about a surge in remote/digital services which were under-represented in the literature. A dearth of relevant studies meant few cost-effectiveness conclusions could be drawn. Conclusions There was no strong evidence to suggest any existing service model was better than another. Instead, we developed a coproduced, evidence-based model that incorporates the fundamental components necessary for high-quality children's mental health services and which has utility for policy, practice and research. Future work Future work should focus on: the potential of our model to assist in designing, delivering and auditing children's mental health services; reasons for non-engagement in services; the cost effectiveness of different approaches in children's mental health; the advantages/disadvantages of digital/remote platforms in delivering services; understanding how and what the statutory sector might learn from the non-statutory sector regarding choice, personalisation and flexibility. Study registration This study is registered as PROSPERO CRD42018106219. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/08) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 13. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Steven Pryjmachuk
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Susan Kirk
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Claire Fraser
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Nicola Evans
- School of Healthcare Studies, Cardiff University, Cardiff, UK
| | - Rhiannon Lane
- School of Healthcare Studies, Cardiff University, Cardiff, UK
| | | | - Elizabeth Camacho
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Peter Bower
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Penny Bee
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Tim McDougall
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
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Tassone F, Protic D, Allen EG, Archibald AD, Baud A, Brown TW, Budimirovic DB, Cohen J, Dufour B, Eiges R, Elvassore N, Gabis LV, Grudzien SJ, Hall DA, Hessl D, Hogan A, Hunter JE, Jin P, Jiraanont P, Klusek J, Kooy RF, Kraan CM, Laterza C, Lee A, Lipworth K, Losh M, Loesch D, Lozano R, Mailick MR, Manolopoulos A, Martinez-Cerdeno V, McLennan Y, Miller RM, Montanaro FAM, Mosconi MW, Potter SN, Raspa M, Rivera SM, Shelly K, Todd PK, Tutak K, Wang JY, Wheeler A, Winarni TI, Zafarullah M, Hagerman RJ. Insight and Recommendations for Fragile X-Premutation-Associated Conditions from the Fifth International Conference on FMR1 Premutation. Cells 2023; 12:2330. [PMID: 37759552 PMCID: PMC10529056 DOI: 10.3390/cells12182330] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The premutation of the fragile X messenger ribonucleoprotein 1 (FMR1) gene is characterized by an expansion of the CGG trinucleotide repeats (55 to 200 CGGs) in the 5' untranslated region and increased levels of FMR1 mRNA. Molecular mechanisms leading to fragile X-premutation-associated conditions (FXPAC) include cotranscriptional R-loop formations, FMR1 mRNA toxicity through both RNA gelation into nuclear foci and sequestration of various CGG-repeat-binding proteins, and the repeat-associated non-AUG (RAN)-initiated translation of potentially toxic proteins. Such molecular mechanisms contribute to subsequent consequences, including mitochondrial dysfunction and neuronal death. Clinically, premutation carriers may exhibit a wide range of symptoms and phenotypes. Any of the problems associated with the premutation can appropriately be called FXPAC. Fragile X-associated tremor/ataxia syndrome (FXTAS), fragile X-associated primary ovarian insufficiency (FXPOI), and fragile X-associated neuropsychiatric disorders (FXAND) can fall under FXPAC. Understanding the molecular and clinical aspects of the premutation of the FMR1 gene is crucial for the accurate diagnosis, genetic counseling, and appropriate management of affected individuals and families. This paper summarizes all the known problems associated with the premutation and documents the presentations and discussions that occurred at the International Premutation Conference, which took place in New Zealand in 2023.
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Affiliation(s)
- Flora Tassone
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA 95817, USA;
- MIND Institute, University of California Davis, Davis, CA 95817, USA; (B.D.); (D.H.); (V.M.-C.)
| | - Dragana Protic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia;
- Fragile X Clinic, Special Hospital for Cerebral Palsy and Developmental Neurology, 11040 Belgrade, Serbia
| | - Emily Graves Allen
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; (E.G.A.); (P.J.); (K.S.)
| | - Alison D. Archibald
- Victorian Clinical Genetics Services, Royal Children’s Hospital, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Genomics in Society Group, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - Anna Baud
- Department of Gene Expression, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznan, Poland; (A.B.); (K.T.)
| | - Ted W. Brown
- Central Clinical School, University of Sydney, Sydney, NSW 2006, Australia;
- Fragile X Association of Australia, Brookvale, NSW 2100, Australia;
- NYS Institute for Basic Research in Developmental Disabilities, New York, NY 10314, USA
| | - Dejan B. Budimirovic
- Department of Psychiatry, Fragile X Clinic, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
- Department of Psychiatry & Behavioral Sciences-Child Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jonathan Cohen
- Fragile X Alliance Clinic, Melbourne, VIC 3161, Australia;
| | - Brett Dufour
- MIND Institute, University of California Davis, Davis, CA 95817, USA; (B.D.); (D.H.); (V.M.-C.)
- Department of Pathology and Laboratory Medicine, Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children of Northern California, School of Medicine, University of California Davis, Sacramento, CA 95817, USA;
| | - Rachel Eiges
- Stem Cell Research Laboratory, Medical Genetics Institute, Shaare Zedek Medical Center Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel;
| | - Nicola Elvassore
- Veneto Institute of Molecular Medicine (VIMM), 35129 Padova, Italy; (N.E.); (C.L.)
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
| | - Lidia V. Gabis
- Keshet Autism Center Maccabi Wolfson, Holon 5822012, Israel;
- Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
| | - Samantha J. Grudzien
- Department of Neurology, University of Michigan, 4148 BSRB, 109 Zina Pitcher Place, Ann Arbor, MI 48109, USA; (S.J.G.); (P.K.T.)
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Deborah A. Hall
- Department of Neurological Sciences, Rush University, Chicago, IL 60612, USA;
| | - David Hessl
- MIND Institute, University of California Davis, Davis, CA 95817, USA; (B.D.); (D.H.); (V.M.-C.)
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Abigail Hogan
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (A.H.); (J.K.)
| | - Jessica Ezzell Hunter
- RTI International, Research Triangle Park, NC 27709, USA; (J.E.H.); (S.N.P.); (M.R.); (A.W.)
| | - Peng Jin
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; (E.G.A.); (P.J.); (K.S.)
| | - Poonnada Jiraanont
- Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
| | - Jessica Klusek
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (A.H.); (J.K.)
| | - R. Frank Kooy
- Department of Medical Genetics, University of Antwerp, 2000 Antwerp, Belgium;
| | - Claudine M. Kraan
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Diagnosis and Development, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Cecilia Laterza
- Veneto Institute of Molecular Medicine (VIMM), 35129 Padova, Italy; (N.E.); (C.L.)
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
| | - Andrea Lee
- Fragile X New Zealand, Nelson 7040, New Zealand;
| | - Karen Lipworth
- Fragile X Association of Australia, Brookvale, NSW 2100, Australia;
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60201, USA;
| | - Danuta Loesch
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Reymundo Lozano
- Departments of Genetics and Genomic Sciences and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Marsha R. Mailick
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Apostolos Manolopoulos
- Intramural Research Program, Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD 21224, USA;
| | - Veronica Martinez-Cerdeno
- MIND Institute, University of California Davis, Davis, CA 95817, USA; (B.D.); (D.H.); (V.M.-C.)
- Department of Pathology and Laboratory Medicine, Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children of Northern California, School of Medicine, University of California Davis, Sacramento, CA 95817, USA;
| | - Yingratana McLennan
- Department of Pathology and Laboratory Medicine, Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children of Northern California, School of Medicine, University of California Davis, Sacramento, CA 95817, USA;
| | | | - Federica Alice Maria Montanaro
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Matthew W. Mosconi
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS 66045, USA;
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS 66045, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS 66045, USA
| | - Sarah Nelson Potter
- RTI International, Research Triangle Park, NC 27709, USA; (J.E.H.); (S.N.P.); (M.R.); (A.W.)
| | - Melissa Raspa
- RTI International, Research Triangle Park, NC 27709, USA; (J.E.H.); (S.N.P.); (M.R.); (A.W.)
| | - Susan M. Rivera
- Department of Psychology, University of Maryland, College Park, MD 20742, USA;
| | - Katharine Shelly
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA; (E.G.A.); (P.J.); (K.S.)
| | - Peter K. Todd
- Department of Neurology, University of Michigan, 4148 BSRB, 109 Zina Pitcher Place, Ann Arbor, MI 48109, USA; (S.J.G.); (P.K.T.)
- Ann Arbor Veterans Administration Healthcare, Ann Arbor, MI 48105, USA
| | - Katarzyna Tutak
- Department of Gene Expression, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznan, Poland; (A.B.); (K.T.)
| | - Jun Yi Wang
- Center for Mind and Brain, University of California Davis, Davis, CA 95618, USA;
| | - Anne Wheeler
- RTI International, Research Triangle Park, NC 27709, USA; (J.E.H.); (S.N.P.); (M.R.); (A.W.)
| | - Tri Indah Winarni
- Center for Biomedical Research (CEBIOR), Faculty of Medicine, Universitas Diponegoro, Semarang 502754, Central Java, Indonesia;
| | - Marwa Zafarullah
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA 95817, USA;
| | - Randi J. Hagerman
- MIND Institute, University of California Davis, Davis, CA 95817, USA; (B.D.); (D.H.); (V.M.-C.)
- Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
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Nazari A, Garmaroudi G, Foroushani AR, Hosseinnia M. The effect of web-based educational interventions on mental health literacy, stigma and help-seeking intentions/attitudes in young people: systematic review and meta-analysis. BMC Psychiatry 2023; 23:647. [PMID: 37667229 PMCID: PMC10478184 DOI: 10.1186/s12888-023-05143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/26/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVES This study aims to provide a systematic review and meta-analysis of the literature on The Effect of Web-Based Educational Interventions on Mental Health Literacy, Stigma and Help-seeking intentions/attitudes in young people. METHODS Articles in English published between April 1975 and February 2023 were retrieved from seven databases, leading to a total of 2023 articles identified. RESULTS 20 studies were included after applying exclusion criteria, 10 of which were eligible for meta-analysis. Results showed that web-based educational interventions had a significant positive effect on mental health literacy knowledge (SMD = 0.70, 95% CI = [0.16, 1.25]), but not on stigma (SMD = -0.20, 95% CI = [-0.48, 0.08]) or help-seeking intentions/attitudes (SMD = 0.48, 95% CI = [-0.50, 1.46]). CONCLUSION This study reviewed and analyzed the effect of web-based educational interventions on mental health literacy, stigma, and help-seeking intentions/attitudes among young people. The results showed that web-based educational interventions improved mental health literacy knowledge, but not stigma or help-seeking outcomes. The study suggested several recommendations to enhance the effectiveness of web-based educational interventions on stigma and help-seeking outcomes, such as using more rigorous designs and methods, more comprehensive and multifaceted interventions, more tailored and targeted interventions, and more collaborative and participatory approaches. The study concluded that web-based educational interventions may have a greater impact on reducing stigma and promoting help-seeking among young people, which may ultimately lead to better mental health outcomes and well-being for this population.
