Facilitating Sustainment Through Implementation Feedback: The SIC Coaching Model

项目总结/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-衡量从 参与（第1阶段）到能力发展（第8阶段）-SIC教练的随机评估 提出了SIC-CS策略。研究活动包括将SIC扩展到维持阶段， 测试SIC-CS以支持采用新的循证方案。 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，而且开发了基础设施的概率 以确保它能够持续下去。成本和资源分配的模式将使用 实施新战略的成本绘图工具，作为标准行业分类的一个辅助工具，用于评估资源使用情况 影响项目的可持续性。一个基于网络的SIC和COINS工具提供有关网站的反馈， 实施行为相对于其他成功的网站，并将用于本研究的一部分， SIC-CS。TFCO和MDFT的承办人将接受培训，将SIC辅导纳入其现有辅导 新采用研究中心随机接受SIC-CS的活动。SIC数据和反馈将被扣留 随机分配至标准（STAND）会诊的研究中心。在快速审计和反馈系统中， 假设接受综合实施和干预保真度反馈作为其 技术援助将更有可能发展可持续的方案，而不是接受标准支持的网站。 研究目标包括以下具体目标：（a）评估SIC-CS对项目成果的影响 采用和维持，（B）扩展SIC以包括维持的测量，以及（c）审查成本 以及最有可能产生可持续项目的资源模式。这种数据驱动的方法来指导新网站 有可能帮助他们实施针对青少年物质的可持续循证计划 滥用和其他高风险行为。如果成功，该研究将对组织产生重大影响 采用新的方案，并有可能通过增加 为昂贵的公共卫生问题提供循证方案。

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 randomized evaluation of a SIC Coaching Strategy (SIC-CS) is proposed. Study activities include extending the SIC into the Sustainment Phase and testing the SIC-CS 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 tool, 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-CS. Purveyors for TFCO and MDFT will be trained to integrate SIC coaching into their existing coaching activities with newly adopting sites randomized to receive the SIC-CS. SIC data and feedback will be withheld from sites randomized to Standard (STAND) Consultation. Within a rapid audit and feedback system, it is hypothesized that sites that receive integrated implementation and intervention fidelity feedback as part of their technical assistance will more likely develop sustainable programs than sites that receive standard support. Study targets include the following specific aims: (a) evaluate the effect of SIC-CS 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 implement 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.