Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
BMJ Open. 2021 Jun 29;11(6):e051190. doi: 10.1136/bmjopen-2021-051190.
Transition from child and adolescent mental health services (CAMHS) to community or adult mental health services (AMHS) is a highly problematic health systems hurdle, especially for transition-aged youth. A planned and purposeful transition process is often non-existent or experienced negatively by youth and their caregivers. Stakeholders, including youth and their caregivers, have demanded interventions to support more effective transitions, such a transition navigator. The transition navigator model uses a navigator to facilitate complex transitions from acute care CAMHS to community or AMHS. However, despite the widespread implementation of this model, there has been no evaluation of the programme, hindering its scalability. This paper describes the study protocol of the Navigator Evaluation Advancing Transitions study that aims to collaborate with patients, caregivers and clinicians in the evaluation of the navigator model.
A pre and post mixed-method study will be conducted, using the Triple Aim Framework, to evaluate the navigator model. We will recruit participants from one large tertiary and two community hospitals in Toronto, Canada. For the quantitative portion of the study, we will recruit a sample of 45 youth (15 at each site), aged 16-18, and their caregivers at baseline (referral to navigator) (T1) and 6 months (T2). Youth and caregiver participants will complete a set of standardised measures to assess mental health, service utilisation, and satisfaction outcomes. For the qualitative portion of the study, semistructured interviews will be conducted at 6 months (T2) with youth, their caregivers and clinicians to better understand their experience and satisfaction with the model.
Research Ethics Board (REB) approval has been obtained from the lead research sites, the University of Toronto and the Hospital for Sick Children. The results of the study will be reported in peer-reviewed publications, webinars and conferences and to all relevant stakeholders.
从儿童和青少年心理健康服务（CAMHS）过渡到社区或成人心理健康服务（AMHS）是一个极具挑战性的卫生系统障碍，尤其是对过渡年龄的年轻人而言。通常情况下，青年及其照顾者并没有经历过有计划、有目的的过渡过程，或者经历的过程并不理想。利益相关者，包括青年及其照顾者，要求采取干预措施来支持更有效的过渡，例如过渡导航员。过渡导航员模式使用导航员来协助从急性 CAMHS 到社区或 AMHS 的复杂过渡。然而，尽管该模式已广泛实施，但尚未对该方案进行评估，这阻碍了其可扩展性。本文介绍了“导航员评估促进过渡研究”的研究方案，该研究旨在与患者、照顾者和临床医生合作评估导航员模式。
将使用三重目标框架进行一项前瞻性和回顾性混合方法研究，以评估导航员模式。我们将从加拿大多伦多的一家大型三级医院和两家社区医院招募参与者。在研究的定量部分，我们将招募 45 名年龄在 16-18 岁的青年（每个地点 15 名）及其照顾者作为样本，在基线（转介给导航员）（T1）和 6 个月（T2）时进行研究。青年和照顾者参与者将完成一套标准措施，以评估心理健康、服务利用和满意度结果。在研究的定性部分，将在 6 个月（T2）时对青年、其照顾者和临床医生进行半结构化访谈，以更好地了解他们对该模型的体验和满意度。
已从牵头研究地点（多伦多大学和 SickKids 医院）获得了研究伦理委员会（REB）的批准。该研究的结果将在同行评议的出版物、网络研讨会和会议以及所有相关利益攸关方中报告。