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Affiliation(s)
- Abouzar Nazari
- Department of Health Education and Promotion, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Garmaroudi
- Department of Health Education and Promotion, School of Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maede Hosseinnia
- Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Notice M, Robertson J, Smith K, Kim S, LaRiviere M, Byno L, Binette N, Anaeche C, Tadros E. A Phenomenological Exploration of Families' Experiences of the Mental Health System of Care in the Monadnock Region. Community Ment Health J 2023; 59:1217-1226. [PMID: 36905553 DOI: 10.1007/s10597-023-01104-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023]
Abstract
Accessing mental health treatment in rural locations is a unique challenge for families with youth experiencing adverse mental health conditions. Families often experience a variety of difficulties accessing and negotiating changes within the system of care. This study aimed to understand the experiences of families and their youth in navigating the mental health system in a rural community. Interpretative phenomenological analysis was used to examine how participants interpret their experiences within the local system of care. Qualitative interviews were conducted with eight families. Results included five main themes: youth experience, family experience, access to a system of care, relationships between stakeholders, and larger societal beliefs. Families highlighted their experiences accessing the local care system and their hope for strengthening community access and partnerships. Findings indicate that prioritizing family voices should be encouraged by local systems.
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Affiliation(s)
- Maxine Notice
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA.
- School of Health and Human Services, Abilene Christian University, 16633 Dallas Parkway, Suite 800, Addison, TX, 75001, USA.
| | - Janet Robertson
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
| | - Karmen Smith
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
| | - Seon Kim
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
| | - Martha LaRiviere
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
| | - Lucille Byno
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
| | - Neil Binette
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
| | - Collins Anaeche
- Department of Applied Psychology, Antioch University New England, 40 Avon Street, Keene, NH, 03431, USA
- Department of Marriage and Family Therapy, Eastern University, 1300 Eagle Road, St. Davids, PA, 19087, USA
| | - Eman Tadros
- Division of Psychology and Counseling, Governors State University, 1 University Pkwy, University Park, IL, 60484, USA
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Liao Y, Ameyaw MA, Liang C, Li W. Research on the Effect of Evidence-Based Intervention on Improving Students' Mental Health Literacy Led by Ordinary Teachers: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:949. [PMID: 36673704 PMCID: PMC9859505 DOI: 10.3390/ijerph20020949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND the purpose of this study was to systematically review the effects of intervention experiments led by ordinary teachers to improve students' mental health literacy and to provide evidence-based research and new ideas for improving students' mental health literacy. METHODS A systematic search using 5 English (Web of Science, PubMed, ProQuest, EBSCO, Springer Link) and 3 Chinese (CNKI, WanFang, and VIP) databases was initiated to identify controlled trials assessing the immediate effect and delay effect of the intervention experiment led by ordinary teachers on improving students' mental health knowledge, anti-stigma, willingness, or behavior to seek-help. RESULTS a total of 14 experiments with 7873 subjects were included. The results showed that the immediate effect of the intervention on promoting students' mental health knowledge [g = 0.622, 95% CI (0.395, 0.849)] and anti-stigma [g = 0.262, 95% CI (0.170, 0.354)] was significant, but the amount of delay effect is not significant. CONCLUSIONS the results of this review show that ordinary classroom teachers can effectively participate in projects to improve students' mental health literacy, significantly improve students' mental health knowledge and attitudes towards psychological problems, and make up for the shortage of full-time mental health teachers in schools. In future, more attention should be paid to students' mental health literacy, and evidence-based intervention research should be strengthened. Furthermore, we can improve students' mental health literacy and avoid poor mental health by addressing delays in early intervention, as well as improve experimental design, prolong the intervention time, and improve the effectiveness of the intervention.
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Chad-Friedman E, Leppert KA, Olino TM, Bufferd SJ, Dougherty LR. Affective Dynamics and Mean Levels of Preschool Irritability and Sadness: Predictors of Children's Psychological Functioning Two Years Later. Child Psychiatry Hum Dev 2022; 53:244-255. [PMID: 33479889 DOI: 10.1007/s10578-021-01121-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2021] [Indexed: 11/25/2022]
Abstract
Although irritability and sadness are cardinal symptoms of depression, they are also common in preschoolers. The daily experiences of these emotions are not well-understood during early childhood, yet may provide insight into identification of early depressive symptoms. The current longitudinal study examined daily mean levels and emotion dynamics of preschool-aged children's irritability and sadness and psychiatric outcomes in early school-age. Parents (n = 291) completed 14 consecutive daily diaries about their preschoolers' emotions. Two years later, parents (n = 164) completed a semi-structured clinical interview and questionnaires about their children's psychological functioning. Strong correlations between mean and dynamic measures (rs = 0.65-0.91) were identified. Preschoolers' mean daily levels and dynamics of irritability (variability, instability, inertia) and sadness (instability, inertia) predicted symptoms and impairment 2 years later. Sadness instability and inertia continued to predict difficulties after adjusting for mean daily sadness. Fine-grained daily measures of preschoolers' affect may be help identify children at-risk for psychological problems.
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Affiliation(s)
- Emma Chad-Friedman
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - Katherine A Leppert
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | | | | | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA.
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Olson JR, Benjamin PH, Azman AA, Kellogg MA, Pullmann MD, Suter JC, Bruns EJ. Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2021; 60:1353-1366. [PMID: 33785404 DOI: 10.1016/j.jaac.2021.02.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/22/2021] [Accepted: 02/19/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Wraparound is a common method for coordinating care for children and adolescents with serious emotional disorders (SED), with nearly 100,000 youths served annually in the United States. The current systematic review and meta-analysis estimated effects on youth outcomes (symptoms, functioning, school, juvenile justice, and residential placement) and costs. METHOD A literature search identified 17 peer-reviewed and gray literature studies meeting criteria, which were coded on characteristics of sample, design, implementation, and outcomes. Random effects modeling was conducted using Comprehensive Meta-Analysis Version 3.0. Effect sizes were calculated using Hedges g. Homogeneity of effects were assessed using Q statistics. RESULTS Medium-sized effects favored Wraparound-enrolled youths for costs (g = 0.391, CI = 0.282-0.500, p < .001), residential outcomes (g = 0.413, CI = 0.176-0.650, p = .001), and school functioning (g = 0.397, CI = 0.106-0.688, p = .007); small effects were found for mental health symptoms (g = 0.358, CI = 0.030-0.687, p = .033) and functioning (g = 0.315, CI = 0.086-0.545, p = .007). Larger effects were found for peer-reviewed studies, quasi-experimental designs, samples with a larger percentage of youths of color, and Wraparound conditions with higher fidelity. CONCLUSION Results indicate positive effects for Wraparound, especially for maintaining youths with SED in the home and community. However, many studies showed methodological weaknesses, and fidelity measurement was largely absent, suggesting a need for additional research. Nonetheless, the results should aid decisions around resource allocation, referral practices, and system partnerships among child psychiatrists and other behavioral health professionals.
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Affiliation(s)
- Jonathan R Olson
- Drs. Olson, Pullmann, Bruns, Mr. Benjamin, and Mss. Azman and Kellogg are with the University of Washington School of Medicine, Seattle.
| | - Philip H Benjamin
- Drs. Olson, Pullmann, Bruns, Mr. Benjamin, and Mss. Azman and Kellogg are with the University of Washington School of Medicine, Seattle
| | - Alya A Azman
- Drs. Olson, Pullmann, Bruns, Mr. Benjamin, and Mss. Azman and Kellogg are with the University of Washington School of Medicine, Seattle
| | - Marianne A Kellogg
- Drs. Olson, Pullmann, Bruns, Mr. Benjamin, and Mss. Azman and Kellogg are with the University of Washington School of Medicine, Seattle
| | - Michael D Pullmann
- Drs. Olson, Pullmann, Bruns, Mr. Benjamin, and Mss. Azman and Kellogg are with the University of Washington School of Medicine, Seattle
| | - Jesse C Suter
- Dr. Suter is with the Center on Disability and Community Inclusion, University of Vermont, Burlington
| | - Eric J Bruns
- Drs. Olson, Pullmann, Bruns, Mr. Benjamin, and Mss. Azman and Kellogg are with the University of Washington School of Medicine, Seattle
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Jeffrey JK, Venegas-Murillo AL, Krishna R, Hajal NJ. Rating Scales for Behavioral Health Screening System Within Pediatric Primary Care. Child Adolesc Psychiatr Clin N Am 2021; 30:777-795. [PMID: 34538448 DOI: 10.1016/j.chc.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Barriers to conducting standardized behavioral health screening within pediatric primary care settings include engaging youth and families, limited time available for this activity, and difficulties related to obtaining behavioral health consultation and treatment from specialists. Child and adolescent psychiatrists may assist pediatric primary care practices with engaging youth and families around screening by assisting with identifying rating scales that have good psychometric characteristics across multiple languages and are validated in diverse samples and available within the public domain. Additionally, they may partner with pediatric primary care professionals to assist with optimizing screening workflows and linkage to specialized services.
