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Boustani MM, Daleiden E, Bernstein A, Michelson D, Gellatly R, Malik K, Patel V, Chorpita B. Using relevance mapping methodology to design an adolescent mental health intervention in India. Glob Health Action 2020; 13:1775062. [PMID: 32588780 PMCID: PMC7480414 DOI: 10.1080/16549716.2020.1775062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adolescents in low and middle-income countries experience pronounced mental health needs in contexts where infrastructure and resources are scarce. While evidence-based treatment are readily available, they may not fit the unique needs of certain contexts. OBJECTIVE This manuscript illustrates the systematic process of applying 'relevance mapping' methodology to leverage the youth mental health evidence base to identify candidate practices for inclusion in the development of a contextually appropriate psychological treatment protocol for common adolescent mental health problems in India. METHODS The practice identification was informed by two datasets obtained from adolescent samples in India. The first was an epidemiological dataset from a large community sample in Goa (N = 2,048); the second incorporated 'youth top problems' reported by service-seeking students presenting to school counsellors in Goa and Delhi (N = 78). Problems identified in each dataset were categorized using structured codes. Problem codes and youth demographics were then indexed against a database of hundreds of evidence-based psychological treatments and their associated clinical trials. This methodology revealed the most common practice elements (discrete therapeutic strategies) and their most efficient combinations with evidence of effectiveness matching the demographics and diagnostic category (anxiety, disruptive behaviors and depression) prevalent in the planned treatment population. RESULTS For anxiety, the most common practice elements for this age group were exposure, cognitive coping, and psychoeducation. For disruptive behaviors, the most common practices were problem-solving, goal-setting, and rapport-building. For depression, cognitive coping, behavioral activation, and psychoeducation were the most common practice elements. CONCLUSION These practice elements provided the treatment development team with a preliminary list of candidate content for the development of an intensive psychological treatment within a stepped care service model to address common adolescent mental health problems in schools in India.
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Affiliation(s)
- Maya M Boustani
- Department of Psychology, Loma Linda University , Loma Linda, CA, USA
| | | | | | | | - Resham Gellatly
- Department of Psychology, University of California , Los Angeles, CA, USA
| | | | - Vikram Patel
- Sangath , Goa, India.,Department of Global Health and Population, Harvard Medical School , Cambridge, MA, USA
| | - Bruce Chorpita
- Department of Psychology, University of California , Los Angeles, CA, USA
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2
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Pediatric Consultation-Liaison: Patient Characteristics and Considerations for Training in Evidence-Based Practices. J Clin Psychol Med Settings 2020; 28:529-542. [PMID: 32779089 DOI: 10.1007/s10880-020-09738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Consultation-liaison services are an integral part of many pediatric hospital settings, yet characteristics of this patient population have not been extensively documented. The current study is a retrospective one-year chart review of the consultation-liaison service at a large pediatric hospital in the Southwestern United States. The purpose of this study is twofold: (1) to characterize this hospital's CL population and (2) to use these characteristics to identify preliminary evidence-based practices that should be considered for CL provider training. Identifying evidence-based practice elements that align with the characteristics of consultation-liaison patient populations may inform trainings for consultation-liaison staff. This would help to ensure that youth seen in hospital consultation-liaison services are getting the best available services, which is critical given the shortened time frame available to work with this patient population.
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Reid GJ, Stewart SL, Barwick M, Carter J, Leschied A, Neufeld RWJ, St Pierre J, Tobon JI, Vingilis E, Zaric GS. Predicting patterns of service utilization within children's mental health agencies. BMC Health Serv Res 2019; 19:993. [PMID: 31870372 PMCID: PMC6929287 DOI: 10.1186/s12913-019-4842-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/16/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Some children with mental health (MH) problems have been found to receive ongoing care, either continuously or episodically. We sought to replicate patterns of MH service use over extended time periods, and test predictors of these patterns. METHODS Latent class analyses were applied to 4 years of visit data from five MH agencies and nearly 6000 children, 4- to 13-years-old at their first visit. RESULTS Five patterns of service use were identified, replicating previous findings. Overall, 14% of cases had two or more episodes of care and 23% were involved for more than 2 years. Most children (53%) were seen for just a few visits within a few months. Two patterns represented cases with two or more episodes of care spanning multiple years. In the two remaining patterns, children tended to have just one episode of care, but the number of sessions and length of involvement varied. Using discriminant function analyses, we were able to predict with just over 50% accuracy children's pattern of service use. Severe externalizing behaviors, high impairment, and high family burden predicted service use patterns with long durations of involvement and frequent visits. CONCLUSIONS Optimal treatment approaches for children seen for repeated episodes of care or for care lasting multiple years need to be developed. Children with the highest level of need (severe pathology, impairment, and burden) are probably best served by providing high intensity services at the start of care.
