Enhancing Early Engagement (E3) in mental health services training for children’s advocacy center’s victim advocates: feasibility protocol for a randomized controlled trial

Abstract Background Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative. Methods The feasibility study protocol is to develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training embeds key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs were randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program and differential impact and costs by level of training will be examined. Discussion The overarching goal of this project is to test the feasibility of training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child, and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods hybrid type II effectiveness-implementation and cost-effectiveness trial of family navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols. Trial registration NCT04221633 Date and version identifier March 25, 2021; Vers. 1.0 (original); September 11, 2021; Vers 2.0 (revision); October 29, 2021; Vers. 3.0 (revision)

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Enhancing Early Engagement (E3) in Mental Health Services Training for Children's Advocacy Center's Victim Advocates: Protocol for a Randomized Controlled Trial

10.21203/rs.3.rs-375263/v1 ◽

2021 ◽

Author(s):

Erin K. Taylor ◽

Alex R. Dopp ◽

Kaitlin Lounsbury ◽

Yutian Thompson ◽

Michelle Miller ◽

...

Keyword(s):

Mental Health ◽

Large Scale ◽

Controlled Trial ◽

Scale Up ◽

The United States ◽

Evidence Based Practices ◽

Web Based ◽

Victim Advocates ◽

National Initiative ◽

Level Of Training

Abstract Background: Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative.Methods: We developed, implemented, and will evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training will embed key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs will be randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program, and differential impact and costs by level of training will be examined.Discussion: The overarching goal of this project is to test a training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods Hybrid Type II effectiveness-implementation and cost-effectiveness trial of Family Navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols.Trial registration: NCT04221633Date and version identifier: March 25 2021; Vers. 1.0 (original)

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Enhancing Early Engagement (E3) in Mental Health Services Training for Children's Advocacy Center's Victim Advocates: Protocol for a Randomized Clinical Trial

10.21203/rs.3.rs-51847/v1 ◽

2020 ◽

Author(s):

Erin K Taylor ◽

Alex R Dopp ◽

Kaitlin Lounsbury ◽

Yutian Thompson ◽

Michelle Miller ◽

...

Keyword(s):

Mental Health ◽

Large Scale ◽

Scale Up ◽

The United States ◽

Differential Impact ◽

Evidence Based Practices ◽

Web Based ◽

Victim Advocates ◽

National Initiative ◽

Level Of Training

Abstract Background: Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative.Methods: We will develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training will embed key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs will be randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program, and differential impact and costs by level of training will be examined.Discussion: The overarching goal of this project is to test a training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods Hybrid Type II effectiveness-implementation and cost-effectiveness trial of Family Navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols.Trial registration: NCT04221633

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Enhancing Early Engagement (E3) in Mental Health Services Training for Children's Advocacy Center's Victim Advocates: Protocol for a Randomized Clinical Trial

10.21203/rs.3.rs-50262/v1 ◽

2020 ◽

Author(s):

Erin K Taylor ◽

Alex R Dopp ◽

Kaitlin Lounsbury ◽

Yutian Thompson ◽

Michelle Miller ◽

...

Keyword(s):

Mental Health ◽

Large Scale ◽

Scale Up ◽

The United States ◽

Differential Impact ◽

Evidence Based Practices ◽

Web Based ◽

Victim Advocates ◽

National Initiative ◽

Level Of Training

Abstract Background: Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative. Methods: We will develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training will embed key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs will be randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program, and differential impact and costs by level of training will be examined.Discussion: The overarching goal of this project is to test a training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods Hybrid Type II effectiveness-implementation and cost-effectiveness trial of Family Navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols.Trial registration: NCT04221633

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Mental health and caregiving experiences of family carers supporting people with psychosis

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796020001067 ◽

2021 ◽

Vol 30 ◽

Author(s):