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Affiliation(s)
- Jessica K Jeffrey
- Department of Psychiatry & Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, A7-372A, Los Angeles, CA 90095, USA.
| | - Angela L Venegas-Murillo
- Department of Pediatrics, College of Medicine, Charles R. Drew University of Medicine & Science, 1748 East 118th Street, Room N147, Los Angeles, CA 90059, USA; Department of General Internal Medicine and Health Service Research, UCLA Health, Los Angeles, CA, USA
| | - Rajeev Krishna
- Behavioral Health, Department of Psychiatry, Nationwide Children's Hospital, 444 Butterfly Garden's Drive, Columbus, OH 43215, USA
| | - Nastassia J Hajal
- Department of Psychiatry & Biobehavioral Sciences, Division of Population Behavioral Health, UCLA-Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA
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9
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Lebow J, O'Brien JRG, Mattke A, Narr C, Geske J, Billings M, Clark MM, Jacobson RM, Phelan S, Le Grange D, Sim L. A primary care modification of family-based treatment for adolescent restrictive eating disorders. Eat Disord 2021; 29:376-389. [PMID: 31675286 DOI: 10.1080/10640266.2019.1656468] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although eating disorders pose a significant threat to the health and well-being of children and adolescents, due to a profound scarcity of specialty providers, only a small percentage of patients receives evidence-based treatment. To improve access to care for restrictive eating disorders, we developed a modified version of Family-Based Treatment to be delivered by primary care providers (PCPs) and conducted a pilot study to evaluate the feasibility and preliminary outcomes of this intervention. Fifteen adolescents (mean age = 15.5 years) with restrictive eating disorders and their caregiver(s) were enrolled in Family-Based Treatment for Primary Care (FBT-PC), delivered by three trained PCPs. Retention for the intervention was high (n = 13, 86.7%). Over the course of 3 months, participants attended an average of 9.2 (SD = 2.8) sessions and experienced a significant increase in BMI percentile from 39.1 to 54.8 (t (13) = -6.71, p < .001; d = .61). FBT-PC appears to be feasible for implementation in the primary care setting and has the potential to improve access to treatment and yield positive outcomes for young patients with restrictive eating disorders.
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Affiliation(s)
- Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | | | - Angela Mattke
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Cassandra Narr
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Jennifer Geske
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Marcie Billings
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA.,Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Sean Phelan
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, CA, USA.,Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA (Emeritus)
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA
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10
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Lebow J, Mattke A, Narr C, Partain P, Breland R, Gewirtz O'Brien JR, Geske J, Billings M, Clark MM, Jacobson RM, Phelan S, Harbeck-Weber C, Le Grange D, Sim L. Can adolescents with eating disorders be treated in primary care? A retrospective clinical cohort study. J Eat Disord 2021; 9:55. [PMID: 33892810 PMCID: PMC8067301 DOI: 10.1186/s40337-021-00413-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Family-Based Treatment (FBT) is considered the first-line intervention for adolescent anorexia nervosa. However, access to this treatment is limited. Treatment programs for other pediatric mental health conditions have successfully overcome barriers to accessing evidence-based intervention by integrating mental health services into primary care. This study evaluated the proof-of-concept of a novel modification of FBT, Family-Based Treatment for Primary Care (FBT-PC) for adolescent restrictive eating disorders designed for delivery by primary care providers in their practices. METHODS This retrospective clinical cohort study evaluated 15 adolescents with restrictive eating disorders receiving FBT-PC and 15 adolescents receiving standard FBT. We examined improvement in BMI percentile, reduction in weight suppression, and clinical benchmarks of eating disorder recovery including weight restoration to > 95% of expected body weight (EBW) and resolution of DSM-5 criteria for eating disorders. RESULTS In both groups, effect sizes for increased BMI percentile exceeded Cohen's convention for a large effect (FBT-PC: d = .94; standard FBT: d = 1.15) as did effect sizes for reduction in weight suppression (FBT-PC: d = 1.83; standard FBT: d = 1.21). At the end of treatment, 80% of the FBT-PC cohort and 87% in the standard FBT group achieved > 95%EBW and 67% in the FBT-PC group and 60% in the standard FBT group no longer met DSM-5 criteria for an eating disorder. There were no cohort differences in the number of treatment drop-outs or referrals to a more intensive level of eating disorder treatment. CONCLUSIONS Findings suggest that primary care providers have potential to improve weight and clinical status in adolescents with restrictive eating disorders. Based on these results, more rigorous testing of the FBT-PC model is warranted.
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Affiliation(s)
- Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. .,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.
| | - Angela Mattke
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Cassandra Narr
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Paige Partain
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Renee Breland
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | | | - Jennifer Geske
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Marcie Billings
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Robert M Jacobson
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA.,Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Sean Phelan
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Cynthia Harbeck-Weber
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.,Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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11
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Duong MT, Bruns EJ, Lee K, Cox S, Coifman J, Mayworm A, Lyon AR. Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 48:420-439. [PMID: 32940884 DOI: 10.1007/s10488-020-01080-9] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/21/2023]
Abstract
A meta-analysis was conducted to examine the relative rates of youth mental health service utilization across settings among the general population and among those with elevated mental health symptoms or clinical diagnoses. Rates of school-based mental health were compared to outpatient, primary care, child welfare, juvenile justice, and inpatient. Nine studies presented rates of mental health service use for general-population youth in the U.S., and 14 studies presented rates for youth with elevated symptoms or clinical diagnoses. Random effects meta-analysis was used to calculate mean proportions of youth receiving care in each sector. Of general population youth, 7.28% received school mental health services. Rates for other sectors are as follows: 7.26% in outpatient settings, 1.76% in primary care, 1.80% in inpatient, 1.35% in child welfare, and 0.90% juvenile justice. For youth with elevated mental health symptoms or diagnoses, 22.10% of youth were served by school-based mental health services, 20.56% outpatient settings, 9.93% primary care, 9.05% inpatient, 7.90% child welfare, and 4.50% juvenile justice. Schools and outpatient settings are the most common loci of mental health care for both the general population and samples of youth with elevated symptoms or clinical diagnoses, although substantial amounts of care are also provided in a range of other settings. Results hold potential for informing resource allocation, legislation and policy, intervention development, and research. Given that mental health services are delivered across many settings, findings also point to the need for interconnection across child-serving sectors, particularly schools and outpatient clinics.
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Affiliation(s)
- Mylien T Duong
- Education, Research, and Impact, Committee for Children, Seattle, USA.
| | - Eric J Bruns
- University of Washington School of Medicine, Seattle, USA
| | - Kristine Lee
- University of Washington School of Medicine, Seattle, USA
| | - Shanon Cox
- University of Washington School of Medicine, Seattle, USA
| | | | | | - Aaron R Lyon
- University of Washington School of Medicine, Seattle, USA
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12
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Newham JJ, McLean K, Ginja S, Hurt L, Molloy C, Lingam R, Goldfeld S. Brief evidence-based interventions for universal child health services: a restricted evidence assessment of the literature. BMC Public Health 2020; 20:993. [PMID: 32580720 PMCID: PMC7315474 DOI: 10.1186/s12889-020-09104-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/12/2020] [Indexed: 11/29/2022] Open
Abstract
Background Universal child health services (UCHS) provide an important pragmatic platform for the delivery of universal and targeted interventions to support families and optimize child health outcomes. We aimed to identify brief, evidence-based interventions for common health and developmental problems that could be potentially implemented in UCHS. Methods A restricted evidence assessment (REA) of electronic databases and grey literature was undertaken covering January 2006 to August 2019. Studies were eligible if (i) outcomes related to one or more of four areas: child social and emotional wellbeing (SEWB), infant sleep, home learning environment or parent mental health, (ii) a comparison group was used, (iii) universal or targeted intervention were delivered in non-tertiary settings, (iv) interventions did not last more than 4 sessions, and (v) children were aged between 2 weeks postpartum and 5 years at baseline. Results Seventeen studies met the eligibility criteria. Of these, three interventions could possibly be implemented at scale within UCHS platforms: (1) a universal child behavioural intervention which did not affect its primary outcome of infant sleep but improved parental mental health, (2) a universal screening programme which improved maternal mental health, and (3) a targeted child behavioural intervention which improved parent-reported infant sleep problems and parental mental health. Key lessons learnt include: (1) Interventions should impart the maximal amount of information within an initial session with future sessions reinforcing key messages, (2) Interventions should see the family as a holistic unit by considering the needs of parents with an emphasis on identification, triage and referral, and (3) Brief interventions may be more acceptable for stigmatized topics, but still entail considerable barriers that deter the most vulnerable. Conclusions Delivery and evaluation of brief evidence-based interventions from a UCHS could lead to improved maternal and child health outcomes through a more responsive and equitable service. We recommend three interventions that meet our criteria of “best bet” interventions.
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Affiliation(s)
- James J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Karen McLean
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
| | - Samuel Ginja
- School of Psychology, Ulster University, Coleraine, UK
| | - Lisa Hurt
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Carly Molloy
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
| | - Raghu Lingam
- School of Women's & Children's Health, University of New South Wales, Randwick, Australia.
| | - Sharon Goldfeld
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
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13
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Makini GK, Hishinuma ES, Guerrero AP, Goebert DA. Protecting Youth in the Mental Health Service Settings. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:80-86. [PMID: 32490391 PMCID: PMC7260874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The authors present the development of the field of psychiatry with the evolution of patient safeguards. They address the recent publicized events involving sexual harassment and abuse perpetrated by mental health service providers who have harmed youth who were under their direct psychiatric care. Recommendations are provided for primary care physicians and parents and legal guardians to further ensure patient safety.
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Affiliation(s)
- George K. Makini
- George K. Makini, Jr. MD; 1356 Lusitana Street, 4th Fl., Honolulu, HI 96813;
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14
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Developing an Evidence-Based Technical Assistance Model: a Process Evaluation of the National Training and Technical Assistance Center for Child, Youth, and Family Mental Health. J Behav Health Serv Res 2020; 47:312-330. [PMID: 31974705 PMCID: PMC7324420 DOI: 10.1007/s11414-020-09686-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The National Training and Technical Assistance Center for Child, Youth, and Family Mental Health (NTTAC) supports the development and implementation of systems of care (SOC) for youth with serious emotional disorders (SED) and their families. This article presents results from a process evaluation of NTTAC, conducted to support the Center’s quality improvement and contribute to the knowledge base around provision of technical assistance (TA). The evaluation used a mixed methods approach with data collection focused on a defined subset of NTTAC TA recipients—recipients of federal Comprehensive Community Mental Health Services for Children SOC grants. Data sources included coded administrative records from SOC grant sites, administrative data from NTTAC, standardized measures of SOC development, and stakeholder survey data. Results indicate that TA dosage matched needs and goals of TA recipients (SOC sites), overall levels of satisfaction with TA were high, and TA content was generally aligned with need. TA recipients reported significant progress on indicators of SOC development over time. Together, these findings suggest that it is possible to develop TA methods that reflect the level and type of TA recipients’ goals and needs, and, in turn, positively impact SOC development and behavioral health service delivery.
