Adaptive School-based Implementation of CBT (ASIC): clustered-SMART for building an optimized adaptive implementation intervention to improve uptake of mental health interventions in schools.
Adaptive School-based Implementation of CBT (ASIC): clustered-SMART for building an optimized adaptive implementation intervention to improve uptake of mental health interventions in schools.
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基于学校的适应性 CBT 实施 (ASIC)：集群 SMART，用于构建优化的适应性实施干预措施，以提高学校对心理健康干预措施的采用。
DOI：
10.1186/s13012-018-0808-8
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发表时间：
2018-09-05
期刊：
影响因子：
--
通讯作者：
Almirall D
中科院分区：
文献类型：
--
作者：
Kilbourne AM;Smith SN;Choi SY;Koschmann E;Liebrecht C;Rusch A;Abelson JL;Eisenberg D;Himle JA;Fitzgerald K;Almirall D
抑郁症和焦虑症影响了20-30%的学龄青年，其中大多数人没有得到足够的服务，导致发展和学业成绩不佳。认知行为疗法（CBT）等循证实践（EBP）可以改善结果，但许多障碍限制了受影响青年的获得。许多年轻人试图在学校获得心理健康服务，但学校专业人员（SP：辅导员，心理学家，社会工作者）很少接受过CBT方法的充分培训。此外，服务提供者在提供CBT方面面临组织障碍，如缺乏行政支持。三种有前途的实施策略可以解决基于学校的CBT交付的障碍，包括（1）复制有效计划（REP），部署定制的CBT包装、CBT教学培训和技术援助;（2）辅导，通过现场监督扩展培训，以提高SP在CBT交付方面的能力;以及（3）促进，即雇用一名组织专家指导战略规划者进行战略思维，以提高获得行政支持的自我效能。REP是一种相对低强度/低成本的战略，而辅导和促进则需要额外的资源。然而，并不是所有的学校都需要这三种策略。本研究的主要目的是比较学校层面的适应性实施干预的有效性，涉及REP，教练，和促进与REP单独的频率上的CBT提供给学生的SP和学生的心理健康结果。次要和探索性目标检查成本效益，主持人，和实施战略的机制。使用聚类、序贯多重分配、随机试验（SMART）设计，来自密歇根州100所学校的≥ 200名SP将首先随机接受REP与REP+辅导。8周后，不符合预先规定的实施基准的学校将被重新随机分配，以继续实施最初的战略或通过促进来加强。在个人最有可能寻求护理的环境中，需要成功和有效地实施循证优先事项，以便对公共卫生产生大规模影响。适应性执行干预措施有望提供具有成本效益的执行支助。这是第一项测试在全州范围内对学龄青年进行CBT适应性实施的研究，由学校工作人员提供，将EBP带到精神卫生保健有限的大量人群中。NCT 03541317-于2018年5月29日在ClinicalTrials.gov上注册 PRS本文的在线版本（10.1186/s13012-018-0808-8）包含补充材料，可供授权用户使用。
Depressive and anxiety disorders affect 20–30% of school-age youth, most of whom do not receive adequate services, contributing to poor developmental and academic outcomes. Evidence-based practices (EBPs) such as cognitive behavioral therapy (CBT) can improve outcomes, but numerous barriers limit access among affected youth. Many youth try to access mental health services in schools, but school professionals (SPs: counselors, psychologists, social workers) are rarely trained adequately in CBT methods. Further, SPs face organizational barriers to providing CBT, such as lack of administrative support. Three promising implementation strategies to address barriers to school-based CBT delivery include (1) Replicating Effective Programs (REP), which deploys customized CBT packaging, didactic training in CBT, and technical assistance; (2) coaching, which extends training via live supervision to improve SP competence in CBT delivery; and (3) facilitation, which employs an organizational expert who mentors SPs in strategic thinking to promote self-efficacy in garnering administrative support. REP is a relatively low-intensity/low-cost strategy, whereas coaching and facilitation require additional resources. However, not all schools will require all three strategies. The primary aim of this study is to compare the effectiveness of a school-level adaptive implementation intervention involving REP, coaching, and facilitation versus REP alone on the frequency of CBT delivered to students by SPs and student mental health outcomes. Secondary and exploratory aims examine cost-effectiveness, moderators, and mechanisms of implementation strategies. Using a clustered, sequential multiple-assignment, randomized trial (SMART) design, ≥ 200 SPs from 100 schools across Michigan will be randomized initially to receive REP vs. REP+coaching. After 8 weeks, schools that do not meet a pre-specified implementation benchmark are re-randomized to continue with the initial strategy or to augment with facilitation. EBPs need to be implemented successfully and efficiently in settings where individuals are most likely to seek care in order to gain large-scale impact on public health. Adaptive implementation interventions hold the promise of providing cost-effective implementation support. This is the first study to test an adaptive implementation of CBT for school-age youth, at a statewide level, delivered by school staff, taking an EBP to large populations with limited mental health care access. NCT03541317—Registered on 29 May 2018 on ClinicalTrials.gov PRS The online version of this article (10.1186/s13012-018-0808-8) contains supplementary material, which is available to authorized users.
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DOI：
10.1080/1754730x.2015.1037848
发表时间：
2015
期刊：
Advances in school mental health promotion
影响因子：
--
作者：
Eiraldi R;Wolk CB;Locke J;Beidas R
通讯作者：
Beidas R
DOI：
10.1037/spq0000017
发表时间：
2013-06
期刊：
School psychology quarterly : the official journal of the Division of School Psychology, American Psychological Association
影响因子：
--
作者：
Chiu AW;Langer DA;McLeod BD;Har K;Drahota A;Galla BM;Jacobs J;Ifekwunigwe M;Wood JJ
通讯作者：
Wood JJ
影响因子：
7.6
作者：
Asarnow, JR;Jaycox, LH;Wells, KB
通讯作者：
Wells, KB
影响因子：
9.7
作者：
BURNS, BJ;COSTELLO, EJ;ERKANLI, A
通讯作者：
ERKANLI, A
DOI：
10.1023/b:mhsr.0000024351.12294.65
发表时间：
2004-06-01
期刊：
Mental health services research
影响因子：
--
作者：
Aarons, Gregory A
通讯作者：
Aarons, Gregory A