Glisson Charles, Williams Nathaniel J, Hemmelgarn Anthony, Proctor Enola, Green Philip
Center for Behavioral Health Research, University of Tennessee.
College of Social Work, Boise State University.
J Consult Clin Psychol. 2016 Aug;84(8):713-25. doi: 10.1037/ccp0000107. Epub 2016 Jun 2.
The Availability, Responsiveness, and Continuity (ARC) organizational intervention is designed to improve community-based youth mental health services by aligning organizational priorities with 5 principles of effective service organizations (i.e., mission driven, results oriented, improvement directed, relationship centered, participation based). This study assessed the effect of the ARC intervention on youth outcomes and the mediating role of organizational priorities as a mechanism linking the ARC intervention to outcomes.
Fourteen community-based mental health agencies in a midwestern metropolis along with 475 clinicians and 605 youth (ages 5-18) served by those agencies were randomly assigned to the 3-year ARC intervention or control condition. The agencies' priorities were measured with the ARC Principles Questionnaire (APQ) completed by clinicians at the end of the intervention. Youth outcomes were measured as total problems in psychosocial functioning described by their caregivers using the Shortform Assessment for Children (SAC) at 6 monthly intervals.
The rate of improvement in youths' psychosocial functioning in agencies assigned to the ARC condition was 1.6 times the rate of improvement in agencies assigned to the control condition, creating a standardized difference in functioning of d = .23 between the 2 groups at the 6-month follow-up. The effect on youth outcomes was fully mediated by the alignment of organizational priorities described in the 5 ARC principles (d = .21).
The ARC organizational intervention improves youth outcomes by aligning organizational priorities with the 5 ARC principles. The findings suggest that organizational priorities explain why some community mental health agencies are more effective than others. (PsycINFO Database Record
可及性、响应性和连续性（ARC）组织干预旨在通过使组织优先事项与有效服务组织的5项原则（即使命驱动、结果导向、改进导向、关系中心、参与基础）保持一致，来改善基于社区的青少年心理健康服务。本研究评估了ARC干预对青少年结果的影响，以及组织优先事项作为将ARC干预与结果联系起来的一种机制的中介作用。
中西部一个大都市的14个社区心理健康机构以及由这些机构服务的475名临床医生和605名青少年（5 - 18岁）被随机分配到为期3年的ARC干预组或对照组。通过临床医生在干预结束时完成的ARC原则问卷（APQ）来衡量机构的优先事项。青少年的结果通过其照顾者使用儿童简短评估量表（SAC）每隔6个月描述的心理社会功能总问题来衡量。
被分配到ARC组的机构中青少年心理社会功能的改善率是被分配到对照组机构的1.6倍，在6个月的随访中两组之间功能的标准化差异为d = 0.23。对青少年结果的影响完全由5项ARC原则中描述的组织优先事项的一致性所介导（d = 0.21）。
ARC组织干预通过使组织优先事项与5项ARC原则保持一致来改善青少年结果。研究结果表明，组织优先事项解释了为什么一些社区心理健康机构比其他机构更有效。（PsycINFO数据库记录）
