The application proposes collaboration between one of the largest children?s non-profit community mental health service agencies in New York City, the Jewish Board of Family and Children?s services (JBFCS), and the Mount Sinai School of Medicine (MSSM), to address child trauma and posttraumatic stress disorder (PTSD), an extremely important public health problem. The partners seek to take advantage of a unique opportunity to integrate their response to the RISP RFA within a major organizational change now occurring in the JBFCS, that includes defining best practice models of care, and representing them in an electronic medical record (EMR). We propose to build on this infrastructure platform to conduct field-based exploratory studies of trauma screening and treatment, and to evaluate the ability of the proposed system to support the conduct of collaborative research. This proposal is organized around three major programmatic aims: (1) the development of an infrastructure, including an electronic medical record, that supports the conduct of clinical research in a field setting, (2) implementation of three pilot projects to test the infrastructure using increasingly sophisticated designs and to advance our knowledge regarding child trauma screening and treatment, (3) development of an integrated training program designed to facilitate collaborative clinical research and team building between JBFCS and MSSM clinicians and investigators. Achieving these aims will help us to create a collaborative field research organization capable of supporting a broad variety of child mental health clinical and research initiatives within community practice settings. The three specific projects will be carried out during the funded period. These are: an evaluation of the impact of the EMR on clinical perception of EMR and system performance indicators, evaluating the impact of several different methods of screening for childhood victimization/trauma history in a large clinical service delivery system, and comparing the efficacy of a disorder-specific treatment for children and youths with PTSD to usual care in a large complex clinical service delivery system. Concurrently, we will establish an effective governance structure, including an internal peer review capacity, so to develop a generative collaboration that allows for the development of satellite research projects of mentees and junior faculty in field based intervention research.
