+ All Categories

.ppt

Date post: 20-Nov-2014
Category:
Upload: dentistryinfo
View: 440 times
Download: 2 times
Share this document with a friend
Description:
 
Popular Tags:
31
Fostering research to improve the health and well-being of children and youth Engaging users of child and youth mental health prevention programs? CYHRNet Annual Meeting November 3, 2009 Bonnie Leadbeater, Ph D.
Transcript
Page 1: .ppt

Fostering research to improve the health and well-being of children and

youth

Engaging users of child and youth mental health prevention programs?

CYHRNet Annual MeetingNovember 3, 2009

Bonnie Leadbeater, Ph D.

Page 2: .ppt

Fostering research to improve the health and well-being of children and

youth

The Ideal

Page 3: .ppt

Fostering research to improve the health and well-being of children and

youth

Evaluation

Development & Innovation

Uptake

Infidelity

Abandonment

The Reality Processes of Knowledge Uptake for Mental Health Programs

Page 4: .ppt

Fostering research to improve the health and well-being of children and

youth

The PUSH

Program Developer(an academic

or research team)

USERSGATEKEEPERS

Principals Police forceTherapistsCounselors

Page 5: .ppt

Fostering research to improve the health and well-being of children and

youth

The PULL

Knowledge USERS

Professional Development

Activities

Marketing

PrivateCommunications

Page 6: .ppt

Fostering research to improve the health and well-being of children and

youth

The Solution Community Based Research?

• Involve stakeholders early in program development

• Enhanced knowledge exchange• Increase relevance• Speed uptake

–YES, but ….

Page 7: .ppt

Fostering research to improve the health and well-being of children and

youth

How does CBR affect going to scale?

• Programs may be more relevant and acceptable.• But programs are ultimately packaged and

dissemination requires ….. • Pushing and pulling mechanisms to – Recreate interested community partners in new setting– Recreate trained workforce – delivery folks– Reevaluate cultural applicability and local relevance of the

program

»For example

Page 8: .ppt

Fostering research to improve the health and well-being of children and

youth

Preventing peer victimization

Page 9: .ppt

Fostering research to improve the health and well-being of children and

youth

The WITS Rock Solid Primary Prevention Program is a Partnership

Judy Stevenson, Susan Underwood, Sonya Einstadt

Wendy Holob, John Gaiptman

Bonnie LeadbeaterWendy Hoglund; Rachel Yeung:Tracy

DesjardinPaweena Sa

Tom Woods; Dorian BrownRock Solid Foundation

Page 10: .ppt

Fostering research to improve the health and well-being of children and

youth

Moving out of the classroom

• Children grow up in relationships &– A growing number of studies show the promise of

school, parent, and community involvement in interventions for reducing peer victimization.

• WITS strategies convey consistent and developmentally appropriate messages for peaceful conflict resolution across contexts

Page 11: .ppt

Fostering research to improve the health and well-being of children and

youth

WITS Program Components

1. Emergency Services Personnel Manual 2. Student/WITS Representative3. WITS Booklist 4. Curriculum for Teachers and Librarians5. Activities for the Classroom and School6. Resources for Parents

www.uvic.ca/WITS

Page 12: .ppt

Fostering research to improve the health and well-being of children and

youth

Evaluations

• 2001-2003 (4 waves)– 432 children families & their teachers

• 2007-2008 (3 waves)– 1132 children families & their teachers

Page 13: .ppt

Fostering research to improve the health and well-being of children and

youth

More reported victimization and greater rate of decline levels of victimization

Page 14: .ppt

Fostering research to improve the health and well-being of children and

youth

Bridging the gap – Transportability

Knowledge Practice

BetterImplementation

Strategies

Page 15: .ppt

Fostering research to improve the health and well-being of children and

youth

Obstacles to transportabilityAccess to mental health services/programs:

• Heterogeneity of services delivered (medication, psychotherapy, groups etc.)

• Clogged public systems mainly treats adolescents with severe illness and urgent needs

• Scattered sites for service delivery (schools, child welfare, juvenile justice, health clinics, private offices)

• Multiple service providers – Intervention (physicians, psychologist, therapists,

counselors) & – Prevention (Police: D.A. R. E.) (Teachers: F.R.I.E.N.D.S. for

Life, School Counselors

Page 16: .ppt

Fostering research to improve the health and well-being of children and

youth

More obstacles – Complexity of problems and solutions

• Ecology child health and illness creates need for preventions in the context of family, school, neighborhood,

• Complexity of mental health concerns – comorbidity (anxiety, depression, ODD, CD)

• Even Prodromal & subclinical symptoms affect functioning in many domains (physical academic)

Page 17: .ppt

Fostering research to improve the health and well-being of children and

youth

More obstacles – Creating Research Evidence

• Lack of empirically-based programs for some concerns (but many do exist)

• Lack of consensus or regulation in what counts as evidence-based (RTCs vs real world)

• Incentives to do intervention research• Longterm commitment is neededVaccination-like

programs don’t work even if wide spread, short term single shot programs show no evidence of lasting effects – e.g. D.A.R.E longitudinal research is needed

• Researchers have short lives!

Page 18: .ppt

Fostering research to improve the health and well-being of children and

youth

NOW WHAT ?