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Affiliation(s)
- Graham J Reid
- Departments of Psychology, Family Medicine, and Paediatrics, The University of Western Ontario, Westminster Hall Room 319E, London, ON, N6A 3K7, Canada.
- Children's Health and Therapeutics, Children's Health Research Institute, London, Canada.
| | - Shannon L Stewart
- Children's Health and Therapeutics, Children's Health Research Institute, London, Canada
- Faculty of Education, The University of Western Ontario, London, Canada
| | - Melanie Barwick
- Research Institute, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- The Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jeffrey Carter
- Quality Improvement, Vanier Children's Services, London, Canada
- Departments of Psychology and Psychiatry, The University of Western Ontario, London, Canada
| | - Alan Leschied
- Faculty of Education, The University of Western Ontario, London, Canada
| | - Richard W J Neufeld
- Departments of Psychology, Psychiatry, and Neuroscience, The University of Western Ontario, London, Canada
| | - Jeff St Pierre
- Departments of Psychology and Psychiatry, The University of Western Ontario, London, Canada
- Child and Parent Resource Institute, London, Canada
| | - Juliana I Tobon
- Department of Psychology, The University of Western Ontario, London, Canada
- St. Michael's Hospital Academic Family Health Team, Toronto, Canada
| | - Evelyn Vingilis
- Departments of Family Medicine and Epidemiology and Biostatistics, The University of Western Ontario, London, Canada
| | - Gregory S Zaric
- Ivey Business School, The University of Western Ontario, London, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Canada
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Cunningham CE, Barwick M, Rimas H, Mielko S, Barac R. Modeling the Decision of Mental Health Providers to Implement Evidence-Based Children's Mental Health Services: A Discrete Choice Conjoint Experiment. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:302-317. [PMID: 28918498 PMCID: PMC5809569 DOI: 10.1007/s10488-017-0824-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Using an online, cross sectional discrete choice experiment, we modeled the influence of 14 implementation attributes on the intention of 563 providers to adopt hypothetical evidence-based children’s mental health practices (EBPs). Latent class analysis identified two segments. Segment 1 (12%) would complete 100% of initial training online, devote more time to training, make greater changes to their practices, and introduce only minor modifications to EBPs. Segment 2 (88%) preferred fewer changes, more modifications, less training, but more follow-up. Simulations suggest that enhanced supervisor support would increase the percentage of participants choosing the intensive training required to implement EBPs. The dissemination of EBPs needs to consider the views of segments of service providers with differing preferences regarding EBPs and implementation process design.
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Affiliation(s)
- Charles E Cunningham
- Patient Centered Health Care, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Melanie Barwick
- CHES Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Heather Rimas
- Patient Centered Health Care, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Stephanie Mielko
- Patient Centered Health Care, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Raluca Barac
- Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, Canada
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Raviola G, Naslund JA, Smith SL, Patel V. Innovative Models in Mental Health Delivery Systems: Task Sharing Care with Non-specialist Providers to Close the Mental Health Treatment Gap. Curr Psychiatry Rep 2019; 21:44. [PMID: 31041554 DOI: 10.1007/s11920-019-1028-x] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW Most people do not have access to adequate mental health care, and lack of skilled human resources is a major factor. We provide a narrative review of approaches to implementing task sharing-engaging non-specialist providers-to deliver mental health care. RECENT FINDINGS There is strong evidence both for the effectiveness of task sharing as a means of delivering care for a range of conditions across settings and for the effectiveness of non-specialist providers and health workers in delivering elements of culturally adapted psychosocial and psychological interventions for common and severe mental disorders. Key approaches to facilitate task sharing of care include balanced care, collaborative care, sustained training and supervision, use of trans-diagnostic interventions based on a dimensional approach to wellness and illness, and the use of emerging digital technologies. Non-specialist providers and health workers are well positioned to deliver evidence-based interventions for mental disorders, and a variety of delivery approaches can support, facilitate, and sustain this innovation. These approaches should be used, and evaluated, to increase access to mental health services.
