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加强幼儿心理健康初级保健服务:马萨诸塞州“启动计划”项目评估

Enhancing Early Childhood Mental Health Primary Care Services: Evaluation of MA Project LAUNCH.

作者信息

Molnar Beth E, Lees Kristin E, Roper Kate, Byars Natasha, Méndez-Peñate Larisa, Moulin Christy, McMullen William, Wolfe Jessica, Allen Deborah

机构信息

Institute on Urban Health Research, Northeastern University, 360 Huntington Ave., Boston, MA, 02115, USA.

Bouvé College of Health Sciences, Institute on Urban Health Research, Northeastern University, 360 Huntington Ave, M/S 314 INV, Boston, MA, 02115, USA.

出版信息

Matern Child Health J. 2018 Oct;22(10):1502-1510. doi: 10.1007/s10995-018-2548-4.

Abstract

Objectives The purpose of this study was to evaluate the efficacy of an innovative early childhood mental health intervention, Massachusetts Project LAUNCH. Early childhood mental health clinicians and family partners (paraprofessionals with lived experience) were embedded within community pediatric medical homes. Methods A longitudinal study design was used to test the hypotheses that (1) children who received services would experience decreased social, emotional and behavioral problems over time and (2) caregivers' stress and depressive symptoms would decrease over time. Families who were enrolled in services and who consented to participate in the evaluation study were included in analyses (N = 225). Individual growth models were used to test longitudinal effects among MA LAUNCH participants (children and caregivers) over three time points using screening tools. Results Analyses showed that LAUNCH children who scored in age-specific clinically significant ranges of social, emotional and behavioral problems at Time 1 scored in the normal range on average by Time 3. Caregivers' stress and depressive symptoms also declined across the three time points. Results support hypotheses that the LAUNCH intervention improved social and emotional health for children and caregivers. Conclusions for Practice This study led to sustainability efforts, an expansion of the model to three additional communities across the state and development of an online toolkit for other communities interested in implementation.

摘要

目标 本研究旨在评估一项创新的幼儿心理健康干预措施——马萨诸塞州LAUNCH项目的效果。幼儿心理健康临床医生和家庭伙伴(有实际生活经验的辅助专业人员)被安排在社区儿科医疗之家工作。方法 采用纵向研究设计来检验以下假设:(1)接受服务的儿童随着时间推移社会、情感和行为问题会减少;(2)照顾者的压力和抑郁症状会随着时间推移而减轻。纳入接受服务并同意参与评估研究的家庭进行分析(N = 225)。使用个体成长模型,通过筛查工具在三个时间点测试马萨诸塞州LAUNCH项目参与者(儿童和照顾者)之间的纵向效应。结果 分析表明,在时间1时社会、情感和行为问题处于特定年龄临床显著范围的LAUNCH项目儿童,到时间3时平均得分处于正常范围。照顾者的压力和抑郁症状在三个时间点也有所下降。结果支持了LAUNCH项目干预改善了儿童和照顾者的社会和情感健康这一假设。实践结论 本研究促成了可持续发展努力,该模式在全州另外三个社区的推广,以及为其他有兴趣实施该项目的社区开发了一个在线工具包。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cca/6153762/4b2ac0bbb805/10995_2018_2548_Fig1_HTML.jpg

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