Mental Health Issue, Teamwork
Conditions
Keywords
Mental health screening, Implementation, Teamwork
Brief summary
Child Advocacy Centers (CACs) are well-positioned to identify children at risk for mental health problems and to facilitate access to evidence-based treatments. Implementation of standardized mental health screening and referral protocols may improve recognition of mental health needs and facilitate treatment engagement. Implementation strategies that improve teamwork may enhance implementation outcomes in team-based settings like CACs. In this study, CACs will implement the Care Process Model for Pediatric Traumatic Stress (CPM-PTS) and be randomized to either team-focused implementation or standard implementation. The study aims are to evaluate the feasibility of team-focused implementation and the effect of the CPM-PTS on caregiver understanding of mental health needs and intentions to initiate treatment.
Detailed description
This study is a pilot cluster randomized controlled hybrid Type II effectiveness-implementation trial in 4 rural Child Advocacy Centers. All CACs will implement the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), a mental health screening and referral protocol. CACs will be randomized to team-focused implementation (n = 2) or standard implementation (n = 2). The study is designed to evaluate the acceptability, appropriateness, and feasibility of team-focused implementation strategies. It will also test the effect of the CPM-PTS on caregiver understanding of mental health needs and intentions to initiate treatment. Mixed methods will be used to evaluate the feasibility of team-focused implementation, test the effect of team strategies on teamwork, and assess implementation outcomes. Administrative data collected anonymously from caregivers will be used to test the effectiveness of the CPM-PTS.
Interventions
BEHAVIORALTeam-focused Implementation
CACs randomized to the experimental condition (n = 2) will participate in team-focused implementation. They will receive team development interventions (e.g., goal-setting exercise, training in communication skills) integrated with standard CPM-PTS training and technical assistance strategies.
BEHAVIORALStandard Implementation
CACs randomized to the comparison condition (n = 2) will receive standard training and technical assistance strategies to support CPM-PTS implementation. They will receive CPM-PTS materials (e.g., manual, REDCap surveys, referral protocols), an interactive training, and six months of technical assistance.
Sponsors
University of Pittsburgh
National Institute of Mental Health (NIMH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
The trial includes two groups: team-focused implementation and standard implementation (comparison group).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Individuals at least 18 years of age who are members of the multidisciplinary team at the participating CACs.
Exclusion criteria
* Under 18 years old.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability of Team-focused Implementation Assessed by the Acceptability of Intervention Measure | Month 6 | Perceived acceptability of team-focused implementation will be assessed with items from the Acceptability of Intervention Measure. Each item is rated on a 1-5 Likert scale. Scores will be averaged; higher scores indicate more positive perceptions (range 1-5). |
| Appropriateness of Team-focused Implementation Assessed by the Intervention Appropriateness Measure | Month 6 | Perceived appropriateness of team-focused implementation will be assessed with items from the Intervention Appropriateness Measure. Each item is rated on a 1-5 Likert scale. Scores will be averaged; higher scores indicate more positive perceptions (range 1-5). |
| Feasibility of Team-focused Implementation Assessed by the Feasibility of Intervention Measure | Month 6 | Perceived feasibility of team-focused implementation will be assessed with items from the Feasibility of Intervention Measure. Each item is rated on a 1-5 Likert scale. Scores will be averaged; higher scores indicate more positive perceptions (range 1-5). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Team Functioning (Learning Behavior) From Baseline to 6-month Follow-up | Baseline, month 6 | Affective, behavioral, and cognitive processes and states will be assessed with survey items rated on Likert scales. Scores will be averaged; higher scores indicate more adaptive team functioning (range 1-7). Learning behavior was assessed with 3 items. |
| Change in Team Functioning (Learning Behavior) From Baseline to 12-month Follow-up | Baseline, month 12 | Affective, behavioral, and cognitive processes and states will be assessed with survey items rated on Likert scales. Scores will be averaged; higher scores indicate more adaptive team functioning (range 1-7). Learning behavior was assessed with 3 items. |
| Change in Team Performance From Baseline to 6- and 12-month Follow-up | Baseline, month 6, month 12 | The overall quality of work done by the team will be assessed with 4 items rated on a 5-point Likert scale. Scores will be averaged; higher scores indicate better performance (range 1-5). |
| CPM-PTS Acceptability Assessed by the Acceptability of Intervention Measure | Month 6 | Perceived acceptability of the CPM-PTS will be assessed with items from the Acceptability of Intervention Measure. Each item is rated on a 1-5 Likert scale. Scores will be averaged; higher scores indicate more positive perceptions (range 1-5). |
| CPM-PTS Appropriateness Assessed by the Intervention Appropriateness Measure | Month 6 | Perceived appropriateness of the CPM-PTS will be assessed with items from the Intervention Appropriateness Measure. Each item is rated on a 1-5 Likert scale. Scores will be averaged; higher scores indicate more positive perceptions (range 1-5). |
| CPM-PTS Feasibility Assessed by the Feasibility of Intervention Measure | Month 6 | Perceived feasibility of the CPM-PTS will be assessed with items from the Feasibility of Intervention Measure. Each item is rated on a 1-5 Likert scale. Scores will be averaged; higher scores indicate more positive perceptions (range 1-5). |
| CPM-PTS Adoption | From start of the study for up to 12 months after CPM-PTS implementation | Adoption will be indicated by the number of days from training to the first completed screening. |
| CPM-PTS Reach | Monthly for 9 months after CPM-PTS implementation | Reach will be indicated by screening rates (i.e., completed screenings / eligible children) and calculated for monthly and quarterly periods (possible range 0-100%). Reported below are the average monthly screening rate over 9 months (all available data) and the average quarterly screening rate across 3 quarters (all available data). |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORElizabeth McGuier, PhD
University of Pittsburgh
Participant flow
Recruitment details
Only current team members were eligible to participate at each timepoint. Participants who joined the team after the study began were invited to participate in data collection for later timepoints. Participants who left the team before a follow-up timepoint were not invited to participate in additional data collection.
Pre-assignment details
One center withdrew from the study during baseline data collection and before randomization. Participants affiliated with this center (n = 55) did not participate in any additional data collection. Outcome measures are not available for these participants. No caregivers were enrolled in this study.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 42.81 Years STANDARD_DEVIATION 12.69 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 5 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 47 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 18 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 18 Participants |
| Race (NIH/OMB) White | 51 Participants |
| Sex: Female, Male Female | 25 Participants |
| Sex: Female, Male Male | 15 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 55 | 0 / 37 |
| other Total, other adverse events | 0 / 55 | 0 / 37 |
| serious Total, serious adverse events | 0 / 55 | 0 / 37 |
Outcome results
None listed