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Improving Mental Health Services Access among Older Chinese Adults: A Mixed-Methods Study to Explore Implementation of Mental Health Task Sharing
Improving Mental Health Services Access among Older Chinese Adults: A Mixed-Methods Study ...
Improving Mental Health Services Access among Older Chinese Adults: A Mixed-Methods Study to Explore Implementation of Mental Health Task Sharing

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자료유형  
 학위논문 서양
최종처리일시  
20250211152726
ISBN  
9798383607206
DDC  
361
저자명  
Hu, Yuanyuan.
서명/저자  
Improving Mental Health Services Access among Older Chinese Adults: A Mixed-Methods Study to Explore Implementation of Mental Health Task Sharing
발행사항  
[Sl] : New York University, 2024
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2024
형태사항  
187 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-02, Section: B.
주기사항  
Advisor: Stanhope, Victoria.
학위논문주기  
Thesis (Ph.D.)--New York University, 2024.
초록/해제  
요약Older Chinese adults face mental health distress but experience structural barriers to accessing quality care. Collaborative task-sharing approaches to improve mental health services have been implemented to address this issue, establishing collaboration between community-based social service services and mental health services and sharing mental health tasks with less specialized providers. However, limited studies have explored the implementation of task sharing model with collaboration between community-based social services and mental health systems serving marginalized communities and how certain factors could facilitate higher implementation outcomes. This mixed-method study examined how community-based aging services for older Chinese adults implemented the task-sharing program, identified factors influencing cross-system collaboration with mental health specialists, and identified facilitators that impacted the implementation outcomes. Primary qualitative and quantitative data was collected from 30 providers from 14 community-based aging services implementing collaborative task-sharing programs to integrate mental health services into social service routines. Paper #1 conducted qualitative analyses using the framework method to explore factors influencing the implementation using semi-structured interview data. Paper #2 specifically focused on cross-system collaboration, the core mechanism of the task-sharing program, drawing on qualitative data from administrators and frontline providers involved in a state-wide implementation of cross-system interventions between social services and behavioral health systems. This study aimed to highlight key factors influencing the quality of cross-system collaboration. Based on prior findings, Paper #3 integrated qualitative and quantitative data and conducted a matrixed multiple case study to perform within- and across-case analysis. Paper #1 findings demonstrated three barrier themes (limited mental health resources, competing priorities, and varying levels of mental health competencies) and four facilitator themes (training and knowledge transmission, supportive leadership, culturally tailored engagement strategies, and close teamwork). Paper #2 found that two barriers emerged from the thematic analysis: misalignment of treatment requirements and expectations between child welfare and behavioral health systems and varied attitudes towards substance use and treatment among stakeholders. Prior collaborative experiences, supportive leadership, and designated personnel were reported to help establish and maintain collaborative relationships and facilitate ongoing activities. Paper #3 identified six facilitators that promoted positive implementation outcomes: (1) consistent availability of mental health providers and resources; (2) financial incentives for comprehensive services; (3) clear stepped-care pathways for screening, counseling, referral, and treatment; (4) active involvement of staff at all levels; (5) high integration of social and mental health services; and (6) involvement of master-level or licensed staff in implementation. Collectively, these studies provided a comprehensive analysis of the complex factors influencing the implementation of the collaborative task-sharing care model in social service settings, especially for older Chinese adults. The results uncovered the complex interplay of factors within the multiple levels of the CFIR framework, demonstrating how these factors influenced implementation outcomes and how organizations adopted implementation strategies to overcome barriers.
일반주제명  
Social work
일반주제명  
Mental health
일반주제명  
Public health
일반주제명  
Asian American studies
키워드  
Cross-system collaboration
키워드  
Implementation science
키워드  
Mental health task sharing
키워드  
Older Chinese adults
키워드  
Social services
기타저자  
New York University PhD Program
기본자료저록  
Dissertations Abstracts International. 86-02B.
전자적 위치 및 접속  
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MARC

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■0820  ▼a361
■1001  ▼aHu,  Yuanyuan.
■24510▼aImproving  Mental  Health  Services  Access  among  Older  Chinese  Adults:  A  Mixed-Methods  Study  to  Explore  Implementation  of  Mental  Health  Task  Sharing
■260    ▼a[Sl]▼bNew  York  University▼c2024
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2024
■300    ▼a187  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-02,  Section:  B.
■500    ▼aAdvisor:  Stanhope,  Victoria.