• Need for a national, provincial and and local infrastructures committed to facilitating dissemination of effective based mental health treatment programs for children

&Children’s Mental Health

Promotion Programs

Page 19: .ppt

Fostering research to improve the health and well-being of children and

youth

Applying Applying Child Policy Initiatives Child Policy Initiatives

(Julius Richmond) (Julius Richmond)

KnowledgeKnowledgeBaseBase

(Growing)(Growing)

PoliticalPoliticalWillWill

(Growing) (Growing)

Social StrategySocial Strategy(Fragmented)(Fragmented)

Page 20: .ppt

Fostering research to improve the health and well-being of children and

youth

Alternate approaches to public health problems

• Preventive dentistry– Licensed and accredited providers– Lifespan, prevention oriented perspective– Public and private involvement (fluoride in

water, and tooth paste)

• Put WITS in your water to prevent relationship decay?

Page 21: .ppt

Fostering research to improve the health and well-being of children and

youth

Pharmaceutical medicineFood & Drug Act (2005 budget – $170M for 5 years)

• Evidenced-based approaches built into regulatory standards for insuring safety, efficacy and quality

• Industry lead mechanisms for development,dissemination, marketing

• Monetary Incentives for development and dissemination

• Nationally regulated(Health Canada)• Training restrictions related

to for distribution – few gatekeepers

• Public payment for use of medications + private insurance

• Fueled by academic research

Page 22: .ppt

Fostering research to improve the health and well-being of children and

youth

Approaches to improve access to Evidence-based mental health programs

• Standardize and clarify training and scope of practice of service providers – teachers don’t just teach

• Public funding of mental health prevention and prevention services to children and youth

• National accreditation of evidenced-based treatments (with clear operational criteria)

• Centralized and accelerated dissemination of evidenced-based programs

• Identifiable settings for mental health treatment

Page 23: .ppt

Fostering research to improve the health and well-being of children and

youth

Drug Safety and Effectiveness Network Launched July 2008

• Minister of Health, Leona Aglukkaq:• “Canadians can be confident that this government

is taking the steps necessary to ensure that our drug safety system remains one of the best in the world. The Network complements Canada’s rigorous pre-testing of drugs by studying how Canadians respond over time to already-approved drugs. The results will help in decision making and enhance overall consumer safety” (32M for first 5 years then 10M per year after)

Page 24: .ppt

Fostering research to improve the health and well-being of children and

youth

Which system would you choose for your child?

• Regulated, pharmaceutical system with few, easy to access, gatekeepers (physicians) and sound educators (pharmacists) ?

• Unregulated, hard to find, fragmented psychological services with potentially unproven benefits, delivered by variously trained individuals, in multiple settings?

Page 25: .ppt

Fostering research to improve the health and well-being of children and

youth

A NATIONAL Mental Health Strategy

Minister of Health, Leona Aglukkaq will make the strong claim that:

“Canadians can be confident that this government is taking the steps necessary to ensure that our children’s mental health is among the best in the world!”

Page 26: .ppt

Fostering research to improve the health and well-being of children and

youth

Recommendations for programs for treatment and prevention of mental

health programs in children• National accreditation of evidence-based

programs.• Regulation of training of mental health service

providers.• Enhance access to and use of accredited

programs by schools.• Public payment for mental health care for

children and youth.

Page 27: .ppt

Fostering research to improve the health and well-being of children and

youth

First Steps - Federal• The Public Health Agency of Canada – listing of

promising programs and “Innovative strategy to Reduce Health Inequalities in Canada”

• Canadian Mental Health Commission• Canadian Alliance on Mental– Illness and Mental Health (CAMIMH),

• PREVNET –Promoting relationships eliminating violence Network- began with a National Centre for Excellence

Page 28: .ppt

Fostering research to improve the health and well-being of children and

youth

First steps – Provincial

• BC Ministry for Child and Family Development: Ten Year Mental Health Plan – Dissemination of FRIENDS For LIFE Program

• Children’s Mental Health Ontario (CMHO) Evidence-Based Practice Technical Assistance Centre

Page 29: .ppt

Fostering research to improve the health and well-being of children and

youth

First steps – local

• Toolkits for community engagement and development. – Rand Foundation entitled Getting to Outcomes

http://www.rand.org/pubs/technical_reports/TR101/

Page 30: .ppt

Fostering research to improve the health and well-being of children and

youth

Getting to outcomes: Questions

• 1: What Are the Underlying Needs and Conditions in the Community? (Needs/Resources)

• #2: What Are the Goals, Target Populations, and Objectives (i.e., Desired Outcomes)? (Goals)

• #3: Which Evidence-Based Programs Can Be Used to Reach Your Goal? (Best Practice)

• #4: What Actions Need to Be Taken So That the Selected Program “Fits” the Community Context?

• #5: What Organizational Capacities Are Needed to Implement the Program? (Capacities)

Page 31: .ppt

Fostering research to improve the health and well-being of children and

youth

Getting to Outcomes (Continued)

• #6: What Is the Plan for this Program? (Plan)• #7: How Will the Quality of Program and/or

Initiative Implementation Be Assessed? (Process)• #8: How Well Did the Program Work? (Outcomes)• #9: How Will Continuous Quality Improvement

Strategies Be Incorporated? (CQI)• #10: If the Program Is Successful, How Will It Be

Sustained? (Sustain)


Recommended