J. Sin ◽

J. Elkes ◽

R. Batchelor ◽

C. Henderson ◽

S. Gillard ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

General Population ◽

Large Scale ◽

Controlled Trial ◽

Population Sample ◽

Poor Mental Health ◽

Mental Wellbeing ◽

Family Carers ◽

Negative Experience

Abstract Aims Family carers supporting an individual with psychosis often experience poorer mental health, however, little is known about specific risk factors among these carers. We investigated the associations between demographic, caregiving characteristics and mental health outcomes in family carers supporting an individual with psychosis and compared carers' outcomes with general population norms. Methods We analysed baseline data from the COPe-support randomised controlled trial of online psychoeducation and peer support for adult carers supporting an individual with psychosis between 2018 and 2020. We collected carers' demographic and health outcome data, including wellbeing using Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS as primary outcome), quality of life using EQ-5D-5L and caregiving experience assessed with Experience of Caregiving Inventory. We tested associations between carers' demographic and caregiving characteristics for each outcome in turn and meta-analysed carers' WEMWBS and EQ-5D-5L with Health Survey England (HSE) general population data from 2016 and 2017, respectively. Results The 407 carers of people with psychosis had a mean WEMWBS score of 42.2 (s.d. 9.21) and their overall weighted pooled WEMWBS score was 7.3 (95% confidence interval (CI) −8.6 to −6.0, p < 0.01) lower than the HSE general population sample, indicating carers have poorer mental wellbeing by more than double the minimum clinically important difference of 3 points on WEMWBS. Among all caring relationships, partners had poorer wellbeing compared to parents with lower WEMWBS score (−6.8, −16.9 to 3.3, p = 0.03). Single carers had significantly poorer wellbeing (−3.6, −5.6 to −1.5, p < 0.01) and a more negative caregiving experience than those who were cohabiting. Spending more than 35 h per week caregiving increased carers' negative experience significantly (p = 0.01). Conclusion Carers of people with psychosis have poorer mental health than non-carers. Partners, lone carers and those spending more than 35 h per week on caring were found to be most at risk of poor mental health. Based on the results, we advocate that the details of carers for individuals with psychosis should be added to the existing carers or severe mental illness registers at all general practitioner surgeries and for their wellbeing screened routinely. Future large-scale prospective studies are needed to develop a predictive model to determine risk factors, hence to aid early identification of carers' support needs. Such understandings are also useful to inform tailored intervention development.

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Lesson Study to Scale Up Research-Based Knowledge: A Randomized, Controlled Trial of Fractions Learning

Journal for Research in Mathematics Education ◽

10.5951/jresematheduc.48.3.0261 ◽

2017 ◽

Vol 48 (3) ◽

pp. 261-299 ◽

Cited By ~ 29

Author(s):

Catherine Lewis ◽

Rebecca Perry

Keyword(s):

Randomized Controlled Trial ◽

Elementary Teachers ◽

Teacher Leadership ◽

Lesson Study ◽

Controlled Trial ◽

Scale Up ◽

Linear Representation ◽

The United States ◽

New Approach ◽

Randomized Controlled

An understanding of fractions eludes many U.S. students, and research-based knowledge about fractions, such as the utility of linear representation, has not broadly influenced instruction. This randomized trial of lesson study supported by mathematical resources assigned 39 educator teams across the United States to locally managed lesson study supported by a fractions lesson study resource kit or to 1 of 2 control conditions. Educators (87% of whom were elementary teachers) self-managed learning over a 3-month period. HLM analyses indicated significantly greater improvement of educators' and students' fractions knowledge for teams randomly assigned to lesson study with resource kits. Results suggest that integrating researchbased resources into lesson study offers a new approach to the problem of “scale-up” by combining the strengths of teacher leadership and research-based knowledge.

