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Evaluating the Effectiveness of a Statewide School-Based Behavioral Health Program for Rural and Urban Elementary-Aged Students
School Mental Health ( IF 2.5 ) Pub Date : 2021-03-27 , DOI: 10.1007/s12310-021-09441-x
Amy D. Herschell , Patricia L. Schake , Shari L. Hutchison , Irina O. Karpov , James G. Gavin , Tiberiu Bodea Crisan , Deborah S. Wasilchak

Community and School-Based Behavioral Health Service (CSBBH) was developed through a collaborative process that included schools, behavioral health providers, counties, and a payor. The clinical model within CSBBH relies on a common factors approach. To evaluate the effectiveness of CSBBH to meet the needs of students across a diverse state, clinical model performance and outcomes were examined for 2,584 Medicaid-eligible children aged 4.5 to 11 years in urban and rural communities. First, propensity score matching was used to compare CSBBH to Treatment as Usual (TAU). CSBBH was associated with greater improvement in child functioning and slightly lower therapeutic alliance compared to TAU. Next, the utility of the model for urban vs. rural students was compared. As expected, there were many differences at baseline between children in urban and rural settings. Compared to children from rural settings, children from urban settings were more culturally diverse and had higher rates of utilization of prior mental health services but had lower rates of complex diagnoses. Despite these differences, the service was consistently applied across schools and caregiver-reported outcomes were comparable and positive across groups. Teachers in urban and rural schools reported improvements in hyperactivity, but other outcomes (e.g., prosocial behavior, emotional symptoms) varied. This study highlights the importance of a scalable and sustainable payor–provider collaborative approach to address the needs of children across a diverse state.



中文翻译:

评估针对农村和城市小学年龄段学生的全州范围内基于学校的行为健康计划的有效性

社区和基于学校的行为健康服务(CSBBH)是通过协作过程开发的,该过程包括学校,行为健康提供者,县和付款人。CSBBH内的临床模型依赖于公共因素方法。为了评估CSBBH满足各州学生需求的有效性,对城市和农村地区的2584名4.5至11岁符合Medicaid资格的儿童的临床模型表现和结果进行了检查。首先,倾向得分匹配用于将CSBBH与“常规治疗”(TAU)进行比较。与TAU相比,CSBBH与儿童功能的更大改善和治疗联盟略低有关。接下来,比较了该模型对城市学生与农村学生的效用。不出所料 在城市和农村地区,儿童在基线时有很多差异。与农村地区的儿童相比,城市地区的儿童在文化上更加多样化,以前的精神卫生服务的利用率较高,但复杂的诊断率较低。尽管存在这些差异,但该服务始终在学校中得到应用,并且照护者报告的结果在各组中均具有可比性和积极性。城乡学校的教师报告说,多动症有所改善,但其他结果(如亲社会行为,情绪症状)却有所不同。这项研究强调了采用可扩展的,可持续的付款人与提供者合作的方法来满足不同州儿童的需求的重要性。来自城市地区的儿童在文化上更具多样性,并且以前使用精神卫生服务的比例较高,但复杂诊断的比例较低。尽管存在这些差异,但该服务始终在学校中得到应用,并且照护者报告的结果在各组中均具有可比性和积极性。城乡学校的教师报告说,多动症有所改善,但其他结果(如亲社会行为,情绪症状)却有所不同。这项研究强调了采用可扩展的,可持续的付款人与提供者合作的方法来满足不同州儿童的需求的重要性。来自城市地区的儿童在文化上更具多样性,并且以前使用精神卫生服务的比例较高,但复杂诊断的比例较低。尽管存在这些差异,但该服务始终在学校中得到应用,并且照护者报告的结果在各组中均具有可比性和积极性。城乡学校的教师报告说,多动症有所改善,但其他结果(如亲社会行为,情绪症状)却有所不同。这项研究强调了采用可扩展的,可持续的付款人与提供者合作的方法来满足不同州儿童的需求的重要性。该服务在各个学校中得到了一致的应用,并且照护者报告的结果在各个群体之间都是可比的并且是积极的。城乡学校的教师报告说,多动症有所改善,但其他结果(如亲社会行为,情绪症状)却有所不同。这项研究强调了采用可扩展的,可持续的付款人与提供者合作的方法来满足不同州儿童的需求的重要性。该服务在各个学校中得到了一致的应用,并且照护者报告的结果在各个群体之间都是可比的并且是积极的。城乡学校的教师报告说,多动症有所改善,但其他结果(如亲社会行为,情绪症状)却有所不同。这项研究强调了采用可扩展的,可持续的付款人与提供者合作的方法来满足不同州儿童的需求的重要性。

更新日期:2021-03-27
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