Child maltreatment is a major public issue in the United States1, causing significant mental health effects (e.g., posttraumatic stress disorders2), as well as adverse educational and occupational outcomes3,4. Unfortunately, most children affected by abuse or neglect never engage in evidence based practices (EBP) for child mental.5-7 Enhancing early engagement of families in mental health assessment and EBP is a priority target for Children's Advocacy Centers (CACs') leadership at the National Children's Alliance (NCA). CACs are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Family Advocate mirrors the Mental Health Family Navigator national initiative. The Training Intervention for the Engagement of Families (TIES) program has a long history of success in enhancing engagement in services by families who are financially disadvantaged and impacted by service disparities.15, 21, 42 With TIES training targeting knowledge (e.g., child mental health conditions, EBP identification) and skills (e.g., motivational and engagement), Family Advocates can greatly impact early engagement of families in mental health services. For this study, the University of Oklahoma Health Sciences Center (OUHSC), NCA, and the University of Arkansas will partner with TIES experts will partner to develop, implement, and evaluate web-based and consultative training for Family Advocates to enhance early engagement in services (E3 training). The interactive web-based training will embed key targets of knowledge and skills related to family engagement, trauma, EBP, and EBP services in the community. Fifty CACs will be randomized to E3 webinar-based training or E3 webinar plus consultation, given previous research on EBPs indicating that ongoing consultation augments training outcomes.22 In addition, a subset of CACs not receiving training (N = 25) will be selected as a comparison group. The overarching goal of the project is to pilot test the E3 training's impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to services. This study will examine the feasibility of implementing the training program and examine the differential impact and costs of the level of training (i.e., E3web or E3web+ consultation). Outcomes and costs results will be used to plan a large-scale comprehensive, mixed-methods Hybrid Type II effectiveness- implementation,24 and cost-effectiveness trial of Family Navigator E3 training. Nationwide impact on access to EBP for children who experience child maltreatment is feasible given the broad reach of NCA and the wide distribution of the CACs across the country.

Public Health Relevance

Child Advocacy Centers' Family Advocates are well positioned to substantially enhance efforts in early engagement in mental health services of families of children impacted by child abuse and neglect. This study will examine the feasibility, outcome, and costs of implementing the Family Navigator E3 training program's level of training (i.e., with and without consultation) on screening, referral, and access to services supported by Family Advocates. These results will be used to plan a large-scale comprehensive, mixed-methods Hybrid Type II effectiveness- implementation and cost-effectiveness trial of E3 Training for Family Advocates.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Mental Health Services Research Committee (SERV)
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Pintello, Denise
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University of Oklahoma Health Sciences Center
Schools of Medicine
Oklahoma City
United States
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