Advancing community-driven optimization for implementation of early childhood mental health prevention in pediatric learning health systems: Mental Health, Earlier ALACRITY Research Center

This Center strategically addresses a key developmental driver of the youth mental health crisis: Currently, 1 in 5 children have an identified mental health problem as early as age 3. This Mental Health, Earlier ALACRITY Implementation Science Research Center addresses the grand challenge of achieving population-level impact of early childhood mental health prevention efforts within routine pediatric care, a promising setting for achieving population impact. The Center is Northwestern based, including longstanding partnerships with Lurie Children’s Hospital, community health centers within Nemours Children’s Health and AllianceChicago’s practice-based research network, and University of Utah Health. The Center’s connective thread is a novel implementation framework, human-centered design methods, and a novel Roll-Out Implementation Optimization trial design, which systematically engages partners in strategy optimization. Center Aims: (1) Develop novel caregiver-focused, system-, and clinician-level strategies to advance implementation of developmentally- and ecologically-grounded early mental health screening and interventions in pediatric primary care; (2) Address the unique needs of varied communities and families via engagement in tailored evidence-based prevention services; and (3) Create a national resource for implementation of childhood mental health innovation in pediatric primary care, including fostering a cadre of scientific and workforce leaders and experts, and an open access toolkit. Center Signature Project (Peds-BRITE) and four Research Projects (RPs) innovate, implement, and integrated evidence-based interventions and strategies, with RPs testing novel approaches and/or levels of inquiry designed to address recognized, but understudied, barriers; Pediatricians Building Resilience through early Identification for Toddler Well-Being (Peds-BRITE): This cluster randomized trial implements an evidence-based toddler mental health risk decision tool with coordinated care to the Family Check-Up Online to support parenting and toddler self-regulation; Talking Early About Mental Health for Access (TEAM4Access): Deploys digital case-based training to improve clinician confidence and family-centered communication about toddler mental health risk for families from varied backgrounds and communities; Supporting Parent Action for Resilient Kids: A Single-Session Intervention to Boost Caregiver Adoption of Early Childhood Mental Health Services (SPARK): Adapts an evidence-based adjunctive digital single-session intervention to increase families’ mental health services use; Researching Ethics and Assessment of Unintended Consequences in Healthcare for Mental Health Earlier (REACH4MHE): Explores unintended consequences of early mental health prevention via an integrated bioethical-implementation framework. Community & Scientific Engagement & Administrative- and Methods Incubation Cores provide vision, coordination, methodologic and career development supports to advance implementation of early mental health promotion across a range of pediatric primary care systems and families.