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15
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Dodge KA. Toward population impact from early childhood psychological interventions. ACTA ACUST UNITED AC 2019; 73:1117-1129. [PMID: 30525790 DOI: 10.1037/amp0000393] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acting alone, psychologists rarely achieve population impact on important mental health and well-being outcomes for families and young children. The traditional Institute of Medicine model of moving from efficacy trials to effectiveness trials to scaling up has not succeeded, partly due to degradation of program quality and impact during scale-up and partly due to a failure to consider system-context issues at the outset. Analysis of barriers to population impact leads to the proposal of a new comprehensive system of care that includes both top-down coordination among community agencies providing services and bottom-up outreach to every family to connect them with services. The North Carolina Smart Start Initiative is a top-down approach to improving the community-level quality of early childcare and education services. A natural experiment demonstrates that it improves population indicators of children's education outcomes. Family Connects is a bottom-up approach that reaches all families giving birth in a community through brief home visits to assess needs and connect families with community resources. A randomized controlled trial reveals increased community connectedness, lower maternal anxiety, reduced emergency health episodes, and lower rates of investigations for child abuse. These initiatives point toward the promise of population impact through psychological interventions in early life that are delivered in a collaborative system of care. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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16
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Sellers R, Smith AF, Leve LD, Nixon E, Cane T, Cassell JA, Harold GT. Utilising Genetically-Informed Research Designs to Better Understand Family Processes and Child Development: Implications for Adoption and Foster Care Focused Interventions. ADOPTION & FOSTERING 2019; 43:351-371. [PMID: 31576061 PMCID: PMC6771282 DOI: 10.1177/0308575919866526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Understanding the interplay between genetic factors and family environmental processes (e.g., inter-parental relationship quality, positive versus negative parenting practices) and children's mental health (e.g., anxiety, depression, conduct problems, ADHD) in the contexts of adoption and foster-care research and practice is critical for effective prevention and intervention programme development. Whilst evidence highlights the importance of family environmental processes for the mental health and well-being of children in adoption and foster care, there is relatively limited evidence of effective interventions specifically for these families. Additionally, family-based interventions not specific to the context of adoption and foster-care typically show small to medium effects, and even where interventions are efficacious, not all children benefit. One explanation for why interventions may not work well for some is that responses to intervention may be influenced by an individual's genetic make-up. This paper summarises how genetically-informed research designs can help disentangle genetic from environmental processes underlying psychopathology outcomes for children, and how this evidence can provide improved insights into the development of more effective preventative intervention targets for adoption and foster-care families. We discuss current difficulties in translating behavioural genetics research to prevention science, and provide recommendations to bridge the gap between behavioural genetics research and prevention science, with lessons for adoption and foster-care research and practice.
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Affiliation(s)
- R Sellers
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - A F Smith
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
| | - L D Leve
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - E Nixon
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
| | - T Cane
- School of Social Work and Social Care, University of Sussex, UK
| | - J A Cassell
- Brighton and Sussex Medical School, Falmer, Brighton BN1 9PH
| | - G T Harold
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
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17
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Leppert KA, Bufferd SJ, Olino TM, Dougherty LR. A Daily Diary Analysis of Preschool Depressive Behaviors: Prospective Associations and Moderators Across 14 Days. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:1547-1558. [PMID: 30911869 PMCID: PMC7755310 DOI: 10.1007/s10802-019-00535-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Depressive disorders can be observed in early childhood and are associated with significant concurrent and prospective impairment; however, little is known about day-to-day variations in common depressive behaviors in children. This study examined the day-to-day variability of two common depressive behaviors in preschool-aged children, sadness and irritability, and factors associated with the daily occurrence of these behaviors. Participants included 291 parents of preschool-aged children, and parents completed a 14-day daily diary. Results indicated that sleep quality did not prospectively predict next-day sadness or irritability the following day. We observed between-person stability, but within-person variability, in children's sadness and irritability across 14 days. We observed greater between-person stability and greater within-person variability in sadness and irritability for males and for children with fewer baseline psychiatric symptoms and lower baseline impairment. Findings provide a developmental perspective on normative patterns of sadness and irritability in young children and can inform prevention and individualized intervention efforts to reduce negative sequelae in at-risk preschoolers.
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Affiliation(s)
- Katherine A Leppert
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - Sara J Bufferd
- Department of Psychology, California State University, San Marcos, San Marcos, CA, 92096, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA.
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18
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Abstract
Introduction: Intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours require innovative models of health care delivery to break them. We describe a programme of research informed service development targeting vulnerable families in inner metropolitan Sydney, Australia that is designed to build and confirm a “Theory of Neighbourhood Context, Stress, Depression, and the Developmental Origins of Health and Disease (DOHaD)”. We describe the development of an intervention design and business case that drew on earlier realist causal and programme theoretical work. Methods: Realist causal and programme theory were used to inform the collaborative design of initiatives for vulnerable families. The collaborative design process included: identification of desirable and undesirable outcomes and contextual factors, consultation forums, interagency planning, and development of a service proposal. Results: The design elements included: perinatal coordination, sustained home visiting, integrated service model development, two place-based hubs, health promotion and strengthened research and analysis capability. Conclusions: We demonstrate here the design of interventions for vulnerable families in Sydney utilising translational research from previous realist causal and program theory building to operational service design. We have identified the importance of our earlier analysis of underlying causal mechanisms and related programme mechanisms for identifying the elements for the full intervention design. The application of theory added rigour to the design of the integrated care initiatives. In applying the theory to the local situation the analysis took into account: the role of the local agencies; evidence of program effectiveness; determinants and outcomes for local children and their families; the current deployment of service resources; and insights from front-line staff and interagency partners.
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19
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Zand DH, Pierce KJ, Ladage J, Heaney MS, Sallee HM. I Get By With A Little Help From My Friends: Models of Psychological Intervention in Pediatric Primary Care. MISSOURI MEDICINE 2019; 116:111-116. [PMID: 31040496 PMCID: PMC6461326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The pediatric primary care setting is ideal for addressing children's and adolescents' mental health needs. As a result of extensive training in health promotion, consultation, assessment, and treatment of psychological disorders, psychologists are uniquely positioned to support primary care pediatricians in this endeavor. This paper provides a review of models of psychology interventions in pediatric primary care including: care delivery, scope of practice, implementation and recent research. It concludes with a case example and recommendations.
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Affiliation(s)
- Debra H Zand
- Debra H. Zand, PhD, Professor, Saint Louis University Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Katherine J Pierce
- Katherine J. Pierce, PhD, Research Coordinator, Saint Louis University, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Jennifer Ladage
- Jennifer Ladage, MD, Associate Professor, Saint Louis University Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Mary S Heaney
- Mary S. Heaney, MD, MPH, Professor, Saint Louis University Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Heidi M Sallee
- Heidi M. Sallee, MD, Associate Professor, Saint Louis University Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
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20
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Goodman WB, O'Donnell K, Murphy RA, Dodge KA. Moving Beyond Program to Population Impact: Toward a Universal Early Childhood System of Care. JOURNAL OF FAMILY THEORY & REVIEW 2019; 11:112-126. [PMID: 30923572 PMCID: PMC6433400 DOI: 10.1111/jftr.12302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/10/2018] [Indexed: 06/09/2023]
Abstract
Families have clearly benefited from increased availability of evidence-based intervention, including home-visiting models and increased federal funding for programs benefiting parents and children. The goal of population-level impact on the health and well-being of infants and young children across entire communities, however, remains elusive. New approaches are needed to move beyond scaling of individual programs toward an integrated system of care in early childhood. To advance this goal, the current article provides a framework for developing an early childhood system of care that pairs a top-down goal for the alignment of services with a bottom-up goal of identifying and addressing needs of all families throughout early childhood. Further, we describe how universal newborn home visiting can be utilized to both support alignment of and family entry into an early childhood system of care with broad reach, high quality, and evidence of population impact for families and children.
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Affiliation(s)
| | - Karen O'Donnell
- Duke University, 2024 W. Main St., Box 90539, Durham, NC 27709-0539
| | - Robert A Murphy
- Duke University, 2024 W. Main St., Box 90539, Durham, NC 27709-0539
| | - Kenneth A Dodge
- Duke University, 2024 W. Main St., Box 90539, Durham, NC 27709-0539
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21
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Rojas LM, Bahamón M, Wagstaff R, Ferre I, Perrino T, Estrada Y, St George SM, Pantin H, Prado G. Evidence-based prevention programs targeting youth mental and behavioral health in primary care: A systematic review. Prev Med 2019; 120:85-99. [PMID: 30610888 DOI: 10.1016/j.ypmed.2018.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/07/2018] [Accepted: 12/16/2018] [Indexed: 01/05/2023]
Abstract
The objectives of this systematic review were to: 1) identify evidence-based youth (i.e., infancy, pre-school age, school age, and adolescence) mental and behavioral health disorder preventive interventions conducted in or offered by primary care settings, and 2) describe these interventions' characteristics, efficacy, and clinical involvement. Randomized controlled trials that targeted the prevention of mental or behavioral health outcomes for youth and had a connection to primary care were included. The PRISMA guidelines were utilized for two phases: 1) searching PubMed, EMBASE, PsycInfo, CINAHL, and Cochrane databases in January 2017; and 2) searching United States Preventive Services Task Force (USPSTF) Systematic Reviews in November 2017. The two phases revealed 504 and 58 potential articles, respectively. After removal of duplicates, screening of abstracts, and full-text reviews, 19 interventions (infancy: n = 2, pre-school age: n = 3, school age: n = 6, adolescence: n = 8) were included: 1) 10 interventions described in 17 articles from the databases, and 2) 9 interventions described in 11 articles from the USPSTF reviews. The included interventions capitalized on primary care settings as a natural entry point to engage youth and families into interventions without requiring a large amount of clinic involvement. Commonalities of efficacious interventions and recommendations for future research are discussed. The authors encourage primary care providers, mental and behavioral health providers, and/or public health researchers to continue developing and testing preventive interventions, or adapting existing interventions, to be implemented in primary care.
