Clinical trial NCT05450094: Reducing Unmet Mental Health Need of African-American Children
Official title: Patient-Centered Enhancements to Reduce Unmet Mental Health Need of African-American Children
Study type: INTERVENTIONAL
Overall status: ENROLLING_BY_INVITATION
Phase: NA
Conditions: Mental Health
Lead sponsor: University of Florida
Sponsor class: OTHER
Collaborators: name: Patient-Centered Outcomes Research Institute
First posted: 2022-07-08
Enrollment: 19106
Sex: ALL
Minimum age (years): 5
Maximum age (years): 105
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this study is to compare two versions of school-based mental health screening to improve the receipt of mental health services among elementary school students.

Detailed description: School-based mental health (SBMH) is a critical pathway for accessing mental health services for African American/Black (AAB) youth who experience the greatest gap in unmet mental health need in comparison to their White, non-Hispanic peers, but are twice as likely to access mental health services in schools as outpatient or specialty clinics. Unfortunately, AAB children's access to SBMH is dependent on school intervention team decision making, which often involves consideration of factors other than student need. School personnel on intervention teams disproportionately attribute AAB youth's behavior problems as disciplinary issues rather than mental health needs, reducing the likelihood AAB students receive SBMH services. Consistent with the empirical literature, patient families and stakeholders recommend universal mental health screening to better identify AAB children with mental health needs and enhancements to address unintentional racial biases and poor mental health literacy of school personnel making intervention referral decisions. Thus, we will evaluate the comparative effectiveness of the SBMH delivery system enhanced with screening to a package of enhancements implemented with screening in SBMH to increase the likelihood AAB students receive the services they critically need. The enhancements include three components: (1) unintentional racial bias training and (2) mental health literacy training for voluntary school team members, and (3) a refinement to school teams' data-based decision-making process in which they also voluntarily review screening, mental referral/receipt, and discipline data disaggregated by race/ethnicity to identify and problem solve system-level inequities. We will test both whether and how (i.e., mediational analyses of causal pathway including knowledge, attitudinal, and behavioral observation of unintentional bias and mental health literacy) these enhancements impact student-level intervention and disciplinary referral outcomes. In a mixed method process evaluation and comparative analysis, we will also examine school-level contextual factors (i.e., team member tenure, pre-intervention discipline rates, racial/ethnic and socioeconomic composition of student body, and perceptions of intervention impact and acceptability) and implementation outcomes (i.e., fidelity, dosage/exposure, and reach).

Eligibility criteria: Inclusion Criteria:

* Students at study school
* School intervention teams at study school

Exclusion Criteria:

* Students who are wards of the state or any other institution, agency, or entity

Primary outcomes:
measure: Mean change from baseline in student referral to a mental health intervention as measured by the number of students referred to mental health interventions each quarter
timeFrame: From first day of school in year 1 to last day of school in year 2
Secondary outcomes:
measure: Mean change from baseline in student disciplinary encounters as measured by the number of Office Discipline Referrals each quarter
timeFrame: From first day of school in year 1 to last day of school in year 2
Other outcomes:
Locations:
city: Gainesville
country: United States
facility: Name withheld to protect anonymity of study site
state: Florida
Study officials:
affiliation: University of Florida
name: Joni Splett, Ph.D
role: PRINCIPAL_INVESTIGATOR
References: