Building a collaboration model between the primary and secondary mental healthcare levels to improve care for trauma-exposed children in Norway: study protocol for the NorStep Collaborate study.

introductionChildhood trauma is a public health challenge, and low-threshold interventions are important to prevent long-term problems. A stepped care approach is recommended so the intensity of care can be adjusted according to the child's needs. This approach requires coordination and collaboration between service levels. However, interagency collaboration can be challenging. The aim of the NorStep Collaborate study is to develop and evaluate a model for collaboration between the primary and secondary mental healthcare levels in Norway. METHODS AND ANALYSIS: NorStep Collaborate is part of an ongoing randomised controlled trial investigating the effectiveness of a low-threshold, parent-led trauma treatment provided in the primary care level services. Children in need of more therapist-intensive treatment will be stepped up to the secondary care level. NorStep Collaborate is based on principles of participatory action research, and the collaboration model will be developed together with stakeholders from six primary level services and four secondary level services. In phase I, the model will be developed. Stakeholders will participate in focus group interviews and full-day dialogue conferences to suggest and discuss routines for collaboration and a suggested collaboration model will be refined through feedback meetings. In phases II and III, the co-created model will be implemented and tested for 1 year, and therapists, leaders, children and parents will be interviewed about their experiences with the collaboration and transfer between the primary and secondary care level. Interviews will be analysed with thematic analyses. In phase IV, results of the evaluation will be shared, and final adjustments made if necessary. ETHICS AND DISSEMINATION: The study has been evaluated by the Norwegian Agency for Shared Services in Education and Research (SIKT, reference number 161459) and is approved by the data protection officer at Norwegian Centre for Violence and Traumatic Stress Studies, Norway. Participants will be provided with written information about the study, and participation is voluntary, based on verbal consent and assent. The findings will be presented to the Norwegian Ministry of Health and Care, all participating services and the professional public via conferences, and in international and Norwegian peer-reviewed publications.