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Affiliation(s)
- Lourdes M Rojas
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA.
| | - Mónica Bahamón
- Emergency Department, Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL 33136, USA
| | - Rachel Wagstaff
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
| | - Isabella Ferre
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
| | - Tatiana Perrino
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
| | - Yannine Estrada
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
| | - Hilda Pantin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA
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Mundt MP, Zakletskaia LI. Adolescent Friendship Formation and Mental Health: A Stochastic Actor-Based Model of Help-Seeking Behavior. JOURNAL OF SOCIAL STRUCTURE : JOSS 2019; 20:50-69. [PMID: 38817714 PMCID: PMC11138242 DOI: 10.21307/joss-2019-006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
This study investigates how adolescent peer friendship formation relates to help-seeking behavior and how the structure of peer social networks contributes to the creation of social connections by psychological counseling recipients. The study sample comprised 2,264 adolescents ages 12-19 from the National Longitudinal Study of Adolescent Health (Add Health). Stochastic actor-based modeling simulated the co-dependence of peer friendship networks and adolescent help-seeking behavior from an initial data state to a final data state while accounting for social selection and influence effects in the same model. Results indicated that adolescents who sought psychological counseling in the past year nominated 65% more peers as friends than otherwise identical adolescents who did not use psychological services. Adolescent psychological counseling did not contribute to the loss of friends. Users of psychological services were twice as likely to be named as friends in highly interconnected peer social networks (i.e. more friendship connections among their friends), as opposed to individuals in less interconnected peer groups. The findings indicate improved social functioning of adolescents as a result of psychological counseling. The results advocate for use of psychological services and point to the necessity of wide-spread screening and early detection and treatment of mental ill-health among U.S. adolescents. Group interventions targeting building social skills to enhance peer group social network interconnectivity may promote better social connections for adolescent users of psychological counseling.
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Affiliation(s)
- Marlon P Mundt
- Department of Family Medicine and Community Health and Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Court, Madison WI 53715
| | - Larissa I Zakletskaia
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Abram KM, Azores-Gococo NM, Emanuel KM, Aaby DA, Welty LJ, Hershfield JA, Rosenbaum MS, Teplin LA. Sex and Racial/Ethnic Differences in Positive Outcomes in Delinquent Youth After Detention: A 12-Year Longitudinal Study. JAMA Pediatr 2017; 171:123-132. [PMID: 27992626 PMCID: PMC5704941 DOI: 10.1001/jamapediatrics.2016.3260] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Longitudinal studies of delinquent youth have focused on criminal recidivism, not on psychosocial outcomes in adulthood. This omission is critical because after detention most youth return to the community, where they become the responsibility of pediatric health care professionals. OBJECTIVE To investigate 8 positive outcomes among delinquent youth 5 and 12 years after detention, focusing on sex and racial/ethnic differences. DESIGN, SETTING, AND PARTICIPANTS In the Northwestern Juvenile Project, a longitudinal US study of long-term outcomes of delinquent youth after detention, participants were interviewed in detention between November 20, 1995, and June 14, 1998, and reinterviewed up to 9 times during the 12-year study period, through May 12, 2011. Data analysis was conducted between November 18, 2013, and July 25, 2016. EXPOSURES Juvenile detention. MAIN OUTCOMES AND MEASURES Achievement of positive outcomes in 8 domains: educational attainment, residential independence, gainful activity, desistance from criminal activity, mental health, abstaining from substance abuse, interpersonal functioning, and parenting responsibility. Outcomes were assessed with widely used measures supplemented by correctional records. RESULTS The study included 1829 youth at baseline (1172 males and 657 females; mean [SD] age, 14.9 [1.4] years). At the end of the study, 1520 (83.1%) of the original sample remained (944 males and 576 females; mean [SD] age, 27.6 [1.4] years). Twelve years after detention, females were more likely than males to have positive outcomes for gainful activity (odds ratio [OR], 2.53; 95% CI, 1.86-3.44), desistance from criminal activity (OR, 5.89; 95% CI, 4.38-7.92), residential independence (OR, 3.41; 95% CI, 2.57-4.52), parenting responsibility (OR, 18.65; 95% CI, 12.29-28.30), and mental health (OR, 1.48; 95% CI, 1.13-1.92). Twelve years after detention, only 21.9% of males and 54.7% of females had achieved more than half of the outcomes. As youth aged, the number of positive outcomes increased only modestly (mean increase for males, 0.37; 95% CI, 0.13-0.62; for females, 0.29; 95% CI, 0.13-0.45). Among males, non-Hispanic white individuals were significantly more likely to achieve most positive outcomes compared with minorities, but less likely to abstain from substance abuse. For example, 12 years after detention, non-Hispanic white males had nearly 3 times the odds of educational attainment compared with African American (OR, 2.82; 95% CI, 1.77-4.50) and Hispanic males (OR, 2.91; 95% CI, 1.75-4.82), and 2 to 5 times the odds of gainful activity compared with African American (OR, 5.17; 95% CI, 3.16-8.45) and Hispanic males (OR, 2.58; 95% CI, 1.56-4.26). Latent class analysis shows that African American males fared the worst, with lives characterized by incarceration, criminal activity, and few positive outcomes. CONCLUSIONS AND RELEVANCE Our findings highlight racial/ethnic disparities among youth in achieving positive outcomes after detention. To improve outcomes, pediatric health care professionals should recognize the importance of psychosocial health, partner with on-site psychosocial services in their practices, and facilitate access to services in the community.
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Affiliation(s)
- Karen M. Abram
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Nicole M. Azores-Gococo
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kristin M. Emanuel
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - David A. Aaby
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Leah J. Welty
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jennifer A. Hershfield
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Melinda S. Rosenbaum
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda A. Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Hacker K, Penfold R, Arsenault LN, Zhang F, Soumerai SB, Wissow LS. The Impact of the Massachusetts Behavioral Health Child Screening Policy on Service Utilization. Psychiatr Serv 2017; 68:25-32. [PMID: 27582240 PMCID: PMC5205553 DOI: 10.1176/appi.ps.201500543] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In 2008, Massachusetts Medicaid implemented a pediatric behavioral health (BH) screening mandate. This study conducted a population-level, longitudinal policy analysis to determine the impact of the policy on ambulatory, emergency, and inpatient BH care in comparison with use of these services in California, where no similar policy exists. METHODS With Medicaid Analytic Extract (MAX) data, an interrupted time-series analysis with control series design was performed to assess changes in service utilization in the 18 months (January 2008-June 2009) after a BH screening policy was implemented in Massachusetts and to compare service utilization with California's. Outcomes included population rates of BH screening, BH-related outpatient visits, BH-related emergency department visits, BH-related hospitalizations, and psychotropic drug use. Medicaid-eligible children from January 1, 2006, to December 31, 2009, with at least ten months of Medicaid eligibility who were older than 4.5 years and younger than 18 years were included. RESULTS Compared with rates in California, Massachusetts rates of BH screening and BH-related outpatient visits rose significantly after Massachusetts implemented its screening policy. BH screening rose about 13 per 1,000 youths per month during the first nine months, and BH-related outpatient visits rose to about 4.5 per 1,000 youths per month (p<.001). Although BH-related emergency department visits, hospitalization and psychotropic drug use increased, there was no difference between the states in rate of increase. CONCLUSIONS The goal of BH screening is to identify previously unidentified children with BH issues and provide earlier treatment options. The short-term outcomes of the Massachusetts policy suggest that screening at preventive care visits led to more BH-related outpatient visits among vulnerable children.
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Affiliation(s)
- Karen Hacker
- Dr. Hacker is with the Allegheny County Health Department and with the Graduate School of Public Health, University of Pittsburgh, Pittsburgh (e-mail: ). Dr. Penfold is with the Department of Health Services Research, Group Health Research Institute, Seattle. Dr Arsenault is with the Institute for Community Health, Cambridge, Massachusetts, and Harvard Medical School, Boston. Dr. Zhang and Dr. Soumerai are with the Department of Population Medicine, Harvard Medical School, and with Harvard Pilgrim Healthcare Institute, Boston. Dr. Wissow is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Robert Penfold
- Dr. Hacker is with the Allegheny County Health Department and with the Graduate School of Public Health, University of Pittsburgh, Pittsburgh (e-mail: ). Dr. Penfold is with the Department of Health Services Research, Group Health Research Institute, Seattle. Dr Arsenault is with the Institute for Community Health, Cambridge, Massachusetts, and Harvard Medical School, Boston. Dr. Zhang and Dr. Soumerai are with the Department of Population Medicine, Harvard Medical School, and with Harvard Pilgrim Healthcare Institute, Boston. Dr. Wissow is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Lisa N Arsenault
- Dr. Hacker is with the Allegheny County Health Department and with the Graduate School of Public Health, University of Pittsburgh, Pittsburgh (e-mail: ). Dr. Penfold is with the Department of Health Services Research, Group Health Research Institute, Seattle. Dr Arsenault is with the Institute for Community Health, Cambridge, Massachusetts, and Harvard Medical School, Boston. Dr. Zhang and Dr. Soumerai are with the Department of Population Medicine, Harvard Medical School, and with Harvard Pilgrim Healthcare Institute, Boston. Dr. Wissow is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Fang Zhang
- Dr. Hacker is with the Allegheny County Health Department and with the Graduate School of Public Health, University of Pittsburgh, Pittsburgh (e-mail: ). Dr. Penfold is with the Department of Health Services Research, Group Health Research Institute, Seattle. Dr Arsenault is with the Institute for Community Health, Cambridge, Massachusetts, and Harvard Medical School, Boston. Dr. Zhang and Dr. Soumerai are with the Department of Population Medicine, Harvard Medical School, and with Harvard Pilgrim Healthcare Institute, Boston. Dr. Wissow is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Stephen B Soumerai
- Dr. Hacker is with the Allegheny County Health Department and with the Graduate School of Public Health, University of Pittsburgh, Pittsburgh (e-mail: ). Dr. Penfold is with the Department of Health Services Research, Group Health Research Institute, Seattle. Dr Arsenault is with the Institute for Community Health, Cambridge, Massachusetts, and Harvard Medical School, Boston. Dr. Zhang and Dr. Soumerai are with the Department of Population Medicine, Harvard Medical School, and with Harvard Pilgrim Healthcare Institute, Boston. Dr. Wissow is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Lawrence S Wissow
- Dr. Hacker is with the Allegheny County Health Department and with the Graduate School of Public Health, University of Pittsburgh, Pittsburgh (e-mail: ). Dr. Penfold is with the Department of Health Services Research, Group Health Research Institute, Seattle. Dr Arsenault is with the Institute for Community Health, Cambridge, Massachusetts, and Harvard Medical School, Boston. Dr. Zhang and Dr. Soumerai are with the Department of Population Medicine, Harvard Medical School, and with Harvard Pilgrim Healthcare Institute, Boston. Dr. Wissow is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore
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Rodger S, Bourdage R, Hancock K, Hsiang R, Masters R, Leschied A. Supporting Students: A GRADE Analysis of the Research on Student Wellness and Classroom Mental Health Support. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573516684069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recommendations derived from research evidence regarding program implementation in school-based mental health [SBMH] require knowledge of the intervention outcomes as well as the potential to translate program components into schools. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) analysis was applied to major areas of the SBMH literature in addressing the areas of effectiveness and the strength of recommendation in implementation. Nine areas were addressed: emotional intelligence, stigma reduction, mindfulness, anxiety, depression, addictions, suicide prevention, trauma, and eating disorders. Ninety-eight studies were retrieved across the nine areas. Effect sizes based on reported outcomes and estimates on the strength of recommendation were generated in each of the nine areas of interest. These results provide an overview of the quality of the evidence that will be of relevance to school personal in making program selections.
