# Optimizing a Paraprofessional, Family Partner Navigation Model for Children

> **NIH NIH R01** · BOSTON MEDICAL CENTER · 2020 · $99,146

## Abstract

PROJECT SUMMARY
Two decades of evidence support the effectiveness of family navigation (FN) as a care-management approach
to reducing disparities in access to health services for disorders; despite substantial promise, widespread
dissemination of FN still faces significant challenges. FN is a complex, multi-component intervention that
generally incorporates motivational interviewing, problem-solving strategies, patient education, and care
coordination. Each of these components can be delivered through a range of strategies including in-person
meetings, telehealth, home visits, and/or web-based technologies. Our team’s research strongly supports FN’s
effectiveness as a whole; however, three questions remain: 1) what are the most effective delivery strategies
for FN; 2) which FN components are the “active ingredients;” and 3) how can FN be disseminated to a broad
population. In the current proposal, FN will be will be delivered by a Family Partner and deployed to improve
access to behavioral health services among children ages 3-12 years. Our study will be carried out at a large
federally qualified health center within a newly formed Accountable Care Organization. For this project, we
propose to optimize FN for dissemination at scale. First, using the Multiphase Optimization Strategy
(MOST), which relies on a randomized, multi-factorial design, we will simultaneously test the effectiveness of
three novel strategies for delivering FN components: (A) technology-assisted delivery of care coordination
using an innovative, web-based platform; (B) community-based; and (C) enhanced symptom tracking using
evidence-based screening instruments (compared to standard pediatric surveillance). Second, using path
analysis, we will test mediators and moderators of FN outcomes. Third, using a mixed-methods approach, we
will study factors that influence implementation. Integration of our three aims will yield a FN model that is
optimized for efficiency, effectiveness, and wider implementation. Our specific aims are: (1) To evaluate the
effectiveness of three strategies to deliver FN components. We will use a 2 x 2 x 2 factorial experimental
design to test three strategies to deliver FN components. Families (n=304) will be randomized to one of eight
conditions. We will estimate main effects of the three experimental factors and the additive effects of
combinations of factors on the study’s primary outcome – engagement in appropriate mental health services. (2)
To evaluate mechanisms of FN effectiveness and for whom it is most effective. (3) To Optimize FN for
dissemination and evaluate implementation strategies. Following Aarons’ scaling-out framework, we will
use mixed methods to explore barriers and facilitators to implementation by evaluating fidelity (to intervention
and implementation), reach, and cost. Then, working with our team of stakeholders, we will integrate these
findings with data from Aim 1 and 2 to optimize FN based on effectiveness, identified mediat...

## Key facts

- **NIH application ID:** 10247210
- **Project number:** 3R01MH117123-03S1
- **Recipient organization:** BOSTON MEDICAL CENTER
- **Principal Investigator:** Sarabeth Broder-Fingert
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $99,146
- **Award type:** 3
- **Project period:** 2018-08-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10247210

## Citation

> US National Institutes of Health, RePORTER application 10247210, Optimizing a Paraprofessional, Family Partner Navigation Model for Children (3R01MH117123-03S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10247210. Licensed CC0.

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