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Long-Term Smoking Cessation Outcomes for Sexual Minority Versus Nonminority Smokers in a Large Randomized Controlled Trial of Two Web-Based Interventions

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz112 ◽

2019 ◽

Vol 22 (9) ◽

pp. 1596-1604

Author(s):

Jaimee L Heffner ◽

Kristin E Mull ◽

Noreen L Watson ◽

Jennifer B McClure ◽

Jonathan B Bricker

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Treatment Outcomes ◽

Sexual Minority ◽

Controlled Trial ◽

Web Based ◽

Psychosocial Profile ◽

Randomized Controlled ◽

Quit Smoking ◽

Baseline Characteristics

Abstract Introduction Despite greater smoking prevalence among sexual minority (SM) individuals relative to non-SM individuals, minimal research has examined whether SM smokers have differential success at quitting, and no prior treatment studies have examined differences within SM subgroups. There is also limited knowledge of the psychosocial characteristics of treatment-seeking SM smokers, which could inform targeted treatments. To address these gaps, we compared treatment outcomes and baseline characteristics for SM and non-SM smokers and for bisexual versus lesbian or gay smokers in a large randomized controlled trial of two web-based cessation treatments. Methods Trial participants completed a survey to assess baseline characteristics, including self-identification as either SM (n = 253; lesbian or gay, n = 122; bisexual, n = 131) or non-SM (n = 2384). The primary cessation outcome was complete-case, self-reported 30-day abstinence at 12 months after randomization. Results Cessation outcomes did not differ significantly for SM versus non-SM smokers (24% vs. 25%, adjusted OR = 0.91, 95% CI = 0.65 to 1.28) or across SM subgroups (24% for bisexual vs. 23% for lesbian or gay, adjusted OR = 1.01, 95% CI = 0.51 to 2.00), and there were no interactions with treatment group assignment. At baseline, SM smokers differed from non-SM smokers on most demographics, were more likely to screen positive for all mental health conditions assessed, and had greater exposure to other smokers in the home. Conclusions Substantial differences in baseline characteristics of SM versus non-SM smokers and bisexual versus lesbian or gay smokers did not translate into differential treatment outcomes. Nonetheless, SM smokers’ willingness or ability to quit smoking could be enhanced by taking their unique psychosocial profile into account when designing targeted interventions. Implications The findings of this study, which included the largest sample of SM smokers in a prospective intervention trial to date, support those of a small extant body of literature showing no differences in treatment-assisted cessation outcomes between SM and non-SM smokers. Regardless of their quit rates relative to non-SM smokers, SM smokers’ willingness or ability to quit smoking could potentially be enhanced by taking their unique psychosocial profile into account in intervention design, including their younger age, lower socioeconomic status, greater likelihood of being racial or ethnic minorities, and greater prevalence of mental health symptoms.

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M108. CONCA: AN ONLINE COGNITIVE ASSESSMENT FOR USE WITH PATIENTS WITH PSYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.420 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S176-S176

Author(s):