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Affiliation(s)
- Susan Rodger
- The University of Western Ontario, London, Canada
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Effectiveness of wraparound versus case management for children and adolescents: results of a randomized study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 42:309-22. [PMID: 24973891 DOI: 10.1007/s10488-014-0571-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study, we compared service experiences and outcomes for youths with serious emotional disorder (SED) randomly assigned to care coordination via a defined wraparound process (n = 47) versus more traditional intensive case management (ICM; n = 46) The wraparound group received more mean hours of care management and services; however, there ultimately were no group differences in restrictiveness of residential placement, emotional and behavioral symptoms, or functioning. Wraparound implementation fidelity was found to be poor. Organizational culture and climate, and worker morale, were poorer for the wraparound providers than the ICM group. Results suggest that, for less-impaired youths with SED, less intensive options such as ICM may be equally effective to poor-quality wraparound delivered in the absence of wraparound implementation supports and favorable system conditions.
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Arora PG, Bohnenkamp JH. Collaborative practices and partnerships across school mental health and pediatric primary care settings. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/1754730x.2016.1216684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Haine-Schlagel R, Roesch SC, Trask EV, Fawley-King K, Ganger WC, Aarons GA. The Parent Participation Engagement Measure (PPEM): Reliability and Validity in Child and Adolescent Community Mental Health Services. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 43:813-823. [PMID: 26520104 PMCID: PMC4852156 DOI: 10.1007/s10488-015-0698-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Parent participation in community-based child mental health services is an important yet understudied process associated with treatment effectiveness. This paper describes the development and psychometrics of the Parent Participation Engagement Measure in a sample of 1374 parents and 563 youth receiving publicly-funded mental health services. Analyses indicated excellent internal consistency, and model fit indices/factor loadings supported a one-factor model. Convergent and discriminant validity were supported, although some coefficients were modest in magnitude. Psychometric results were consistent for Caucasian versus Hispanic, parent versus youth, and English versus Spanish-language respondents. The clinical and research utility of this measure are discussed.
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Affiliation(s)
- Rachel Haine-Schlagel
- Department of Child and Family Development, San Diego State University, San Diego, CA, USA.
- Child & Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA.
| | - Scott C Roesch
- Department of Child and Family Development, San Diego State University, San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Emily V Trask
- Child & Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Kya Fawley-King
- Child & Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - William C Ganger
- Child & Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA
- Research Foundation, San Diego State University, San Diego, CA, USA
| | - Gregory A Aarons
- Child & Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Hage SM, Romano JL, Conyne RK, Kenny M, Matthews C, Schwartz JP, Waldo M. Best Practice Guidelines on Prevention Practice, Research, Training, and Social Advocacy for Psychologists. COUNSELING PSYCHOLOGIST 2016. [DOI: 10.1177/0011000006291411] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preventive interventions have been shown to successfully aid the development of children, youths, and adults and avert maladjustment in individuals at risk for negative outcomes. Continued scientific advancement of preventive interventions is crucial to further the health of U.S. children, youths, and families. This article presents 15 best practice guidelines on prevention practice, research, training, and social advocacy for psychology. These guidelines articulate clear standards and a framework for moving the profession toward improving the well-being of a greater number of individuals and communities. The guidelines are intended to assist psychologists in evaluating their preparation for engaging in prevention work and in furthering their understanding through increased knowledge, skills, and experience in prevention.
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Bruns EJ, Hyde KL, Sather A, Hook AN, Lyon AR. Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 43:350-68. [PMID: 26060099 PMCID: PMC4675692 DOI: 10.1007/s10488-015-0658-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Health information technology (HIT) and care coordination for individuals with complex needs are high priorities for quality improvement in health care. However, there is little empirical guidance about how best to design electronic health record systems and related technologies to facilitate implementation of care coordination models in behavioral health, or how best to apply user input to the design and testing process. In this paper, we describe an iterative development process that incorporated user/stakeholder perspectives at multiple points and resulted in an electronic behavioral health information system (EBHIS) specific to the wraparound care coordination model for youth with serious emotional and behavioral disorders. First, we review foundational HIT research on how EBHIS can enhance efficiency and outcomes of wraparound that was used to inform development. After describing the rationale for and functions of a prototype EBHIS for wraparound, we describe methods and results for a series of six small studies that informed system development across four phases of effort-predevelopment, development, initial user testing, and commercialization-and discuss how these results informed system design and refinement. Finally, we present next steps, challenges to dissemination, and guidance for others aiming to develop specialized behavioral health HIT. The research team's experiences reinforce the opportunity presented by EBHIS to improve care coordination for populations with complex needs, while also pointing to a litany of barriers and challenges to be overcome to implement such technologies.
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Affiliation(s)
- Eric J Bruns
- University of Washington School of Medicine, Seattle, WA, 98105, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington, 2815 Eastlake Ave E, Suite 200, Seattle, WA, 98102, USA.
| | | | - April Sather
- University of Washington School of Medicine, Seattle, WA, 98105, USA
| | - Alyssa N Hook
- University of Washington School of Medicine, Seattle, WA, 98105, USA
| | - Aaron R Lyon
- University of Washington School of Medicine, Seattle, WA, 98105, USA
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Foley KP, Haggerty TS, Harrison N. Curriculum development: Preparing trainees to care for children and adolescents with psychiatric disorders. Int J Psychiatry Med 2015; 50:50-9. [PMID: 26113643 DOI: 10.1177/0091217415592360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Family physicians provide care for about one-third of the children and adolescents in the United States, many of whom present with psychological concerns. Family physicians often do not recognize these psychological disorders and therefore do not diagnose or treat them. This report describes the implementation of a curriculum designed to increase family medicine trainees' level of awareness that children/adolescents experience psychiatric conditions. This goal is achieved through the addition of a clinical child/adolescent psychologist faculty member, resident self-assessment of training needs and subsequent development of didactic presentations to address these needs. The curriculum relies on the acquisition of child/adolescent psychiatric screeners, development of child/adolescent-focused bibliotherapy materials, and the development of a longitudinal behavioral sciences curriculum. To facilitate the screening of child/adolescent psychiatric disorders, a comprehensive collection of age-appropriate psychiatric screeners were compiled and made readily available in all precepting areas. To assist with the identification of specific child/adolescent psychiatric deficit areas, family medicine resident physicians were presented with an inventory of child/adolescent psychiatric, psychosocial, and behavioral topics, based upon American Academy of Family Practice guidelines and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition psychiatric disorders, and self-selected training deficiencies.
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Affiliation(s)
- Kimberly P Foley
- Department of Family Medicine, West Virginia University, Morgantown, WV, USA
| | - Treah S Haggerty
- Department of Family Medicine, West Virginia University, Morgantown, WV, USA
| | - Natasha Harrison
- Department of Family Medicine, West Virginia University, Morgantown, WV, USA
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SLATEN CHRISTOPHERD, ELISON ZACHARYM, HUGHES HAYLEY, YOUGH MIKE, SHEMWELL DANIEL. Hearing the Voices of Youth at Risk for Academic Failure: What Professional School Counselors Need to Know. THE JOURNAL OF HUMANISTIC COUNSELING 2015. [DOI: 10.1002/johc.12012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- CHRISTOPHER D. SLATEN
- Department of Educational Studies; Purdue University
- Now at Department of Educational, School, and Counseling Psychology; University of Missouri-Columbia
| | | | - HAYLEY HUGHES
- Department of Educational Studies; Purdue University
| | - MIKE YOUGH
- Department of Educational Studies; Purdue University
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Leve LD, Harold GT, Ge X, Neiderhiser JM, Patterson G. Refining Intervention Targets in Family-Based Research: Lessons From Quantitative Behavioral Genetics. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 5:516-26. [PMID: 21188273 DOI: 10.1177/1745691610383506] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The results from a large body of family-based research studies indicate that modifying the environment (specifically dimensions of the social environment) through intervention is an effective mechanism for achieving positive outcomes. Parallel to this work is a growing body of evidence from genetically informed studies indicating that social environmental factors are central to enhancing or offsetting genetic influences. Increased precision in the understanding of the role of the social environment in offsetting genetic risk might provide new information about environmental mechanisms that could be applied to prevention science. However, at present, the multifaceted conceptualization of the environment in prevention science is mismatched with the more limited measurement of the environment in many genetically informed studies. In this article, we present a framework for translating quantitative behavioral genetic research to inform the development of preventive interventions. The measurement of environmental indices amenable to modification is discussed within the context of quantitative behavioral genetic studies. In particular, emphasis is placed on the necessary elements that lead to benefits in prevention science, specifically the development of evidence-based interventions. We provide an example from an ongoing prospective adoption study to illustrate the potential of this translational process to inform the selection of preventive intervention targets.
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Affiliation(s)
| | - Gordon T Harold
- Centre for Research on Children and Families and Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Xiaojia Ge
- Institute of Child Development, University of Minnesota, Minneapolis, MN
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Haine-Schlagel R, Walsh NE. A review of parent participation engagement in child and family mental health treatment. Clin Child Fam Psychol Rev 2015; 18:133-150. [PMID: 25726421 DOI: 10.1007/s10567-015-1082-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Engagement in child and family mental health treatment has critically important clinical, implementation, and policy implications for efforts to improve the quality and effectiveness of care. This article describes a review of the existing literature on one understudied element of engagement, parent participation. Twenty-three published articles were identified. Questions asked of the literature include what terms are used to represent parent participation engagement, how parent participation engagement is measured, what are the rates of parent participation engagement reported in studies of child and family mental health treatment, whether parent participation engagement has been found to overlap with attendance engagement, what factors have been identified as associated with parent participation engagement, whether parent participation engagement is associated with improved outcomes, and what strategies have been designed to improve PPE and whether such strategies are associated with improved outcomes. Results indicate varied terms and measures of parent participation engagement, moderate overall rates, and high overlap with measures of attendance engagement. The extant literature on factors associated with parent participation engagement was somewhat limited and focused primarily on parent-/family-level factors. Evidence of links between parent participation engagement and outcome improvements was found across some outcome domains, and strategies designed to target parent participation engagement were found to be effective overall. A framework for organizing efforts to examine the different elements of engagement is described, and findings are discussed in terms of suggestions for consistent terminology, clinical implications, and areas for the future research.
