Jonathan Olson, PhD, is a Research Scientist with the Wraparound Evaluation and Research Team. His research interests include predictors of internalizing and externalizing outcomes among young people, positive youth development, mental health outcomes among young people and adults, and the effectiveness of systems designed to support the implementation and sustainability of prevention and intervention programs for children, youth, and families. His recent research has specifically focused on evaluating the impact of technical assistance support on the implementation of systems of care for youth with complex behavioral health needs and learning about factors that promote successful uptake of such strategies.
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.