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Affiliation(s)
- Giuseppe Raviola
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA. .,Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
| | - Stephanie L Smith
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
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Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, Chisholm D, Collins PY, Cooper JL, Eaton J, Herrman H, Herzallah MM, Huang Y, Jordans MJD, Kleinman A, Medina-Mora ME, Morgan E, Niaz U, Omigbodun O, Prince M, Rahman A, Saraceno B, Sarkar BK, De Silva M, Singh I, Stein DJ, Sunkel C, UnÜtzer JÜ. The Lancet Commission on global mental health and sustainable development. Lancet 2018; 392:1553-1598. [PMID: 30314863 DOI: 10.1016/s0140-6736(18)31612-x] [Citation(s) in RCA: 1125] [Impact Index Per Article: 187.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 06/11/2018] [Accepted: 07/05/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Vikram Patel
- Harvard Medical School, Boston, MA, USA; Harvard TH Chan School of Public Health, Boston, MA, USA; Sangath, Goa, India; Public Health Foundation of India, New Delhi, India.
| | - Shekhar Saxena
- Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Graham Thornicroft
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London UK
| | - Florence Baingana
- WHO Sierra Leone, Freetown, Sierra Leone; Makerere University School of Public Health, Kampala, Uganda
| | - Paul Bolton
- Department of International Health and Department of Mental Health, Center for Humanitarian Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dan Chisholm
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Pamela Y Collins
- University of Washington School of Medicine and School of Public Health, Seattle, WA, USA
| | - Janice L Cooper
- The Carter Center, Monrovia, Liberia; Emory University, Atlanta, GA, USA
| | - Julian Eaton
- CBM International, Bensheim, Germany; Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Helen Herrman
- Orygen, National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; World Psychiatric Association, Melbourne, VIC Australia; WHO Collaborating Centre in Mental Health, Melbourne, VIC Australia
| | - Mohammad M Herzallah
- Palestinian Neuroscience Initiative, Al-Quds University, Jerusalem, Palestine; Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Yueqin Huang
- National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Mark J D Jordans
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Research and Development, War Child, Amsterdam, Netherlands; Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Arthur Kleinman
- Department of Anthropology, Harvard University, Cambridge, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Ellen Morgan
- Templeton World Charity Foundation, Nassau, The Bahamas
| | - Unaiza Niaz
- Psychiatric Clinic and Stress Research Centre, Karachi, Pakistan; University of Health Sciences, Lahore, Pakistan; Dow University of Health Sciences, Karachi, Pakistan
| | - Olayinka Omigbodun
- College of Medicine and Centre for Child and Adolescent Mental Health, University of Ibadan, Ibadan, Nigeria
| | - Martin Prince
- King's Global Health Institute, King's College London, London, UK
| | - Atif Rahman
- University of Liverpool, Liverpool, UK; Human Development Research Foundation, Islamabad, Pakistan
| | - Benedetto Saraceno
- School of Medical Sciences, University Nova of Lisbon, Lisbon, Portugal; Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - Bidyut K Sarkar
- PRIDE Project, Sangath, India; Public Health Foundation of India, New Delhi, India
| | | | - Ilina Singh
- Department of Psychiatry and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Groote Schuur Hospital, Cape Town, South Africa; South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Charlene Sunkel
- South African Federation for Mental Health, Johannesburg, South Africa; Movement for Global Mental Health, Johannesburg, South Africa
| | - JÜrgen UnÜtzer
- Department of Psychiatry and Behavioral Sciences and the Advancing Integrated Mental Health Solutions Center, University of Washington, Seattle, WA, USA
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Boel-Studt S, Huefner JC, Bender K, Huang H, Abell N. Developing Quality Standards and Performance Measures for Residential Group Care: Translating Theory to Practice. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/0886571x.2018.1536494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Shamra Boel-Studt
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | | | | | - Hui Huang
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Neil Abell
- International Programs, Florida State University College of Social Work, Tallahassee, Florida, USA
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Schleider J, Weisz J. A single-session growth mindset intervention for adolescent anxiety and depression: 9-month outcomes of a randomized trial. J Child Psychol Psychiatry 2018; 59:160-170. [PMID: 28921523 DOI: 10.1111/jcpp.12811] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Single-session interventions (SSIs) show promise in the prevention and treatment of youth psychopathology, carrying potential to improve the scalability and accessibility of youth psychological services. However, existing SSIs have conferred greater benefits for youths with anxiety, compared to depression or comorbid problems, and their effects have generally waned over time - particularly for follow-ups exceeding 3 months. METHOD To help address these discrepancies, we tested whether a novel SSI teaching growth mindset of personality (the belief that personality is malleable) could reduce depression and anxiety and strengthen perceived control in high-risk adolescents (N = 96, ages 12-15). At baseline, youths were randomized to receive a 30-min, computer-guided growth mindset intervention or a supportive-therapy control. Youths and parents reported youth anxiety and depressive symptoms, and youths reported their levels of perceived control, at baseline and across a 9-month follow-up period. RESULTS Compared to the control program, the mindset intervention led to significantly greater improvements in parent-reported youth depression (d = .60) and anxiety (d = .28), youth-reported youth depression (d = .32), and youth-reported perceived behavioral control (d = .29) by 9-month follow-up. Intervention effects were nonsignificant for youth-reported anxiety, although 9-month effect sizes reached the small-to-medium range (d = .33). Intervention group youths also experienced more rapid improvements in parent-reported depression, youth-reported depression, and perceived behavioral control across the follow-up period, compared to control group youths. CONCLUSIONS Findings suggest a promising, scalable SSI for reducing internalizing distress in high-risk adolescents. CLINICAL TRIAL REGISTRATION NUMBER NCT03132298.