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Haine-Schlagel R, Walsh NE. A review of parent participation engagement in child and family mental health treatment. Clin Child Fam Psychol Rev 2015; 18:133-50. [PMID: 25726421 PMCID: PMC4433419 DOI: 10.1007/s10567-015-0182-x] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Engagement in child and family mental health treatment has critically important clinical, implementation, and policy implications for efforts to improve the quality and effectiveness of care. This article describes a review of the existing literature on one understudied element of engagement, parent participation. Twenty-three published articles were identified. Questions asked of the literature include what terms are used to represent parent participation engagement, how parent participation engagement is measured, what are the rates of parent participation engagement reported in studies of child and family mental health treatment, whether parent participation engagement has been found to overlap with attendance engagement, what factors have been identified as associated with parent participation engagement, whether parent participation engagement is associated with improved outcomes, and what strategies have been designed to improve PPE and whether such strategies are associated with improved outcomes. Results indicate varied terms and measures of parent participation engagement, moderate overall rates, and high overlap with measures of attendance engagement. The extant literature on factors associated with parent participation engagement was somewhat limited and focused primarily on parent-/family-level factors. Evidence of links between parent participation engagement and outcome improvements was found across some outcome domains, and strategies designed to target parent participation engagement were found to be effective overall. A framework for organizing efforts to examine the different elements of engagement is described, and findings are discussed in terms of suggestions for consistent terminology, clinical implications, and areas for the future research.
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Leijten P, Raaijmakers MAJ, Orobio de Castro B, van den Ban E, Matthys W. Effectiveness of the Incredible Years Parenting Program for Families with Socioeconomically Disadvantaged and Ethnic Minority Backgrounds. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:59-73. [PMID: 25985392 DOI: 10.1080/15374416.2015.1038823] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Families with socioeconomically disadvantaged and ethnic minority backgrounds are often hard to reach for the prevention and treatment of disruptive child behavior problems. We examined whether the Incredible Years parenting intervention can successfully reach and benefit families with socioeconomic disadvantaged and ethnic minority backgrounds in the Netherlands. One hundred fifty-four families from a wide range of socioeconomic and ethnic backgrounds were recruited in an outpatient clinic for child and adolescent psychiatry and in elementary schools serving deprived neighborhoods. Families were randomly assigned to the BASIC Incredible Years parenting intervention or a waiting list control condition. Children were 3-8 years old (M = 5.59, SD = 1.35; 62% boys, 66% ethnic minorities) and 65% of the children met Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria for oppositional defiant disorder, conduct disorder, and/or attention-deficit hyperactivity disorder. Incredible Years reduced parent-reported disruptive child behavior and teacher-reported hyperactive and inattentive child behavior and increased parent-reported use of praise and incentives and reduced harsh and inconsistent discipline. Incredible Years did not affect parent-reported hyperactive and inattentive child behavior; teacher-reported child conduct problems; and parent-reported use of appropriate discipline techniques, clear expectations, physical punishment, and parenting stress. Of importance, the effectiveness of Incredible Years did not differ across families with different socioeconomic and ethnic backgrounds. Effects were maintained at 3-month follow-up. This study shows that socioeconomically disadvantaged and ethnic minority families in disadvantaged neighborhoods can be engaged in and benefit from parenting interventions to reduce disruptive child behavior.
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Affiliation(s)
- Patty Leijten
- a Department of Developmental Psychology , Utrecht University
| | | | | | - Els van den Ban
- b Department of Child and Adolescent Psychiatry , University Medical Centre Utrecht.,c Altrecht Institute for Mental Health Utrecht
| | - Walter Matthys
- d Department of Child and Adolescent Studies , Utrecht University
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Effectiveness of Health System Services and Programs for Youth to Adult Transitions in Mental Health Care: A Systematic Review of Academic Literature. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 43:259-69. [DOI: 10.1007/s10488-015-0638-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Valleley RJ, Romer N, Kupzyk S, Evans JH, Allen KD. Behavioral Health Screening in Pediatric Primary Care. J Prim Care Community Health 2014; 6:199-204. [DOI: 10.1177/2150131914562912] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This pilot study investigated the effect of the Pediatric Symptom Checklist (PSC) on identification of and physician response to behavioral health (BH) concerns. Researchers reviewed 1211 charts of youth aged 4 to 16 years. Records were compared during baseline and an intervention consisting of implementation of the PSC to determine the rate of BH identification and pediatrician response. Access to PSC data resulted in a trivial difference in BH concerns identified by physicians and did not affect physician responses. This case study demonstrates that simply implementing BH screening in primary care may not result in improved outcomes for these children.
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Affiliation(s)
| | | | - Sara Kupzyk
- University of Nebraska Medical Center, Omaha, NE, USA
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Tolan P. Future directions for positive development intervention research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2014; 43:686-94. [PMID: 25023002 DOI: 10.1080/15374416.2014.936604] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The emergence of multiple universal prevention efforts that reduce psychopathology symptoms, along with growing interest in the promotion of healthy development, presents an exciting opportunity for advancing child and adolescent mental health. Multiple frameworks and related construct models of positive development have been developed-and are all driving substantial findings. In addition, efforts under way to understand and systematically review existing interventions as promoting effective development are proving valuable not only for reducing risk but also for improving emotional and social functioning. Principal contributors to this exciting convergence of interests and advancements are described in this article. Moreover, this article presents important challenges and opportunities for moving forward toward a robust integration of positive development and child and adolescent clinical psychology.
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Bruns EJ, Walker JS, Bernstein A, Daleiden E, Pullmann MD, Chorpita BF. Family voice with informed choice: coordinating wraparound with research-based treatment for children and adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2013; 43:256-69. [PMID: 24325146 PMCID: PMC3954919 DOI: 10.1080/15374416.2013.859081] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The wraparound process is a type of individualized, team-based care coordination that has become central to many state and system efforts to reform children's mental health service delivery for youths with the most complex needs and their families. Although the emerging wraparound research base is generally positive regarding placements and costs, effect sizes are smaller for clinical and functional outcomes. This article presents a review of literature on care coordination and wraparound models, with a focus on theory and research that indicates the need to better connect wraparound-enrolled children and adolescents to evidence-based treatment (EBT). The article goes on to describe how recently developed applications of EBT that are based on quality improvement and flexible application of "common elements" of research-based care may provide a more individualized approach that better aligns with the philosophy and procedures of the wraparound process. Finally, this article presents preliminary studies that show the feasibility and potential effectiveness of coordinating wraparound with the Managing and Adapting Practice system, and discusses intervention development and research options that are currently under way.
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Affiliation(s)
- Eric J Bruns
- a Department of Psychiatry and Behavioral Sciences , University of Washington School of Medicine
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Ye C, Browne G, Beyene J, Thabane L. A sensitivity analysis of the Children's Treatment Network trial: a randomized controlled trial of integrated services versus usual care for children with special health care needs. Clin Epidemiol 2013; 5:373-85. [PMID: 24098089 PMCID: PMC3789843 DOI: 10.2147/clep.s48870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background The value of integrated care through comprehensive, coordinated, and family-centered services has been increasingly recognized for improving health outcomes of children with special health care needs (CSHCN). In a randomized controlled trial (RCT), the integrated care provided through the Children’s Treatment Network (CTN) was compared with usual care in improving the psychosocial health of target CSHCN. In this paper, we aimed to estimate the effect of CTN care by conducting multiple analyses to handle noncompliance in the trial. Methods The trial recruited target children in Simcoe County and York Region, ON, Canada. Children were randomized to receive CTN or usual care and were followed for 2 years. The CTN group received integrated services through multiple providers to address their specific needs while the usual care group continued to receive care directed by their parents. The outcome was change in psychosocial quality of life at 2 years. We conducted intention-to-treat, as-treated, per-protocol, and instrumental variable analyses to analyze the outcome. Results The trial randomized 445 children, with 229 in the intervention group and 216 in the control group. During follow-up, 52% of children in the intervention group did not receive complete CTN care for various reasons. At 2 years, we did not find a significant improvement in psychosocial quality of life among the children receiving CTN care compared with usual care (intention-to-treat mean difference 1.50, 95% confidence interval −1.49 to 4.50; P = 0.32). Other methods of analysis yielded similar results. Conclusion Although the effect of CTN care was not significant, there was evidence showing benefits of integrated care for CSHCN. More RCTs are needed to demonstrate the magnitude of such an effect. The CTN study highlights the key challenges in RCTs when assessing interventions involving integrated care, and informs further RCTs including similar evaluations.
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Affiliation(s)
- Chenglin Ye
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, On, Canada ; Biostatistcs Unit, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, On, Canada
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Bernstein A, Chorpita BF, Rosenblatt A, Becker KD, Daleiden EL, Ebesutani CK. Fit of Evidence-Based Treatment Components to Youths Served by Wraparound Process: A Relevance Mapping Analysis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2013; 44:44-57. [DOI: 10.1080/15374416.2013.828296] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Abram Rosenblatt
- c Department of Psychiatry , University of California, San Francisco and EMQ FamiliesFirst
| | - Kimberly D. Becker
- d Division of Child & Adolescent Psychiatry , University of Maryland School of Medicine
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Baker-Ericzén MJ, Jenkins MM, Haine-Schlagel R. Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services. JOURNAL OF CHILD AND FAMILY STUDIES 2013; 22:854-868. [PMID: 24019737 PMCID: PMC3765037 DOI: 10.1007/s10826-012-9644-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and interviews, including: 4 therapist focus groups, 3 parent focus groups, and 10 youth semi-structured interviews. Therapist, parent, and youth stakeholder participants discussed perceived barriers to effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention, etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with services within and across multiple stakeholder groups, including inadequate support and lack of family involvement; however, parents and therapists, in particular, identified different contributing factors to these barriers. Overall, stakeholders reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings can inform service provision, intervention development, and future research.
