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Patient-centered enhancements in school behavioral health: a randomized trial
Investigator (PI): Weist, Mark D
Performing Organization (PO): (Current): University of South Carolina, College of Arts and Sciences, Department of Psychology / (803) 777-4137
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2019
Final Year: 2025
Record Source/Award ID: PCORI/IHS-2018C1-10928
Funding: Total Award Amount: $5,090,121
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background and significance: The mental health needs of children and youth are well-documented as an under-addressed and significant public health need in the United States (U.S.). A number of barriers exist that prevent children, youth, and families from accessing behavioral health services in standard clinic settings, including lack of sufficient transportation, cost, and stigma related to receiving services. School behavioral health (SBH) programs, involving community mental health providers join school teams to better address the social, emotional/behavioral, and academic needs of students are growing in the U.S. related to their ability to reach youth who need, but may not otherwise receive services. However, these efforts are limited by a lack of patient and stakeholder engagement. This has commonly resulted in SBH programs not being implemented, implemented inconsistently, or underutilized. The study will compare an evidence-based Partnership intervention added to an evidence-based framework termed Clinical Services Supports (CSS; termed the Wellness Intervention), in a three-year intervention for students in middle schools. We predict the addition of the Partnership intervention will improve school climate and enhance SBH services toward significantly improved social, emotional/behavioral, and academic outcomes in students. The proposed study is highly responsive to PCORI's call for comparative effectiveness research on alternative features of health care systems, including building effective behavioral health care in schools in ways that are actively guided by patients and diverse stakeholders, involving and coordinating services across youth-serving systems, and connecting progress across school building, district, state, regional, and national levels of scale. Study aims: 1. We will evaluate the extent to which the Partnership intervention increases the number of students and families receiving school behavioral health services and expressing satisfaction with services received. 2. We will evaluate the impact of the Partnership intervention on students' social, emotional/behavioral, and academic outcomes throughout the course of the intervention period (6th-8th grade). 3. We will evaluate the follow-up effects of the Partnership intervention on social, emotional/behavioral, and academic outcomes and risk behaviors in a sample of students followed into high school. Study description: This study will represent a randomized controlled trial, with three years of intervention vs. comparison and conducted in 20 middle schools in rural, suburban, and urban areas, with 10 schools randomly assigned to implement the Wellness intervention and 10 schools randomly assigned to implement the Partnership intervention. The Wellness condition was evaluated in two prior studies and found to be effective for engaging families in services and increasing use of evidence-based practices. The Partnership condition includes the Wellness intervention components and evidence-based Partnership enhancements that target 1) mental health literacy and stigma reduction and 2) enhancing family-school-mental health partnerships. The inclusion of these enhancements are based on feedback given by patients and stakeholders in a series of research forums focused on improving the quality of school behavioral health services through the support of a recently completed PCORI Eugene Washington Engagement award. Throughout the course of the study, a diverse stakeholder advisory board (SAB) will guide the research team in assuring patient and stakeholder engagement, and will guide study planning, implementation, analyses, and sharing of findings. The project will also increase engagement between patients and stakeholders and the research team by utilizing a cutting-edge information sharing and continuing education approach, ECHO (Extension for Community Healthcare Outcomes), which will involve a learning and feedback loop between the research team and SAB (hub), the study schools (spokes), and stakeholders and systems leaders. The SAB will guide dissemination efforts that will capitalize on regional and national conferences that reach more than 1500 participants annually, with listservs that will approach or exceed 100,000 diverse stakeholders by study end. Please see the Southeastern School Behavioral Health Community (www.schoolbehavioralhealth.org), and Center for School Mental Health (http://csmh.umaryland.edu) for professional communities that will support the study and its dissemination.