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Affiliation(s)
| | - John Weisz
- Harvard University - Psychology, Cambridge, MA, USA
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Dorsey S, Lyon AR, Pullmann MD, Jungbluth N, Berliner L, Beidas R. Behavioral Rehearsal for Analogue Fidelity: Feasibility in a State-Funded Children's Mental Health Initiative. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 44:395-404. [PMID: 26966103 PMCID: PMC5734939 DOI: 10.1007/s10488-016-0727-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A substantial number of evidence-based treatments (EBTs) are available, but are delivered infrequently in public mental health. To improve the quality of care, some states and systems have focused on EBT training; however, these efforts have rarely included objective measurement of clinician fidelity because of feasibility issues. The primary goal of the current study was evaluating the feasibility of the behavioral rehearsal (BR) method to assess "analogue fidelity" in a children's mental health quality improvement initiative. Results indicated low-but representative-clinician participation. Participants demonstrated greatest improvement at post-training with maintenance or decreases at 6-months (post-consultation). Implications for future use of BR are discussed.
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Affiliation(s)
- Shannon Dorsey
- Department of Psychology, University of Washington, 335 Guthrie Hall, Box 351525, Seattle, WA, 98195, USA.
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Michael D Pullmann
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Nathaniel Jungbluth
- Department of Psychology, University of Washington, 335 Guthrie Hall, Box 351525, Seattle, WA, 98195, USA
| | - Lucy Berliner
- Department of Psychology, University of Washington, 335 Guthrie Hall, Box 351525, Seattle, WA, 98195, USA
- Harborview Center for Sexual Assault and Traumatic Stress, Seattle, USA
| | - Rinad Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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10
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Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9599-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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11
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Rith-Najarian LR, Daleiden EL, Chorpita BF. Evidence-Based Decision Making in Youth Mental Health Prevention. Am J Prev Med 2016; 51:S132-9. [PMID: 27378254 DOI: 10.1016/j.amepre.2016.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 05/05/2016] [Accepted: 05/19/2016] [Indexed: 11/28/2022]
Abstract
Given the impressive amount of knowledge relevant to prevention efforts, this paper articulates strategies to capitalize on such knowledge through evidence-based decision making. Knowledge, or "evidence," is understood here as coming from multiple sources, including research, individual people, group history, and relevant theory. The presented strategies to facilitate evidence-based decision making are: (1) intervention knowledge management; (2) collaborative design; (3) knowledge resources for intervention; and (4) developmentally sensitive training and supervision. Examples and benefits are outlined for each strategy. It is ultimately argued that evidence-based decision making embodies the scientific approach, and is worth consideration within primary prevention, given its early success in secondary intervention of youth mental health.
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Affiliation(s)
- Leslie R Rith-Najarian
- Department of Psychology, University of California, Los Angeles, Los Angeles, California.
| | | | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; PracticeWise, LLC, Satellite Beach, Florida
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Abstract
Children's mental health problems are among global health advocates' highest priorities. Nearly three-quarters of adult disorders have their onset or origins during childhood, becoming progressively harder to treat over time. Integrating mental health with primary care and other more widely available health services has the potential to increase treatment access during childhood, but requires re-design of currently-available evidence-based practices to fit the context of primary care and place a greater emphasis on promoting positive mental health. While some of this re-design has yet to be accomplished, several components are currently well-defined and show promise of effectiveness and practicality.
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Affiliation(s)
- Lawrence S Wissow
- Center for Mental Health in Pediatric Primary Care, Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, 703 Hampton House, 624 North Broadway, Baltimore, MD 21205, USA.
| | - Nadja van Ginneken
- Departments of Psychological Sciences and Health Services, Institute of Psychology, Health & Society, University of Liverpool, Waterhouse Building, 2nd Floor Block B, 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Jaya Chandna
- Departments of Psychological Sciences and Health Services, Institute of Psychology, Health & Society, University of Liverpool, Waterhouse Building, 2nd Floor Block B, 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Atif Rahman
- Departments of Psychological Sciences and Health Services, Institute of Psychology, Health & Society, University of Liverpool, Waterhouse Building, 2nd Floor Block B, 1-5 Brownlow Street, Liverpool L69 3GL, UK
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