Examining the active ingredients of consultation to improve implementation of a parent-mediated intervention for children with autism in the community mental health system.

检查咨询的有效成分，以改善社区心理卫生系统中自闭症儿童家长介导的干预措施的实施。

• 批准号: 10469331
• 负责人: Diondra Straiton
• 金额: $ 3.9万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-16 至 2023-07-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10469331
• 关键词: Active Learning; Address; Adherence; Affect; Area; Caregivers; Child; Client; Clip; Code; Communities; Competence; Consultations; Contracts; Data Analyses; Educational workshop; Elements; Enrollment; Evidence based intervention; Evidence based practice; Experimental Designs; Exploration Preparation Implementation and Sustainment; Family; Feedback; Feeling; Glossary; Health Insurance Portability and Accountability Act; Health Personnel; Health system; Intervention; Laboratories; Length; Link; Measures; Mediating; Medicaid; Mental Health; Mentorship; Michigan; Modeling; Neurodevelopmental Disability; Oral; Outcome; Parents; Penetration; Phase; Play; Preparation; Problem Solving; Provider; Questionnaires; Randomized; Research; Resource-limited setting; Resources; Role; Self-Direction; Services; Time; Training; United States; Visual; Work; adolescent with autism spectrum disorder; applied behavior analysis; autism spectrum disorder; autistic children; causal model; community setting; design; efficacy research; evidence base; implementation framework; implementation intervention; implementation outcomes; implementation process; implementation research; implementation science; implementation strategy; improved; individuals with autism spectrum disorder; model design; multilevel analysis; online tutorial; programs; provider behavior; recruit; rehearsal; research to practice; rural area; skills; social communication; telehealth; treatment adherence; treatment as usual; uptake

PROJECT SUMMARY/ABSTRACT Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disability that affects 1 in 54 children in the United States. Many evidence-based interventions have been developed that improve child outcomes for children with ASD. Yet there is a 17-year research-to-practice gap in which evidence-based practices (EBPs) developed in laboratory settings finally reach community settings. Consultation models are typically comprised of multiple components, which may differentially influence provider behavior. This single-case experimental design will experimentally manipulate three potential active ingredients of a consultation model (feedback on taped sessions, case support, and skill rehearsal) in 4 applied behavior analysis (ABA) agencies in order to identify potential active ingredients of the consultation model. Consultation will focus on telehealth delivery of an empirically supported manualized parent-mediated intervention for children with ASD (Project ImPACT). Groups of 3-5 providers will be recruited from 4 agencies (N = ~20 providers in total) that contract with regional community mental health agencies within the Michigan Medicaid Autism Benefit, which provides applied behavior analysis services to Medicaid-enrolled youth with ASD. Providers will complete a self-directed online tutorial on Project ImPACT. Each provider will enroll at least one caregiver on their caseload who has a child enrolled in the Michigan Medicaid Autism Benefit (N = ~20 caregivers). Next, each agency will be randomly assigned to a) the length of the baseline period (between 3-6 weeks) and b) the order that they will receive the consultation components. Providers will record one session per week with their enrolled family and submit it via a HIPAA compliant Dropbox link. They will also complete weekly online questionnaires on implementation outcomes. Implementation outcomes will be assessed via observational coding of weekly sessions for treatment adherence and competence, and analysis of weekly provider questionnaires regarding case penetration, and feasibility, acceptability, and appropriateness of Project ImPACT and each of the 3 consultation phases. Providers will submit a final recorded session and questionnaire 8-weeks post- consultation. Caregivers will complete a measure of social communication for their child via online questionnaire at baseline, twice during consultation, and after 8 weeks post-consultation. Data analysis includes multilevel modeling and visual analysis. Results will identify active ingredients of the consultation model which will later be used to develop a causal model of the mechanism by which consultation improves implementation outcomes. The training plan consists of mentorship, courses, workshops, and experiential learning and will develop expertise in efficacy and implementation research within the autism field.

项目总结/摘要 自闭症谱系障碍（ASD）是一种终身神经发育障碍，在美国每54名儿童中就有1名受到影响。 美国的已经制定了许多基于证据的干预措施，以改善儿童的结果， ASD儿童。然而，有一个17年的研究与实践的差距，其中循证实践（EBP） 在实验室环境中开发的最终应用于社区环境。咨询模式通常包括 多个组件，这可能会对供应商的行为产生不同的影响。这一单一案例的实验 设计将实验性地操纵咨询模型的三种潜在的活性成分（关于 录音会议，案例支持和技能排练），在4个应用行为分析（阿坝）机构，以 确定协商模式的潜在有效成分。咨询将侧重于远程保健服务， 一个经验支持的手动家长为ASD儿童介导的干预（项目ImPACT）。 将从4个机构（总共N =约20个提供商）招募3-5名提供商组成的小组，这些机构与区域 密歇根州医疗补助自闭症福利内的社区精神卫生机构， 行为分析服务，以医疗补助登记的青少年与ASD。供应商将完成一个自我导向的在线 ImPACT项目教程。每个提供者将在他们的案例中登记至少一名有孩子的照顾者 参加密歇根州医疗补助自闭症福利（N = ~20名护理人员）。接下来，每个机构将随机 分配给a）基线期的长度（3-6周之间）和B）他们将接受 协商组成部分。提供者将记录每周一次与其注册家庭的会议，并通过 符合HIPAA的Dropbox链接。他们还将完成每周的在线调查问卷， 结果。将通过每周会议的观察编码评估执行成果， 治疗依从性和能力，以及每周提供者问卷调查的分析， 渗透性，可行性，可接受性，项目ImPACT的适当性和3个 咨询阶段。提供者将在会议结束后8周提交最后一次会议记录和调查问卷。 协商护理人员将通过在线方式为孩子完成一定程度的社交沟通 在基线、咨询期间两次以及咨询后8周后进行问卷调查。数据分析 包括多级建模和可视化分析。结果将确定磋商的有效成分 模型，稍后将用于开发协商机制的因果模型， 执行成果。培训计划包括指导、课程、研讨会和体验 学习，并将发展在自闭症领域的疗效和实施研究的专业知识。

项目成果

Factors that influence clinical decisions about offering parent coaching for autistic youth served within the Medicaid system.

• DOI: 10.1177/26334895231153631
• 发表时间: 2023-01
• 期刊: Implementation research and practice
• 作者: Straiton, Diondra;Frost, Kyle;Ingersoll, Brooke
• 通讯作者: Ingersoll, Brooke

Short report: Call to action for autism clinicians in response to anti-Black racism.

• DOI: 10.1177/13623613211043643
• 发表时间: 2022-05
• 期刊: AUTISM
• 影响因子: 5.2
• 作者: Straiton, Diondra;Sridhar, Aksheya
• 通讯作者: Sridhar, Aksheya