Utilizing Health Information Technology to improve Health Care Quality: Implement

利用卫生信息技术提高医疗保健质量：实施

• 批准号: 8338388
• 负责人: ERIC A. STORCH
• 金额: $ 36.9万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2014-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8338388
• 关键词: Utilizing; Health; Information; Technology; improve

DESCRIPTION (provided by applicant): Childhood anxiety disorders are quite common and associated with significant psychosocial impairment and distress. Offering equivalent efficacy to pharmacotherapy without the common side effect profile, cognitive behavioral therapy (CBT) is a first line treatment for anxiety disorders in youth. However, dissemination of CBT to community settings is very limited. Effective treatment via traditional CBT often necessitates that the patient travel to a center that specializes in this treatment, and cost can prove an impediment to those of lower socioeconomic status, in particular. As well, differing theoretical approaches and training result in a minority of children with anxiety receiving evidence-based CBT. Accordingly, there is a great need for more widely accessible practices. As such, we are proposing a two phase trial that evaluates the feasibility of implementing a patient-centered intervention in community mental health centers, followed by an efficacy trial. In Phase I, an open trial of computerized CBT (CCBT) will be completed that focuses on feasibility issues of providing this intervention in community mental health centers. Thereafter, we will complete a randomized controlled trial comparing CCBT to treatment as usual (TAU). The open trial will recruit 18 youth ages 7 to 13 years, with the purpose of testing both practicality and management of an already developed CCBT protocol (Kendall & Khanna, 2010). The outcome trial will recruit 110 youth accounting for attrition, with the purpose of measuring the efficacy of the CCBT protocol in front-line settings. Significantly greater symptom reductions in the CCBT group as compared to the TAU group would provide critical evidence for the inclusion of CCBT as a treatment option for anxious youth without immediate access to such in-person care. While this study will be coordinated by the University of South Florida Rothman Center for Neuropsychiatry team, recruitment will take place at three community mental health centers throughout Florida that serve families of lower socioeconomic status. Dr. Andel from the College of Behavioral and Community Sciences at the University of South Florida will provide data management services. Primary outcomes will be assessed by an independent evaluator, and will include change in anxiety symptom severity; response rates; and remission rates. CCBT will follow the Kendall and Khanna (2008b) manual with appropriate integrity checks. The implications of this study are significant, as computerized CBT may enable widespread dissemination of efficacious therapy for childhood anxiety disorders.

描述（由申请人提供）：儿童焦虑症很普遍，并且与重大的社会心理障碍和困扰有关。认知行为疗法（CBT）提供具有药物治疗的同等疗效，这是青年焦虑症的第一行治疗。但是，将CBT传播到社区环境非常有限。通过传统CBT进行有效的治疗通常需要患者前往专门从事这种治疗的中心，而成本可能会妨碍社会经济地位较低的障碍。同样，不同的理论方法和培训导致少数患有焦虑的儿童接受循证CBT。因此，非常需要更广泛的实践。因此，我们提出了一项两阶段试验，该试验评估在社区心理健康中心实施以患者为中心的干预措施的可行性，然后进行疗效试验。在第一阶段，将完成对计算机CBT（CCBT）的开放试验，该试验重点介绍了在社区心理健康中心提供这种干预的可行性问题。此后，我们将完成一项随机对照试验，将CCBT与往常一样（TAU）进行比较。开放式试验将招募18年的7至13岁青年，目的是测试已经开发的CCBT协议的实用性和管理（Kendall＆Khanna，2010年）。结果试验将招募110名青年损耗，目的是衡量CCBT协议在前线设置中的功效。与TAU组相比，CCBT组的症状降低将大大减轻，将为焦虑的青少年纳入CCBT作为治疗方案提供关键的证据，而无需立即获得此类面对面的护理。虽然这项研究将由南佛罗里达大学Rothman神经精神病学团队协调，但招聘将在佛罗里达州的三个社区精神卫生中心举行，这些中心为社会经济地位较低的家庭提供服务。南佛罗里达大学行为与社区科学学院的安德尔博士将提供数据管理服务。主要结果将由独立评估者评估，并包括焦虑症状严重程度的变化；回应率；和缓解率。 CCBT将遵循Kendall和Khanna（2008b）手册，并进行适当的完整性检查。这项研究的含义很重要，因为计算机化的CBT可能会广泛传播针对儿童焦虑症的有效疗法。