# Improving Quality of Care in Child Mental Health Service Settings

> **NIH NIH R01** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2020 · $747,804

## Abstract

PROJECT SUMMARY/ABSTRACT
Assuring children access to the highest quality mental health care is a top national priority. Yet, quality of care
continues to be highly variable in traditional service settings. Novel, scalable solutions are needed to address
modifiable quality-of-care indicators in sustainable ways. To this end, provider fidelity and children's
engagement are key correlates of clinical outcome and practical targets for intervention. There is tremendous
opportunity to address both through technology. Studies in child education show that interactive games, touch-
screen learning, and demonstration videos enhance engagement, knowledge, motivation, and learning. These
benefits also may extend to the therapeutic context, where strategic integration of technology-based activities
may enhance children's learning, strengthen the therapeutic alliance, and keep providers on protocol. We are
in the final stages of an NIMH R34 in which we piloted a patient- and provider-informed tablet-based toolkit
designed to facilitate delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) – a treatment that
was selected because it addresses a wide range of symptoms using techniques shared by other treatments for
emotional and behavioral disorders. The tablet-based toolkit consists of numerous components (e.g., videos,
interactive games, drawing applications) that are designed to facilitate provider-patient interactions in a way
that enhances children's engagement and supports adherence to the treatment model. The tablet-based toolkit
was very well received by children, caregivers, and providers in our pilot work. Moreover, all benchmarks for
feasibility outlined in our NIMH R34 application were met or exceeded. We now propose to conduct a
hybrid effectiveness-implementation trial to examine the extent to which the tablet intervention may improve
fidelity, engagement, and children's mental health outcomes. We will conduct a randomized controlled trial with
120 mental health providers and 360 families in partnership with dozens of clinics in the Carolinas and Florida.
Providers will be assigned randomly to tablet-facilitated vs. standard TF-CBT. Youth aged 8-16 years with
clinically elevated symptoms of PTSD will be recruited. Baseline and 3-, 6-, 9-, and 12-month post-baseline
assessments will be conducted by independent, blind evaluators. Sessions will be videorecorded for
observational coding of engagement and fidelity by independent raters blind to study hypotheses. We will also
examine costs and conduct semi-structured interviews with families, providers, supervisors, and agency
leaders to inform future dissemination and implementation initiatives. Technology-based resources that are
scalable, easy to use, and designed for efficient integration into everyday practice may have sustained national
impact. The return on investment of these initiatives will ultimately rest on their potential to improve the spread
of best-practice treatments and the qu...

## Key facts

- **NIH application ID:** 9980712
- **Project number:** 5R01MH110620-04
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** Kenneth J Ruggiero
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $747,804
- **Award type:** 5
- **Project period:** 2017-08-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980712

## Citation

> US National Institutes of Health, RePORTER application 9980712, Improving Quality of Care in Child Mental Health Service Settings (5R01MH110620-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9980712. Licensed CC0.

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