Amy Lynham ◽

Jeremy Hall ◽

Ian Jones ◽

James Walters

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Psychiatric Disorders ◽

Cognitive Assessment ◽

Large Scale ◽

Cognitive Testing ◽

World Health ◽

Web Based ◽

Highly Educated ◽

Treatment Research

Abstract Background Cognition is impaired in patient with psychosis and is predictive of functional outcomes. Despite this, cognitive function is not routinely assessed in clinical services in the United Kingdom. Collecting cognitive data for research is also labour-intensive and expensive. Web-based assessments may be a solution for these issues but to date, these have not been utilised in patients with psychosis or other psychiatric disorders. Methods We have developed an online cognitive battery for use in psychosis research (and broader mental health research) in collaboration with The Many Brains Project, website developers, patients and clinicians (Cardiff ONline Cognitive Assessment, CONCA). Tasks were selected to measure the domains outlined by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. We have undertaken a cross-validation study in those with schizophrenia (N=15), bipolar disorder (N=16), depression (N=15) and healthy controls (N=19) to compare the online tasks with the MATRICS battery. Following validation, we invited participants from the Cardiff Cognition in Schizophrenia Study (CardiffCOGS) and the National Centre for Mental Health (NCMH) to complete CONCA. Results Correlations between CONCA and MATRICS tasks ranged from 0.25 to 0.73 in our validation sample (N=65). A total of 6960 individuals were invited to participate and 1227 consented to take part. There was a better response rate from NCMH participants (who were recruited more recently) compared to those from CardiffCOGS. Online participants recruited from NCMH were more highly educated (W=1171600, p<0.001) and more likely to be professionals (χ2(1)=5.4, p=0.02) than the original NCMH cohort. In CardiffCOGS, online participants were more highly educated than non-responders (W=7786.5, p=0.003). A total of 887 individuals met inclusion criteria for our analyses including 43 participants with schizophrenia, 146 with bipolar disorder, 261 with unipolar depression, 187 controls and 250 participants with other psychiatric disorders. Consistent with studies using offline assessments, participants with schizophrenia were the most severely impaired group (compared to controls: g=1.36, p<0.001), exhibiting greater impairments than participants with depression (g=1.04, p<0.001) and bipolar disorder (g=0.71, p=0.002). Of note, lower performance on the battery was associated with poorer functional outcome as assessed using the World Health Organisation’s Disability Assessment Scale (B=-1.77, SE=0.3, p=5.8 x 10–9). Discussion Web-based cognitive testing is a suitable method for collecting large-scale data in psychiatric populations, although there was some evidence of recruitment bias. The results of the validation and recruitment phases were used to inform selection of the final battery. We consulted with patients and health professionals from a youth psychosis service and NCMH’s patient involvement group to create a user-friendly interface and will continue to work with these groups to develop clinically useful feedback to facilitate patient monitoring in early intervention psychosis services.

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Testing a Web-Based, Trained-Peer Model to Build Capacity for Evidence-Based Practices in Community Mental Health Systems

Psychiatric Services ◽

10.1176/appi.ps.201700029 ◽

2018 ◽

Vol 69 (3) ◽

pp. 286-292 ◽

Cited By ~ 10

Author(s):

Ramaris E. German ◽

Abby Adler ◽

Sarah A. Frankel ◽

Shannon Wiltsey Stirman ◽

Paola Pinedo ◽

...

Keyword(s):

Mental Health ◽

Community Mental Health ◽

Health Systems ◽

Evidence Based ◽

Mental Health Systems ◽

Evidence Based Practices ◽

Web Based

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Non-suicidal self-injury in United States adults: prevalence, sociodemographics, topography and functions

Psychological Medicine ◽

10.1017/s0033291710002497 ◽

2011 ◽

Vol 41 (9) ◽

pp. 1981-1986 ◽

Cited By ~ 293

Author(s):

E. D. Klonsky

Keyword(s):

Mental Health ◽

United States ◽

Mental Health Treatment ◽

Large Scale ◽

Age Of Onset ◽

Adult Population ◽

The United States ◽

Epidemiological Studies ◽

Adolescent And Young Adult ◽

Self Injury

BackgroundNon-suicidal self-injury (NSSI) has received increased attention in the mental health literature and has been proposed as a diagnostic entity for DSM-5. However, data on NSSI in the United States adult population are lacking.MethodThe prevalence and nature of NSSI were examined in a random-digit dialing sample of 439 adults in the United States. Participants were recruited during July and August of 2008.ResultsLifetime prevalence of NSSI was 5.9%, including 2.7% who had self-injured five or more times. The 12-month prevalence was 0.9%. Methods of NSSI reported included cutting/carving, burning, biting, scraping/scratching skin, hitting, interfering with wound healing and skin picking. Half of self-injurers reported multiple methods. The average age of onset was 16 years (median 14 years). Instances of NSSI infrequently co-occurred with suicidal thoughts and with use of alcohol or drugs and rarely required medical treatment. Most injurers reported that NSSI functioned to alleviate negative emotions. Fewer reported that they self-injured to punish themselves, to communicate with others/get attention or to escape a situation or responsibility. NSSI was associated with younger age, being unmarried and a history of mental health treatment, but not with gender, ethnicity, educational history or household income.ConclusionsResults are largely consistent with previous research in adolescent and young adult samples. Study limitations notwithstanding, this study provides the most definitive and detailed information to date regarding the prevalence and characteristics of NSSI in US adults. In the future, it will be important for large-scale epidemiological studies of psychopathology to include questions about NSSI.

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