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Affiliation(s)
- Mary J. Baker-Ericzén
- Child and Adolescent Services Research Center, Rady Children’s Hospital, 3020 Children’s Way, MC5033 San Diego, CA 92123
| | | | - Rachel Haine-Schlagel
- Child and Adolescent Services Research Center, Rady Children’s Hospital, 3020 Children’s Way, MC5033 San Diego, CA 92123
- San Diego State University, San Diego, CA
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Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc 2013; 16:18593. [PMID: 23782478 PMCID: PMC3687078 DOI: 10.7448/ias.16.1.18593] [Citation(s) in RCA: 232] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 04/10/2013] [Accepted: 04/16/2013] [Indexed: 12/22/2022] Open
Abstract
Introduction Across the globe, children born with perinatal HIV infection (PHIV) are reaching adolescence and young adulthood in large numbers. The majority of research has focused on biomedical outcomes yet there is increasing awareness that long-term survivors with PHIV are at high risk for mental health problems, given genetic, biomedical, familial and environmental risk. This article presents a review of the literature on the mental health functioning of perinatally HIV-infected (PHIV+) adolescents, corresponding risk and protective factors, treatment modalities and critical needs for future interventions and research. Methods An extensive review of online databases was conducted. Articles including: (1) PHIV+ youth; (2) age 10 and older; (3) mental health outcomes; and (4) mental health treatment were reviewed. Of 93 articles identified, 38 met inclusion criteria, the vast majority from the United States and Europe. Results These studies suggest that PHIV+ youth experience emotional and behavioural problems, including psychiatric disorders, at higher than expected rates, often exceeding those of the general population and other high-risk groups. Yet, the specific role of HIV per se remains unclear, as uninfected youth with HIV exposure or those living in HIV-affected households displayed similar prevalence rates in some studies, higher rates in others and lower rates in still others. Although studies are limited with mixed findings, this review indicates that child-health status, cognitive function, parental health and mental health, stressful life events and neighbourhood disorder have been associated with worse mental health outcomes, while parent–child involvement and communication, and peer, parent and teacher social support have been associated with better function. Few evidence-based interventions exist; CHAMP+, a mental health programme for PHIV+ youth, shows promise across cultures. Conclusions This review highlights research limitations that preclude both conclusions and full understanding of aetiology. Conversely, these limitations present opportunities for future research. Many PHIV+ youth experience adequate mental health despite vulnerabilities. However, the focus of research to date highlights the identification of risks rather than positive attributes, which could inform preventive interventions. Development and evaluation of mental health interventions and preventions are urgently needed to optimize mental health, particularly for PHIV+ youth growing up in low-and-middle income countries.
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Pullmann MD, Bruns EJ, Sather AK. Evaluating fidelity to the wraparound service model for youth: application of item response theory to the Wraparound Fidelity Index. Psychol Assess 2013; 25:583-98. [PMID: 23544392 PMCID: PMC3755947 DOI: 10.1037/a0031864] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The wraparound process is a mechanism for multisystem planning and care coordination for youth with serious emotional and behavioral problems. Fidelity monitoring is critical to effective implementation of evidence-based practices in children's mental health, as it helps ensure that complex interventions like wraparound are implemented as intended. The 40-item Wraparound Fidelity Index, Version 4 (WFI-4; Bruns, Burchard, Suter, Leverentz-Brady, & Force, 2004) is the most frequently used measure of fidelity to the wraparound process, but analysis of its psychometric properties is insufficient. An item response theory approach, Rasch partial credit models for ordered polytomous data, was used on ratings from 1,234 facilitators, 1,006 caregivers, and 221 team members, focused on 1,478 youths (55% male). Results indicated the WFI-4 measured a unidimensional construct, with little evidence of item bias and good item and model fit. However, the item information curve was skewed, with most people endorsing high-fidelity responses, and several items had duplicative location estimates. A reduced 20-item measure is proposed. Internal reliability estimates for scores from this reduced measure were approximately equivalent to the longer measure. However, both versions would benefit from additional items located in the highest fidelity area of either version of the scale where scores by greater than half of our sample fall, but only 3 items are located.
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Affiliation(s)
- Michael D Pullmann
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98102, USA.
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Gerkensmeyer JE, Johnson CS, Scott EL, Oruche UM, Lindsey LM, Austin JK, Perkins SM. Problem-solving intervention for caregivers of children with mental health problems. Arch Psychiatr Nurs 2013; 27:112-20. [PMID: 23706887 PMCID: PMC3697759 DOI: 10.1016/j.apnu.2013.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 01/07/2013] [Accepted: 01/23/2013] [Indexed: 01/22/2023]
Abstract
UNLABELLED Building Our Solutions and Connections (BOSC) focused on enhancing problem-solving skills (PSS) of primary caregivers of children with mental health problems. Aims were determining feasibility, acceptability, and effect size (ES) estimates for depression, burden, personal control, and PSS. METHODS Caregivers were randomized to BOSC (n=30) or wait-list control (WLC) groups (n=31). Data were collected at baseline, post-intervention, and 3 and 6 months post-intervention. RESULTS Three-months post-intervention, ES for burden and personal control were .07 and .08, respectively. ES for depressed caregivers for burden and personal control were 0.14 and 0.19, respectively. CONCLUSIONS Evidence indicates that the intervention had desired effects.
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Affiliation(s)
- J. E. Gerkensmeyer
- Board-Certified Advanced Practice Registered Nurse, Associate Professor and Research Scientist; Indiana University School of Nursing, ; 72 Gull Lake Lane, Grand Marais, MN, 55604; 218-388-2010 and 317-363-6947
| | - C. S. Johnson
- Statistician, Division of Biostatistics, Indiana University, 410 West 10 street, Suite 3000, Indianapolis, IN, 46202-3012; 317-278-0647;
| | - E. L. Scott
- Assistant Professor of Clinical Psychology in Clinical Psychiatry and Clinical Anesthesia, Director of Riley Hospital Pain Center; Co-chief, Tourett’s/OCD/Anxiety Disorders Clinic, Riley Child and Adolescent Psychiatry Clinic, Riley Hospital for Children at Indiana University Health; ; Indiana University School of Medicine; 705 Riley Hospital Dr., Room 4300, Indianapolis, IN, 46202; 317-944-8162
| | - U. M. Oruche
- Board Certified Advanced Practice Registered Nurse, Assistant Professor, Indiana University School of Nursing, ; 1111 Middle Dr., W411, Indianapolis, IN, 46202; 317-278-0748
| | - L. M. Lindsey
- Project Manager; 1111 Middle Drive, NU B17A, Indiana University School of Nursing, Indianapolis, IN, 46202; 317-274-4971,
| | - J. K. Austin
- Distinguished Professor Emerita; 3040 West Ramble Rd., Bloomington, IN, 47408, 821-332-8278;
| | - S. M. Perkins
- Associate Professor, Director of Biostatistics and Data Management Core, IU Simon Cancer Center, Director, Biostatics Core, IU Center for Enhancing Quality of Life in Chronic Illness, Department of Biostatistics, Indiana University School of Medicine, 535 Barnhill Drive, RT 380H, Indianapolis, IN, 46202, , 317-474-2626
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Jones SCT, Lee DB, Gaskin AL, Neblett EW. Emotional Response Profiles to Racial Discrimination. JOURNAL OF BLACK PSYCHOLOGY 2013. [DOI: 10.1177/0095798413488628] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study examined the association between racial identity and patterns of emotional responses to blatant and subtle racial discrimination vignettes in a sample of 129 African American college students. Using latent profile analyses, we identified eight patterns of emotional responses to the scenarios. Multinomial logistic regression analyses revealed that racial identity was associated with these response patterns. Specifically, private and public regard were related to profiles in the blatant condition, while private regard, centrality, and nationalist ideology were related to profiles in the subtle condition. These findings suggest that there are varied ways in which African American youth respond emotionally to discrimination and that the significance and meaning that one places on race may affect these responses.
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Affiliation(s)
| | - Daniel B. Lee
- University of North Carolina at Chapel Hill, NC, USA
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Tolan P, Lovegrove P, Clark E. Stress mitigation to promote development of prosocial values and school engagement of inner-city urban African American and Latino youth. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2013; 83:289-98. [PMID: 23889020 DOI: 10.1111/ajop.12038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Studies of predictors of development of young men of color have been primarily focused on factors that impede positive development rather than factors that promote it. There are also few examples of longitudinal studies of positive development of this population and few that consider multiple protective factors simultaneously. Little is also known about how such positive outcomes might relate to prediction of problematic functioning. This study tests a developmental-ecological framework of positive and risky development among a sample of young men of color growing up in high-risk urban environments. African American and Latino adolescent males (148 African American, 193 Latino) were followed from early to late adolescence. Stress in early adolescence was related to school engagement and prosocial values as well as depressive symptoms and problems assessed 2 years later. The role of family and individual protective factors as direct effects and as mitigating the stress-outcome relation were also tested. Stress predicted problem outcomes but not positive functioning. Early engagement in prosocial activities and coping skills did predict positive outcomes. In contrast, problem outcomes were predicted directly by stress, with some indication of interaction with some protective factors for both such outcomes. Overall results suggest value in focusing on positive outcomes along with negative outcomes, as they are not the antithesis and have some shared but some different predictors. Implications for supporting positive development are presented.
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Affiliation(s)
- Patrick Tolan
- UVA Center to Promote Effective Youth Development, University of Virginia, PO Box 400281, Charlottesville, VA 22904, USA.
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Vaughan EL, Feinn R, Bernard S, Brereton M, Kaufman JS. Relationships between Child Emotional and Behavioral Symptoms and Caregiver Strain and Parenting Stress. JOURNAL OF FAMILY ISSUES 2013; 34:534-556. [PMID: 24707069 PMCID: PMC3975620 DOI: 10.1177/0192513x12440949] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Children with emotional and behavioral disturbance often have difficulties in multiple symptom domains. This study investigates the relationships between child symptoms and caregiver strain and parenting stress among 177 youth and their caregivers participating in a school-based system of care. Youth were grouped by symptom domain and included those with low scores on both internalizing and externalizing symptoms, those with only high internalizing symptoms, those with only high externalizing symptoms, and those with high symptoms levels in both internalizing and externalizing domains. Results revealed significant group differences on measures of caregiver strain and parenting stress. Caregivers of youth with symptoms in both internalizing and externalizing domains reported the highest levels of strain and stress; however, there was some variation in group differences by caregiver outcome. The results of this study emphasize the importance of not only providing services for youth, but also providing support services for their caregivers.
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Affiliation(s)
- Ellen L. Vaughan
- Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut
- Indiana University, Department of Counseling and Educational Psychology, Bloomington, Indiana
| | - Richard Feinn
- Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut
| | - Stanley Bernard
- Southern Connecticut State University, Department of Public Health, New Haven, Connecticut
- The PARK Project, Bridgeport, Connecticut
| | | | - Joy S. Kaufman
- Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut
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