McGuier Elizabeth A, Aarons Gregory A, Wright Jaely D, Fortney John C, Powell Byron J, Rothenberger Scott D, Weingart Laurie R, Miller Elizabeth, Kolko David J
Department of Psychiatry, School of Medicine, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Implement Sci Commun. 2023 May 26;4(1):58. doi: 10.1186/s43058-023-00437-z.
Children's Advocacy Centers (CACs) use multidisciplinary teams to investigate and respond to maltreatment allegations. CACs play a critical role in connecting children with mental health needs to evidence-based mental health treatment, especially in low-resourced rural areas. Standardized mental health screening and referral protocols can improve CACs' capacity to identify children with mental health needs and encourage treatment engagement. In the team-based context of CACs, teamwork quality is likely to influence implementation processes and outcomes. Implementation strategies that target teams and apply the science of team effectiveness may enhance implementation outcomes in team-based settings.
We will use Implementation Mapping to develop team-focused implementation strategies to support the implementation of the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), a standardized screening and referral protocol. Team-focused strategies will integrate activities from effective team development interventions. We will pilot team-focused implementation in a cluster-randomized hybrid type 2 effectiveness-implementation trial. Four rural CACs will implement the CPM-PTS after being randomized to either team-focused implementation (n = 2 CACs) or standard implementation (n = 2 CACs). We will assess the feasibility of team-focused implementation and explore between-group differences in hypothesized team-level mechanisms of change and implementation outcomes (implementation aim). We will use a within-group pre-post design to test the effectiveness of the CPM-PTS in increasing caregivers' understanding of their child's mental health needs and caregivers' intentions to initiate mental health services (effectiveness aim).
Targeting multidisciplinary teams is an innovative approach to improving implementation outcomes. This study will be one of the first to test team-focused implementation strategies that integrate effective team development interventions. Results will inform efforts to implement evidence-based practices in team-based service settings.
Clinicaltrials.gov, NCT05679154 . Registered on January 10, 2023.
儿童权益保护中心（CACs）利用多学科团队来调查和应对虐待指控。在将有心理健康需求的儿童与循证心理健康治疗相联系方面，儿童权益保护中心发挥着关键作用，尤其是在资源匮乏的农村地区。标准化的心理健康筛查和转诊方案能够提高儿童权益保护中心识别有心理健康需求儿童的能力，并促进治疗参与度。在儿童权益保护中心基于团队的环境中，团队合作质量可能会影响实施过程和结果。针对团队并应用团队效能科学的实施策略，可能会提高基于团队环境中的实施效果。
我们将使用实施映射法来制定以团队为重点的实施策略，以支持儿科创伤应激护理流程模型（CPM - PTS）的实施，这是一种标准化的筛查和转诊方案。以团队为重点的策略将整合有效团队发展干预措施中的活动。我们将在一项整群随机混合2型效果 - 实施试验中对以团队为重点的实施进行试点。四个农村儿童权益保护中心在被随机分配到以团队为重点的实施组（n = 2个儿童权益保护中心）或标准实施组（n = 2个儿童权益保护中心）后，将实施CPM - PTS。我们将评估以团队为重点的实施的可行性，并探索在假设的团队层面变化机制和实施结果（实施目标）方面的组间差异。我们将使用组内前后设计来测试CPM - PTS在提高照顾者对其孩子心理健康需求的理解以及照顾者启动心理健康服务的意愿方面的有效性（效果目标）。
针对多学科团队是改善实施效果的一种创新方法。本研究将是首批测试整合有效团队发展干预措施的以团队为重点的实施策略的研究之一。研究结果将为在基于团队的服务环境中实施循证实践的努力提供信息。
Clinicaltrials.gov，NCT05679154。于2023年1月10日注册。