■5021  ▼aThesis  (Ph.D.)--New  York  University,  2024.
■520    ▼aOlder  Chinese  adults  face  mental  health  distress  but  experience  structural  barriers  to  accessing  quality  care.  Collaborative  task-sharing  approaches  to  improve  mental  health  services  have  been  implemented  to  address  this  issue,  establishing  collaboration  between  community-based  social  service  services  and  mental  health  services  and  sharing  mental  health  tasks  with  less  specialized  providers.  However,  limited  studies  have  explored  the  implementation  of  task  sharing  model  with  collaboration  between  community-based  social  services  and  mental  health  systems  serving  marginalized  communities  and  how  certain  factors  could  facilitate  higher  implementation  outcomes.  This  mixed-method  study  examined  how  community-based  aging  services  for  older  Chinese  adults  implemented  the  task-sharing  program,  identified  factors  influencing  cross-system  collaboration  with  mental  health  specialists,  and  identified  facilitators  that  impacted  the  implementation  outcomes.  Primary  qualitative  and  quantitative  data  was  collected  from  30  providers  from  14  community-based  aging  services  implementing  collaborative  task-sharing  programs  to  integrate  mental  health  services  into  social  service  routines.  Paper  #1  conducted  qualitative  analyses  using  the  framework  method  to  explore  factors  influencing  the  implementation  using  semi-structured  interview  data.  Paper  #2  specifically  focused  on  cross-system  collaboration,  the  core  mechanism  of  the  task-sharing  program,  drawing  on  qualitative  data  from  administrators  and  frontline  providers  involved  in  a  state-wide  implementation  of  cross-system  interventions  between  social  services  and  behavioral  health  systems.  This  study  aimed  to  highlight  key  factors  influencing  the  quality  of  cross-system  collaboration.  Based  on  prior  findings,  Paper  #3  integrated  qualitative  and  quantitative  data  and  conducted  a  matrixed  multiple  case  study  to  perform  within-  and  across-case  analysis.  Paper  #1  findings  demonstrated  three  barrier  themes  (limited  mental  health  resources,  competing  priorities,  and  varying  levels  of  mental  health  competencies)  and  four  facilitator  themes  (training  and  knowledge  transmission,  supportive  leadership,  culturally  tailored  engagement  strategies,  and  close  teamwork).  Paper  #2  found  that  two  barriers  emerged  from  the  thematic  analysis:  misalignment  of  treatment  requirements  and  expectations  between  child  welfare  and  behavioral  health  systems  and  varied  attitudes  towards  substance  use  and  treatment  among  stakeholders.  Prior  collaborative  experiences,  supportive  leadership,  and  designated  personnel  were  reported  to  help  establish  and  maintain  collaborative  relationships  and  facilitate  ongoing  activities.  Paper  #3  identified  six  facilitators  that  promoted  positive  implementation  outcomes:  (1)  consistent  availability  of  mental  health  providers  and  resources;  (2)  financial  incentives  for  comprehensive  services;  (3)  clear  stepped-care  pathways  for  screening,  counseling,  referral,  and  treatment;  (4)  active  involvement  of  staff  at  all  levels;  (5)  high  integration  of  social  and  mental  health  services;  and  (6)  involvement  of  master-level  or  licensed  staff  in  implementation.  Collectively,  these  studies  provided  a  comprehensive  analysis  of  the  complex  factors  influencing  the  implementation  of  the  collaborative  task-sharing  care  model  in  social  service  settings,  especially  for  older  Chinese  adults.  The  results  uncovered  the  complex  interplay  of  factors  within  the  multiple  levels  of  the  CFIR  framework,  demonstrating  how  these  factors  influenced  implementation  outcomes  and  how  organizations  adopted  implementation  strategies  to  overcome  barriers.
■590    ▼aSchool  code:  0146.
■650  4▼aSocial  work
■650  4▼aMental  health
■650  4▼aPublic  health
■650  4▼aAsian  American  studies
■653    ▼aCross-system  collaboration
■653    ▼aImplementation  science
■653    ▼aMental  health  task  sharing
■653    ▼aOlder  Chinese  adults
■653    ▼aSocial  services  
■690    ▼a0452
■690    ▼a0347
■690    ▼a0343
■690    ▼a0573
■71020▼aNew  York  University▼bPh.D.  Program.
■7730  ▼tDissertations  Abstracts  International▼g86-02B.
■790    ▼a0146
■791    ▼aPh.D.
■792    ▼a2024
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17163577▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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