Facilitating Sustainment Through Implementation Feedback: The SIC Coaching Model

项目摘要/摘要 本提案是对PAR-16-455的回应，旨在测试经验式实施的影响 战略--在现实世界条件下和跨多个儿童服务系统--关于成功采用和 支持两个解决青少年药物滥用问题的循证方案：治疗福斯特 俄勒冈州CARE(TFco；以前的多维治疗寄养护理)和多维家庭治疗 (MDFT)，两者都是在NIDA的资助下开发的。本研究的方法采用了“基于技术的方法”。 为“实施大规模变革”。利用之前专注于开发和测试8- 分阶段实施完成(SIC)工具--衡量实施进展情况 参与(阶段1)到能力发展(阶段8)-对SIC教练的随机评估 提出了一种策略(SIC-CS)。研究活动包括将SIC扩展到可持续发展阶段和 测试SIC-CS以支持采用新的循证计划。 以前对SIC的研究结果表明，它作为衡量实施忠诚度的指标具有潜在的实用价值。这个 该提案的总体目标是评估实施保真度(保真度 实施过程)与干预保真度(对临床干预的保真度)可以增加 新的组织站点不仅成功地采用了计划，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以下成本进行检查 实施新战略(硬币)成本测绘工具，作为SIC的附属工具，用于评估资源使用情况 影响计划的可持续性。一个基于网络的SIC和硬币工具提供关于网站的反馈 相对于其他成功站点的实施行为，并将在当前研究中作为 SIC-CS。TFco和MDFT的供应商将接受培训，将SIC教练纳入他们现有的教练 新采用的活动地点随机接受SIC-CS。SIC数据和反馈将被扣留 从随机地点到标准(标准)会诊。在一个快速的审计和反馈系统中， 假设接受集成实施和干预的站点将保真度反馈作为其 技术援助将更有可能开发可持续的项目，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对方案结果的影响 采用和维持，(B)扩大SIC，以包括维持的衡量，和(C)审查费用 以及最有可能产生可持续项目的资源模式。这种以数据为导向的方法来指导新站点 有潜力帮助他们实施青少年物质的可持续循证方案 虐待和其他高危行为。如果成功，这项研究将对组织产生重大影响 采用新的计划，并有可能通过增加 为代价高昂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.