Thursday, October 21, 2021
10/21/2021
PROJECT SUMMARY/ABSTRACT Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, as recognized by NIMH’s Strategic Objective 4.2: to develop and validate strategies for sustaining EBTs in partnership with key stakeholders. There remains a particularly significant need for strategic planning tools that can guide coordination of sustainable funding for EBTs among youth mental health service agencies, various public and private funding sources, and purveyor/intermediary organizations (which provide guidance and support on the delivery of specific EBTs). The Specific Aims of the proposed R21 project are to (1) develop and (2) evaluate, with stakeholder input, a fiscal mapping process that will guide strategic planning efforts to finance sustainment of EBTs in youth mental health services. The interdisciplinary project team will employ a mixed method approach – with input from a sample of N = 40 stakeholder participants with expertise in the administration and financing of EBTs – to accomplish these aims. All of the proposed research will focus on two widely-disseminated exemplar EBTs (Parent-Child Interaction Therapy and Trauma-Focused Cognitive-Behavioral Therapy) to maximize generalizability of results within the available resources. Aim 1 of the project is to develop the fiscal mapping process: a multi-step, structured process that guides youth mental health service agencies and their partners in selecting the optimal combination of strategies for financing their EBT sustainment efforts. We will adapt an established intervention mapping process and incorporate a compilation of 23 financing strategies developed by our team. We will engage our stakeholder participants in a modified Delphi exercise to achieve consensus on the key steps of the fiscal mapping process and gather information that can inform selection of financing strategies. Aim 2 of the project, which will proceed concurrently with Aim 1, is to evaluate preliminary impact of the fiscal mapping process on EBT sustainment capacities (i.e., structures and processes that support strategic planning) and outcomes (e.g., intentions to sustain) in youth mental health service agencies. Each participating agency will lead a pilot test of the fiscal mapping process, involving their intermediary and funding agency partners. We will evaluate how the fiscal mapping process impacts capacities and outcomes linked to EBT sustainment using a comparative case study approach, incorporating data from stakeholder focus groups and document review. After pilot testing, the participants will conceptualize the process and outcomes of fiscal mapping in a participatory modeling exercise to help inform future evaluations of the fiscal mapping process. Ultimately, the proposed research will generate a fiscal mapping process that will facilitate the coordination of sustained funding for EBTs in youth mental health services. Consistent with the exploratory objectives of the R21 mechanism, the results of this novel project will directly inform a planned large-scale R01 effectiveness- implementation trial to test the impact of the fiscal mapping process on sustainability of a wide variety of EBTs.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
