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Implementing the NIMH Clinical Pathway in Rural Appalachian School-Based Health Clinics

Award Number: R34MH137618
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/14/2024
PERIOD OF PERFORMANCE END DATE: 06/30/2027

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Implementing the NIMH Clinical Pathway in Rural Appalachian School-Based Health Clinics - Rural Appalachian youth are at disproportionately high risk for suicide and experience significant barriers to health care access. School-Based Health Centers (SBHCs) have the potential to address suicide risk among this underserved population by providing routine evidence-based suicide risk screening, assessment, and follow-up. The NIMH Clinical Pathway is an evidence-based suicide risk detection and management program that has been found to be effective at addressing suicide risk among urban youth. However, the feasibility and impact of the NIMH Clinical Pathway have not been evaluated in rural Appalachian SBHCs, who face unique contextual, resource, and cultural barriers to implementation. To address this health care disparity, we propose a pilot hybrid effectiveness-implementation type-1 study that will use mixed methods and a stepped wedge design to adapt, implement, and evaluate the NIMH Clinical Pathway in two SBHCs located in rural Appalachia. This study will gather data regarding the specific needs of rural Appalachian youth and providers in the SBHC setting, use a Quality Improvement (QI) approach to modify the pathway and tailor implementation, and gather preliminary data on the effectiveness and sustainability of the modified pathway. Data, training materials, and implementation strategies developed can be disseminated to practices throughout rural Appalachia and will be used to support a future R01 trial of the NIMH Clinical Pathway in these Appalachian settings. This study has the following three aims: Aim 1: To adapt the NIMH Clinical Pathway and tailor implementation to address the unique needs of the rural Appalachian SBHC care setting and gather preliminary data on its feasibility, appropriateness, and acceptability. Aim 2: To examine the preliminary effectiveness of the adapted NIMH Clinical Pathway compared to Treatment as Usual (TAU) on overall screening and detection rates as well as service and patient outcomes for youth identified as at risk for suicide. Hypothesis 2a: Overall proportions of screening will be significantly higher during the intervention phase than during TAU and risk detection rates will increase. Hypothesis 2b: Youth receiving the modified NIMH Clinical Pathway will show improvements in service and patient outcomes (safety planning, follow-up visits, suicidal ideation/behavior, depression, and safety plan/acute care usage) compared to TAU. Aim 3: To identify barriers to and facilitators of implementation and sustainability of the adapted NIMH Clinical Pathway in the rural Appalachian SBHC setting. This innovative pilot study will address a critical health care disparity by identifying strategies to increase the widespread adoption of an evidence-based suicide prevention program for rural Appalachian youth.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $270,525 )
2025	2025	WEST VIRGINIA UNIVERSITY	1500 UNIVERSITY AVE	MORGANTOWN	WV	26506	MONONGALIA	USA	Mental Health Research Grants	000	2	6/27/2025	NON-COMPETING CONTINUATION	$270,525
														Subtotal = $270,525

Issue Date FY: 2024 ( Subtotal = $269,646 )
2024	2024	WEST VIRGINIA UNIVERSITY	1500 UNIVERSITY AVE	MORGANTOWN	WV	26506	MONONGALIA	USA	Mental Health Research Grants	000	1	8/14/2024	NEW	$269,646
														Subtotal = $269,646

Grand Total All Awards = $540,171

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Implementing the NIMH Clinical Pathway in Rural Appalachian School-Based Health Clinics

Award Number: R34MH137618

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/14/2024

PERIOD OF PERFORMANCE END DATE: 06/30/2027

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