Collaborative research challenges. The RMC is charged with creating solutions to the inevitable research challenges inherent in collaboratively designed studies, thereby, potentially helping the field increase the ' number of research studies which examine the process of service delivery and outcomes of child mental health services that are co-designed by relevant stakeholders. Specific goals of the RMC are to: a) assist in preparing urban services researchers to effectively conduct collaborative studies (thus, RMC will support CCCR pilot research studies;f) consult with CCCR investigators on current and planned collaborative research studies);b) refine and develop statistical approaches to help stakeholders make decisions regarding which existing and emerging evidence-based services may be relevant for their community or client population (issues of generalizability);c) create multi-step approaches to the design of evidence-informed service delivery that allows for maximum collaborative input and which can be continuously informed by preliminary, qualitative and quantitative and;d) expand research design options which are sufficiently rigorous to produce useful knowledge, but also which have built in flexibility to respond to constraints and preferences. ', . More specifically, the Core must respond to necessary modifications in designs and.methods based upon the collaborative input of stakeholders by developing alternative approaches that can support the conduct of rigorous sen/ices research successfully within "real world" settings and communities, in these settings, the well-controlled, tightly constrained aspects of traditional designs may not be feasible. Random assignment to . no treatment may not be acceptable. Moreover, given the- importance of understanding the impact of ecological factors in real world settings, and the complexity of these multiple interacting, but "uncontrolled" variables, analytic methods and research designs must explore new ways to fully capture the impact of new delivery models on utilization, implementation and multi-level outcomes. These methods must take into account that-it frequently is hot just a characteristic of a child that is the object of study, but the contextually- and historically-shaped transactions between the child and the larger environment (e.g. family, peers). Further, these methods must be sufficiently robust to address common threats in urban studies (e.g. missing data). Next, if the research addresses topics tapping racially sensitive information, modifications in research J procedures and staffing may be necessary (e.g., development of methods to train and supervise community interviewers). Further, instruments and methods that can capture the role of racial and ethnic perspectives, group identify, inner-city context must be further refined. Given the research obstacles inevitably confronted by CCCR investigators within "real world" child serving settings, RMC Core leadership needs to bring substantial expertise in assisting new investigators with strategies that maintain the integrity of the research while simultaneously addressing any or all of the following: difficulty with recruitment, tracking, mobility, retention. conflict with key stakeholders regarding sampling; design, measurement, interpretation and dissemination of findings. Finally, the RMC will concentrate on advancing methods related to understanding the likelihood that an existing evidence-based sen/ice will generalize to new populations of interest, particularly youth and families, impacted by poverty and a range of urban stressors. However, even if an existing evidence-based service appears promising for urban youth and their families, collaboration with key stakeholders (e.g. youth, adult caregivers, providers, communities) is still necessary to facilitate "buy in," enhance cultural and contextual relevance and maximize likelihood of high external validity. Traditional efficacy studies have generally emphasized internal validity, with the assumption that once a service has been proven efficacious, then it can be disseminated to practice settings with relatively few modifications. This has proven to be a faulty assumption as so many evidence-based child mental health ' services have failed to be implemented and sustained within "real world practice settings: (Weiss et al., 2005; Hoagwood et al., 2004). Thus, the RMC will pay particular attention to issues related to the appropriateness of transporting existing evidence-based interventions to urban contexts with specific emphasis on examining issues related to generalizability. An important starting point for the Research Methods Core of the CCCR is that a child mental health service innovation must be optimized to be practical, flexible to adjust to setting constraints, acceptable and sustainable. Funding from the CCCR will support Center faculty to embark on collaborative pilot research studies seen by many traditional investigators as "too messy or too time consuming" in an effort to balance and optimize both internal and external validity. Further, RMC core leadership is prepared to fully partner with, CCCR investigators in the design, implementation and examination of collaboratively designed studies.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory Grants (P20)
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Special Emphasis Panel (ZMH1-ERB-B)
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Icahn School of Medicine at Mount Sinai
New York
United States
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Chor, Ka Ho Brian; Olin, Su-Chin Serene; Weaver, Jamie et al. (2014) Adoption of clinical and business trainings by child mental health clinics in New York State. Psychiatr Serv 65:1439-44
Marcus, Sue M; Lu, Bo; Lim, Sungwoo et al. (2013) Suicide attempts in patients with bipolar disorder tend to precede, not follow, initiation of antiepileptic drugs. J Clin Psychiatry 74:630-1
Marcus, Sue M; Medoff, Deborah; Fang, Li Juan et al. (2013) Generalizability in the family-to-family education program randomized waitlist-control trial. Psychiatr Serv 64:754-63