We propose to establish an Advanced Center to Improve Pediatric Mental Health Care (ACIPMHC) that will be located within the Child and Adolescent Services Research Center (CASRC) at Rady Children's Hospital-San Diego. The ACIPMHC will have strong linkage to the intervention development program at the Center for Research to Practice (CR2P) at the Oregon Social Learning Center (OSLC) and to other intervention and services research programs and networks around the country. The research agenda has a strategic focus on improvement of public pediatric mental health care, primarily in the mental health and child welfare service sectors, through improved integration of evidence-based practice and usual care. The center's program of practice research spans clinical epidemiology studies linked to evidence-based practice, effectiveness, and implementation studies. The research agenda will have a primary focus on effectiveness and equity as two of the six aims for improving health care from the """"""""Crossing the Quality Chasm"""""""" report. An overarching center perspective of cultural exchange will guide active partnership with major stakeholders in youth mental health care, including youth and family consumers, providers, program and funding managers, system administrators, policy makers, and intervention and services researchers. The Principal Research Core (PRC) will focus on practice research through two developmental studies addressing implementation of two established evidence-based practices. These studies and others to be designed by the center network of investigators will be carried out in community-based mental health and child welfare service settings, building on already developed research-practice relationships. The Research Methods Core (RMC) will advance methods for effectiveness and implementation research through four workgroups focusing on (a) design and analysis, (b) measurement, (c) mixed methods, and (d) economic analyses, as well as one developmental study addressing incorporation of research-based measurement in usual care child welfare practice. The Community Network Core (CNC) will strengthen a multiple sector infrastructure in San Diego County and link research activities to an emerging research network in the State of California that partners with the California Institute of Mental Health, a technical assistance arm of the county mental health directors in California. The Operations Core (OC) will provide leadership and will support activities in the other three cores by extending an effective infrastructure developed through two prior services research center grants and participating as one of six sites in an R-25 training consortium. All cores will advance practice research to inform improvements in mental health care that decrease racial-ethnic disparities.
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