자료유형  

 학위논문

Control Number  

0017163577

International Standard Book Number  

9798383607206

Dewey Decimal Classification Number  

361

Main Entry-Personal Name  

Hu, Yuanyuan.

Publication, Distribution, etc. (Imprint  

[S.l.] : New York University., 2024

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Physical Description  

187 p.

General Note  

Source: Dissertations Abstracts International, Volume: 86-02, Section: B.

General Note  

Advisor: Stanhope, Victoria.

Dissertation Note  

Thesis (Ph.D.)--New York University, 2024.

Summary, Etc.  

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.

Subject Added Entry-Topical Term  

Social work.

Subject Added Entry-Topical Term  

Mental health.

Subject Added Entry-Topical Term  

Public health.

Subject Added Entry-Topical Term  

Asian American studies.

Index Term-Uncontrolled  

Cross-system collaboration

Index Term-Uncontrolled  

Implementation science

Index Term-Uncontrolled  

Mental health task sharing

Index Term-Uncontrolled  

Older Chinese adults

Index Term-Uncontrolled  

Social services

Added Entry-Corporate Name  

New York University PhD Program

Host Item Entry  

Dissertations Abstracts International. 86-02B.

Electronic Location and Access  

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Control Number  

joongbu:655666