Facilitating Sustainment Through Implementation Feedback: The SIC Coaching Model

专利授权项目概要/摘要 根据PAR-16-455，本提案旨在测试根据经验得出的实施效果 战略-在现实世界的条件下，并在多个儿童服务系统-对成功的收养， 维持两个解决青少年药物滥用问题的循证方案： 照顾俄勒冈州（TFCO;以前的多维治疗寄养）和多维家庭治疗 （MDFT），两者都是由NIDA资助开发的。本研究的方法采用“基于技术的方法” “实施大规模变革”。利用以前的数据，专注于开发和测试8- 分阶段的实施完成阶段（SIC）工具，用于衡量 参与（阶段1）到能力发展（阶段8），非随机队列设计， 提出了研究活动包括将SIC扩展到维持阶段并测试SIC辅导 支持采用新的循证方案的战略。 SIC以前的研究结果表明，它的潜在效用作为一种措施的实施保真度。的 本提案的首要目标是评估实施保真度（对 实施过程）与干预保真度（对临床干预的保真度）的结合可以增加 一个新的组织网站不仅成功地采用了一个程序，但概率，发展 基础设施，以确保其可持续性。将使用 实施新战略的成本（COINS）成本绘图战略，作为SIC的一个辅助工具， 资源使用影响方案的可持续性。基于网络的SIC和COINS工具提供有关 研究中心相对于其他成功研究中心的实施行为，并将在当前研究中作为 SIC教练策略TFCO和MDFT的供应商将接受培训，以将SIC辅导纳入其 与正在采用新计划的站点开展现有辅导活动。在快速审核和反馈中 系统，假设接收集成的实施和干预保真度反馈的站点， 他们的供应商现场技术援助的一部分将更有可能发展可持续的方案比网站 接受标准供应商驱动的实施支持。 研究目标包括以下具体目标：（a）评估SIC辅导对 计划采用和维持，（B）扩展SIC以包括维持的测量，和（c） 研究最有可能产生可持续方案的成本和资源模式。这种数据驱动的方法， 引导新网站有潜力帮助他们实现可持续发展的循证 青少年药物滥用和其他高风险行为的计划。如果成功的话，这项研究将有一个 对采用新计划的组织产生重大影响，并有可能获得大量公众 通过增加针对昂贵的公共卫生问题的循证方案的可用性来改善健康影响。

PARENT GRANT PROJECT SUMMARY/ABSTRACT This proposal, in response to PAR-16-455, aims to test the impact of an empirically derived implementation strategy—under real-world conditions and across multiple child service systems—on successful adoption and sustainment of two evidence-based programs that address adolescent substance abuse: Treatment Foster Care Oregon (TFCO; formerly Multidimensional Treatment Foster Care) and Multidimensional Family Therapy (MDFT), both developed with funding from NIDA. Methods for this study utilize “technology-based approaches” for “implementing large-scale change.” Leveraging previous data focused on developing and testing the 8- staged Stages of Implementation Completion (SIC) tool, a measure of implementation progress from Engagement (Stage 1) to development of Competency (Stage 8), a non-randomized cohort design is proposed. Study activities include extending the SIC into the Sustainment Phase and testing a SIC Coaching strategy to support the adoption of new evidence-based programs. Previous findings with the SIC suggest its potential utility as a measure of implementation fidelity. The overarching goal of this proposal is to evaluate if the integration of implementation fidelity (fidelity to the implementation process) with intervention fidelity (fidelity to the clinical intervention) can increase the probability that a new organizational site not only successfully adopts a program but, develops the infrastructure to ensure it can sustain. Patterns of cost and resource allocation will be examined, using the Cost of Implementing New Strategies (COINS) cost mapping strategy, an adjunct to the SIC, to assess how resource use impacts program sustainability. A web-based SIC and COINS tool provides feedback about a site's implementation behavior relative to other successful sites and will be used in the current study as part of the SIC Coaching strategy. Purveyors for TFCO and MDFT will be trained to integrate SIC Coaching into their existing coaching activities with sites that are adopting new programs. Within a rapid audit and feedback system, it is hypothesized that sites that receive integrated implementation and intervention fidelity feedback as part of their purveyor-site technical assistance will be more likely to develop sustainable programs than sites that receive standard purveyor-driven implementation support. Study targets include the following specific aims: (a) evaluate the effect of SIC Coaching on outcomes of program adoption and sustainment, (b) extend the SIC to include measurement of sustainment, and (c) examine cost and resource patterns most likely to yield sustainable programs. This data-driven approach to guide new sites has the potential to help them to achieve the development of sustainable evidence-based programs for adolescent substance abuse and other high-risk behaviors. If successful, the study will have a significant impact for organizations adopting new programs and has the potential to have a substantial public health impact by increasing the availability of evidence-based programs for costly public health problems.