Eric Bruns, Ph.D., is a Professor of Psychiatry and Behavioral Sciences in the University of Washington School of Medicine. Dr. Bruns’s research focuses on public child-serving systems, and how to maximize their positive effects on youth with behavioral health needs and their families. Toward this end, Dr. Bruns focuses primarily on two areas with high public health significance. The first is intensive care coordination models for youths with serious emotional and behavioral challenges. In this area, Dr. Bruns co-directs the National Wraparound Initiative (www.nwi.pdx.edu) and the National Wraparound Implementation Center (www.nwic.org), and directs the UW Wraparound Evaluation and Research Team (www.wrapinfo.org). In this area, Dr. Bruns has led multiple federally-funded (NIMH, SAMHSA, CMS) research and intervention development projects aimed at defining and evaluating impact of intensive care coordination models. The second area is school mental health services. In this area, Dr. Bruns is Associate Director of the UW SMART Center, where he leads the Center’s Technical Assistance Core and directs its Institute for Education Sciences (IES)-funded Post-doctoral Research Training Program. He has served as PI or Co-I on six Institute for Education Sciences (IES)-funded research studies, on topics such as development and efficacy testing of an assessment, engagement, triage, and brief intervention strategy for school clinicians and counselors, intensive Tier 3 intervention-models for high school students with SEBC, and methods for addressing racial disparities in school discipline.
Background and Goals:The Wraparound service model (WSM) is the most common care coordination strategy for youth with serious emotional disorders(SEO), with programs in nearly every U.S. state serving more than 100,000 youth. A recent meta-analysis of 17 controlled studies found significant positive effects of WSM on mental health (MH) symptoms, out of home placement rates, and health care expenditures, confirming its critical role in behavioral healthcare for children and adolescents. As is the case for other evidence-based practices, the degree to which data are consistently measured and used to inform care, i.e., "measurement-based care" or MBC, accounts for a large proportion of the variance in outcomes for Wraparound. For example, collection and use of data assessing client satisfaction, therapeutic alliance, and progress substantially increase likelihood of achieving target outcomes as a function of treatment. However, research on WSM shows that measurement and use of data, such as via Routine Outcome Monitoring, is inconsistent at best. The goal of this SBIR is to develop and test a mobile ROM (mROM) system tailored to WSM. The proposed SMART-Wrap (Short Message Assisted Responsive Treatment for Wraparound) product will provide a feasible and acceptable mROM approach for WSM-enrolled parents/caregivers and youth based on evidence-based principles and past research for effective mROM. SMS ("short message system") is supported by every mobile device and network with no software download needed. More than 98% of SMS messages are opened, compared to just 20% of emails, and on average, 90% of SMS messages are opened within the first 3 seconds of receipt.l161 SMART-Wrap will periodically administer brief, straightforward (1-2 items) SMS-based assessments of intermediate outcomes that have been found to predict clinical outcomes of WSM (e.g., harm to self and others, hospitalization, out of home placement)). Data will be used to:
- Populate tabular and graphical displays (based on user permissions) to inform decision-making by WSM care providers, supervisors, and program managers (i.e., the WSM care team);
- Trigger alerts to WSM care team members, such as escalation in caregiver stress or youth symptoms; and
- Generate automated SMS outreach messages for families.