Abstract Archived: Background and significance: The mental health needs of children and youth are well documented as an under-addressed and significant public health need in the United States (U.S.). A number of barriers exist that prevent children, youth, and families from accessing behavioral health services in standard clinic settings, including lack of sufficient transportation, cost, and stigma related to receiving services. School behavioral health (SBH) programs, involving community mental health providers join school teams to better address the social, emotional/behavioral, and academic needs of students are growing in the U.S. related to their ability to reach youth who need, but may not otherwise receive services. However, these efforts are limited by a lack of patient and stakeholder engagement. This has commonly resulted in SBH programs not being implemented, implemented inconsistently, or underutilized. The study will compare an evidence-based Patient-Centered Enhancements (PCE) intervention added to an evidence-based framework termed Clinical Services Supports (CSS), in a three-year intervention for students in middle schools. We predict the addition of the PCE intervention will improve school climate and enhance SBH services toward significantly improved social, emotional/behavioral, and academic outcomes in students. The proposed study is highly responsive to Patient-Centered Outcomes Research Institute's (PCORI) call for comparative effectiveness research on alternative features of health care systems, including building effective behavioral health care in schools in ways that are actively guided by patients and diverse stakeholders, involving and coordinating services across youth-serving systems, and connecting progress across school building, district, state, regional, and national levels of scale. Study aims: 1. We will evaluate the extent to which PCE increases the number of students and families receiving school behavioral health services and expressing satisfaction with services received. 2. We will evaluate the impact of PCE on students' social, emotional/behavioral, and academic outcomes throughout the course of the intervention period (6th-8th grade). 3. We will evaluate the follow-up effects of PCE on social, emotional/behavioral, and academic outcomes and risk behaviors in a sample of students followed into high school. Study description: This study will represent a randomized controlled trial, with three years of intervention vs. comparison and conducted in 20 middle schools in rural, suburban, and urban areas, with 10 schools randomly assigned to implement the Clinical Services Support (CSS) intervention and 10 schools randomly assigned to implement the Patient-Centered Enhancements (PCE) intervention. The CSS condition was evaluated in two prior studies and found to be effective for engaging families in services and increasing use of evidence-based practices. The PCE condition includes the CSS intervention components and evidence-based patient-centered enhancements that target 1) mental health literacy and stigma reduction and 2) enhancing family-school-mental health partnerships. The inclusion of these enhancements is based on feedback given by patients and stakeholders in a series of research forums focused on improving the quality of school behavioral health services through the support of a recently completed PCORI Eugene Washington Engagement award. Throughout the course of the study, a diverse Patient-Stakeholder Advisory Board (PSAB) will guide the research team in assuring patient and stakeholder engagement, and will guide study planning, implementation, analyses, and sharing of findings. The project will also increase engagement between patients and stakeholders and the research team by utilizing a cutting-edge information sharing and continuing education approach, ECHO (Extension for Community Healthcare Outcomes), which will involve a learning and feedback loop between the research team and PSAB (hub), the study schools (spokes), and stakeholders and systems leaders. The PSAB will guide dissemination efforts that will capitalize on regional and national conferences that reach more than 1,500 participants annually, with listservs that will approach or exceed 100,000 diverse stakeholders by study end. Please see the Southeastern School Behavioral Health Community (www.schoolbehavioralhealth.org) and Center for School Mental Health (http://csmh.umaryland.edu) for professional communities that will support the study and its dissemination.

MeSH Terms:
  • Access to Health Care
  • Adolescent
  • Child
  • Child Guidance /*organization & administration
  • Evidence-Based Medicine
  • Health Literacy
  • Humans
  • Medically Underserved Area
  • Mental Health Services /organization & administration
  • Patient-Centered Care /*organization & administration
  • Program Development
  • Program Evaluation
  • Randomized Controlled Trials as Topic
  • Risk
  • Rural Population
  • * School Health Services
  • Schools
  • Social Stigma
  • Suburban Population
  • United States
  • Urban Population
Country: United States
State: South Carolina
Zip Code: 29208
UI: 20193261
CTgovId: NCT03901274
Project Status: Ongoing
Record History: ('2020: Abstract archived to Abstract Archived 1 field and added new abstract.',)