(PS9-19) Driving Measurement-based Care with Digital Tools in a Youth Mental Health Service System

Abstract Text: Measurement-based care (MBC) can enhance the quality of services, support and strengthen clinical decision-making, improve communication across treatment team members, and contribute to quality assurance and improvement (e.g., Gondek et al, 2016; Tam & Ronan, 2017).  Such practices are key in incorporating clients as equal partners and facilitating sustainable change in treatment. As a result, recent practice management systems have begun to facilitate MBC use through both digital documentation of standardized measures and graphical representation of those scores. With that goal in mind, in 2014, the Hawai‘i State Department of Health, Child and Adolescent Mental Health Division (CAMHD) enacted a policy requiring monthly administration of the Youth and Parent versions of the Ohio Scales (Problem Severity, Hopefulness and Wellness Scales; Ogles et al., 2001) for all enrolled clients. However, easily accessible tools graphing visualizations of Ohio Scales total and subscale scores were only implemented with clinical staff in 2023. Given the evolving implementation context, this study aims to examine: (1) patterns in Ohio Scales administration rates over time, (2) patterns in Ohio Scales score visualization tool use by region and professional specialty over time, and (3) the extent to which measure administration and tool use vary as a function of MBC self-efficacy, attitudes towards standardized assessment (clinical utility), and behavioral intention.
Clinical data from approximately N=2000 youth clients receiving services in the CAMHD were collected or reviewed by N~40 clinical staff. Youth had an average age of 13.7 years, were 48% female, and 56% multi-ethnic. Generally, CAMHD clinical staff report that they range in age from 30 to 65, are primarily female (92%), and over half hold master’s degrees (52%). Concerning the first aim, initial findings suggest that Ohio Scales monthly administration and completion rates have gradually increased since 2021 (25% in 2021 and 36% in March 2024), with a noticeable increase after the implementation of accessible, visually based feedback reports. Regarding the second aim, visualization tool use has steadily increased from implementation in February 2023 (97 opens) to March 2024 (175 opens), though the number of unique viewers has remained relatively constant. Finally concerning aim 3, we hypothesize that greater MBC self-efficacy and more positive attitudes towards standardized assessment will predict both Ohio Scales administration and visualization tool use. We will discuss these findings within the context of public health policies aimed at better serving communities through systematic, client-driven data and MBC.