ABSTRACT

Objective

The gap between rates of children’s mental health problems and their participation in services highlights the need to address concerns related to engagement in mental health services more effectively. To identify, understand, and resolve engagement concerns appropriately requires effective measurement. In this study, we employed a multidimensional conceptual framework of engagement to examine the measurement of engagement in intervention studies focused on improving children’s and/or families’ engagement in services.

Method

We coded 52 randomized controlled trials (RCTs) of interventions designed to enhance treatment engagement published between 1974 and 2019 to examine what engagement constructs have been measured, how these constructs have been measured, who has provided information about engagement, and when and why engagement measures have been administered.

Results

Attendance was measured in 94.2% of studies, and 59.6% of studies measured only attendance. Furthermore, most studies (61.5%) measured only one engagement dimension. One hundred twelve unique indicators of treatment engagement were used (61.6% measuring attendance). Infrequent measurement of youth (19.2% of studies) or caregiver (26.9%) perspectives was apparent. About half (54.7%) of measures were completed on one occasion, with 53.7% of measures completed after treatment was concluded.

Conclusions

Results highlight how the field’s measurement of engagement has focused narrowly on attendance and on interventions that improve attendance. We consider promising new directions for capturing the multidimensional, dynamic, and subjective aspects of engagement, and for leveraging measurement in research and practice settings to feasibly and effectively identify, monitor, and address engagement challenges.

中文翻译：

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治疗参与度测量的多维检查：对儿童心理健康服务和研究的影响

摘要

客观的

儿童心理健康问题发生率与其参与服务之间的差距凸显出需要更有效地解决与参与心理健康服务相关的问题。要适当地识别、理解和解决参与问题需要有效的衡量。在这项研究中，我们采用了多维参与概念框架来检验干预研究中参与度的衡量，重点是改善儿童和/或家庭对服务的参与。

方法

我们对 1974 年至 2019 年间发表的 52 项旨在提高治疗参与度的干预措施进行了随机对照试验 (RCT)，以检查测量了哪些参与度结构、如何测量这些结构、谁提供了有关参与度的信息，以及何时以及为何进行参与度测量已被管理。

结果

94.2% 的研究测量了出勤率，59.6% 的研究仅测量了出勤率。此外，大多数研究（61.5%）仅测量一项参与度维度。使用了 112 个治疗参与度的独特指标（61.6% 衡量出勤率）。很明显，对青少年（19.2% 的研究）或看护者（26.9%）观点的测量很少。大约一半（54.7%）的措施是一次性完成的，其中 53.7% 的措施是在治疗结束后完成的。

结论

结果突显了该领域的参与度衡量如何狭隘地关注出勤率和提高出勤率的干预措施。我们认为有希望的新方向是捕捉参与的多维、动态和主观方面，并利用研究和实践环境中的测量来切实有效地识别、监控和解决参与挑战。