Abstract
Problem:
The CN's proposed project will serve First American children that are in need of mental health services within its treaty territory. The CN's treaty territory includes 7,648 square miles that encompass all or part of 13 Oklahoma counties including: Bryan, Carter, Coal, Garvin, Grady, Jefferson, Johnston, Love, Marshall, McClain, Murray, Pontotoc and Stephens. According to the U.S. Census Bureau, the total population of this area is approximately 362,248 with 12 percent (29,193) identifying as exclusively First Americans. Within the CN there are 6,711 Chickasaw children, ages 0 to 17, amongst the 13 counties.
Goals and objectives:
Goal 1: Establish bi-directional training, technical assistance, consultation access and other appropriate resources to transfer expert knowledge of child mental health, rural pediatric practice and the needs of First American children/youth among medical, mental health and allied professionals.
- Objective 1.1: Build the CNPC to integrate the utilization of the pre-existing infrastructure of Project Extension for Community Health Care Outcomes (ECHO) combined with the project design of expert tele-collaboration to serve Chickasaw citizens.
Goal 2: Increase pediatric mental health disorder knowledge and integration of treatment approaches for increased access and referrals to evidence based youth mental health services.
- Objective 2.1: Utilize incentives for provider participation.
- Objective 2.2 Measure provider-level change processes periodically to determine practice based modifications and case specific patient progress.
Goal 3: Actively expand and leverage regional and statewide professional networks and student-to- workforce pipelines to increase the capacity of pediatric practices to provide effective, critically needed and culturally resonant mental health treatment for rural First American children and youth.
- Objective 3.1: Assemble high-quality partnerships with a variety of pediatrics-involved teams from state, academic, clinical, community and tribal levels to offer a robust array of opportunities for investment in tribal capacity expansion.
Methodology:
The Chickasaw Nation (CN) will establish a tribally managed Health Resources and Services Administration (HRSA) Pediatric Mental Health Care Access (PMHCA) program in Oklahoma. The CN PMHCA, through the creation of the CN Pediatric Collaborative (CNPC), will establish bi-directional training and technical assistance, tele-consultation access and care coordination to transfer expert knowledge of child mental health, rural pediatric practice and the needs of First American children amongst medical, mental health and allied professionals in the CN. The CN's aim is to increase knowledge and integration of treatment approaches for increased access to youth mental health services. Through specialty consultation and learning collaborative, this project will actively expand and leverage regional and statewide professional networks and student-to-workforce pipelines to increase the capacity of pediatric practice teams to provide effective, critically needed and culturally resonant mental health treatment for rural First American children and youth.
Coordination:
The CN Department of Treasury and Department of Culture and Humanities will help support the ongoing implementation of this project. The CN Department of Treasury oversees financial budgeting for grant funding and will provide budgeting support for this project. The CN Department of Culture and Humanities provides training and education about the history of the Chickasaw people and the application of Chickasaw culture throughout services and programs. Trainings from the CN Department of Culture and Humanities will ensure services associated with this project will be culturally appropriate and engaged.
Evaluation:
The CN PMHCA evaluation activities will include an initial needs assessment process to allow all 84 potential participating providers to weigh in on their practice needs, project ideas and training delivery structure. CN PMHCA will gain valuable insights through key informant interviews with individuals who currently received a referral or have received referrals to CN pediatric mental healthcare delivery system. Dissemination of key findings outside the project to the multi-disciplinary stakeholder team, key collaborative partners and tribal leadership will be completed through the creation of a summary report designed collaborative with evaluation and marketing contracts. The CNPC staff will collaborate with the evaluation team to conduct ongoing assessments and incorporate multiple methods to monitor project evolution and progress toward achievement of desired goals, objectives and outcomes as well as to provide feedback in a manner that will allow for rapid problem identification and correction. The CNPC staff will apply an integrated approach to evaluation through a combination of quantitative and qualitative methods. The use of qualitative methods will assist in providing richer insights into the target population and process evaluation.