A Computer-Assisted Cognitive Behavioral Therapy Tool to Enhance Fidelity in CBO

计算机辅助认知行为治疗工具可增强 CBO 的保真度

• 批准号: 10208954
• 负责人: Michael Anthony Cucciare
• 金额: --
• 依托单位: CENTRAL ARKANSAS VETERANS HLTHCARE SYS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208954
• 关键词: Anxiety; Anxiety Disorders; Caring; Clinic; Clinical; Cognitive Therapy; Communities; Computer Assisted; Computers; Disease; Effectiveness; Evidence based treatment; Future; Health Personnel; Hybrids; Instruction; Intervention; Measures; Mental Depression; Mental Health; Mental disorders; Methodological Studies; Methods; Modeling; Needs Assessment; Outcome; Outpatients; Patients; Post-Traumatic Stress Disorders; Protocols documentation; Provider; Psychotherapy; Randomized; Randomized Controlled Trials; Rural Community; Technology; Testing; Training; Veterans; base; design; evidence base; implementation tool; improved; medical specialties; primary care setting; programs; routine care; rural area; scale up; tool

DESCRIPTION (provided by applicant): Background and Significance: Randomized Controlled Trials (RTCs) have demonstrated that evidence-based psychotherapies (EBPs), particularly Cognitive Behavioral Therapy (CBT), are highly effective in treating anxiety and depression, the most common mental health disorders in primary care settings. Mental health (MH) providers in VA Community-Based-Out-Patient-Clinics (CBOCs) are often located in rural areas and isolated from educational opportunities. Almost half of Veterans now use CBOCs. Studies have shown that the quality of delivery of EBPs (fidelity) impacts clinical outcomes. This study will test a computer-assisted tool (CALM Tools for Living) that increases fidelity to CBT in treating depression and four common anxiety disorders, including PTSD. Although results of a large RCT, the CALM study, suggested that the tool contributed to fidelity to the CBT protocol, this hypothesis has not been tested. This study will test the tool in primarily rural CBOCs in VA VISN16. Objective: To modify a computer-assisted CBT tool to meet the needs of CBOC MH providers and Veterans, to evaluate the impact on providers' fidelity to the CBT model and clinical outcomes, and to assess how best to support future implementation. Specific Aims/Hypothesis: (1) Engage CBOC MH providers in modifying the computer-assisted CBT tool such that its content is relevant and acceptable to Veterans and providers. We hypothesize that the modified tool will be acceptable to both Veterans and providers. (2) Compare MH provider fidelity to CBT and clinical outcomes among providers who used the tool and those who did not. We hypothesize that clinicians who use the tool will have a higher fidelity to CBT and clinical outcomes among patients will be superior. (3) Prepare for future implementation of the tool in the VA. Methodology: This study will use a Type III hybrid effectiveness design. Methods common to the field of Instructional Design and Technology (IDT) will be used to modify the tool. Thirty-four CBOC MH providers will be trained in CBT and randomized to use the tool or not. Both groups will receive external facilitation to encourage the full implementation of CBT into practice on the clinic level. MH providers will treat 10 patients each. Patients will be assessed at baseline, 3, 6, and 12 months. Provider fidelity to the CBT protocol will be measured, and finally, a tool kit for future implementation of the tool wil be disseminated. Impact: We expect the intervention to improve the technical quality of MH treatment in CBOCs and improve clinical outcomes among Veterans.

描述（由申请人提供）：

项目成果

Assessing fidelity of cognitive behavioral therapy in rural VA clinics: design of a randomized implementation effectiveness (hybrid type III) trial.

• DOI: 10.1186/s13012-016-0432-4
• 发表时间: 2016-05-10
• 期刊: Implementation science : IS
• 作者: Cucciare MA;Curran GM;Craske MG;Abraham T;McCarthur MB;Marchant-Miros K;Lindsay JA;Kauth MR;Landes SJ;Sullivan G
• 通讯作者: Sullivan G

A randomized controlled trial comparing a manual and computer version of CALM in VA community-based outpatient clinics.

• DOI: 10.1016/j.jadr.2021.100202
• 发表时间: 2021-12
• 期刊: Journal of affective disorders reports
• 作者: Cucciare MA;Marchant K;Abraham T;Ecker A;Han X;White P;Craske MG;Lindsay J
• 通讯作者: Lindsay J

Adapting Coordinated Anxiety Learning and Management for Veterans Affairs Community-Based Outpatient Clinics: Iterative Approach.

• DOI: 10.2196/10277
• 发表时间: 2018-08-22
• 期刊: JMIR mental health
• 影响因子: 5.2
• 作者: Abraham TH;Marchant-Miros K;McCarther MB;Craske MG;Curran GM;Kearney LK;Greene C;Lindsay JA;Cucciare MA
• 通讯作者: Cucciare MA