Internet-based Fidelity Enhancement of MTFC

基于互联网的MTFC保真度增强

• 批准号: 8149797
• 负责人: EDWARD GUSTAV FEIL
• 金额: $ 59.85万
• 依托单位: TFC CONSULTANTS, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8149797
• 关键词: Adolescent; Adolescent Behavior; Adopted; Adoption; Behavior; Caring; Certification; Child Welfare; Client; Clinical; Clinical Trials; Collection; Communication; Communities; Complex; Computers; Continuing Education; Data; Data Collection; Data Display; Data Quality; Data Reporting; Data Storage and Retrieval; Development; Disease; Educational Materials; Effectiveness; Europe; Feedback; Funding; Goals; Home environment; Individual; Internet; Intervention; Justice; Link; Marketing; Mediating; Mental Health; Methods; Modeling; Monitor; Movement; North America; Outcome; Parents; Phase; Prevalence; Process; Protocols documentation; Randomized; Randomized Controlled Trials; Relative (related person); Reporting; Research; Research Infrastructure; Resources; Secure; Services; Site; Solutions; Supervision; Support System; System; Systems Development; Telephone; Testing; Time; Translations; Youth; access restrictions; alternative treatment; anti social; base; cohort; commercialization; community setting; cost; design; effectiveness research; flexibility; foster care; foster parent; improved; innovation; knowledge base; meetings; peer; pressure; programs; prototype; public health relevance; response; satisfaction; service intervention; treatment effect; web site

DESCRIPTION (provided by applicant): The proposed project builds upon Phase I "proof of concept" efforts wherein the basic foundational components of an Internet-based Treatment Fidelity Monitoring System, the ITFMS, were created to assist MTFC consultants and implementing agencies to improve clinical outcomes by moving more efficiently towards and maintaining fidelity of program implementation. ITFMS feasibility for community agency, foster parent, and program consultant use was also examined (please see Phase I report). The Phase II aims involve the completion of the ITFMS system and a randomized controlled trial of the effectiveness of the final system. Within our effectiveness examination, we will focus on outcomes related to increasing MTFC agency and program consultant efficiency in moving towards criteria for implementation fidelity. Completion objectives for the ITFMS system will involve: 1) refinement and enhancement of the existing ITFMS foundational system components, in response to both reviewers and Phase I beta testers, such that the full set of site data necessary to fulfill MTFC fidelity criteria and certification requirements can be remotely and more efficiently entered and viewed by implementing agencies; 2) addition of an integrated system component that will take the day-to-day data collected within each implementation site and automatically integrate and display it in a manner that will allow sites, program consultants, and developers to be more formatively aware of agency movement towards MTFC fidelity and more proactive in their feedback and discussions relative to supporting positive changes in site implementation; 3) addition of a professional communication system that will allow for the free-flow of program ideas and implementation information not only between program consultants and sites, but also between implementation sites such that issues, problems and support can be garnered in an on- going, productive, and meaningful manner; and 4) a parent support component with resources and moderated peer-to-peer support. Once ITFMS system development is completed, it will first be offered to currently active MTFC sites for beta-testing and feedback on the entire system. Feedback from these sites will be integrated into the ITFMS system and then new and developing implementation sites will be solicited to participate in the randomized-controlled trial. The trial will involve randomly assigning sites to either a standard or internet-based MTFC consultant-supported implementation service. Because ITFMS is meant to facilitate movement towards MTFC fidelity implementation by community agencies, important fidelity domains derived from the fidelity management and effectiveness research will be assessed, including outcome indicants of implementation process, implementation efficiency, and implementation effectiveness. It is hypothesized that ITFMS agencies will report greater levels within each of these implementation fidelity domains when compared to the traditionally-implemented MTFC program. We will also assess commercialization indicants reflecting ITFMS usage and system satisfaction within implementing agencies. PUBLIC HEALTH RELEVANCE: Mental health, child welfare, and juvenile justice agencies are jointly faced with the challenge of reducing the prevalence of adolescent antisocial behavior, but sadly, even though empirically-validated programs are available and widely disseminated, replication of research results in community settings remains slow and problematic. A critical contributor to unsuccessful dissemination efforts is the prohibitive need for intensive monitoring by intervention developers/consultants; a difficulty exacerbated as the distance increases between these individuals and community agencies attempting to achieve and maintain implementation fidelity. The current project proposes one possible solution to this problem by developing an Internet-based fidelity feedback mechanism for program consultants, clinical supervisors and interventionists as part of an empirically-validated program's data collection and reporting functions; mechanisms that would link local clinical programs and nationally-based dissemination teams through direct, immediate, high quality data and make it more likely that local service organizations can implement services at the highest possible level of fidelity and achieve stronger community-based intervention outcomes.

描述(由申请人提供)：拟议的项目建立在第一阶段“概念验证”工作的基础上，其中创建了基于互联网的治疗保真度监测系统(ITFMS)的基本基础组件，以帮助MTFC顾问和实施机构通过更有效地实现并保持计划实施的保真度来改善临床结果。还研究了社区机构、养父母和项目顾问使用ITFMS的可行性(请参阅第一阶段报告)。第二阶段的目标是完成创新技术监测系统，并对最终系统的有效性进行随机对照试验。在我们的有效性检查中，我们将重点关注与提高MTFC机构和计划顾问效率相关的结果，以实现执行忠诚度的标准。信息和通信技术管理系统的完成目标将包括：1)根据审查员和第一阶段测试员的要求，改进和加强现有的信息和通信技术管理系统基本系统组成部分，以便执行机构能够远程、更有效地输入和查看满足MTFC保真度标准和认证要求所需的全套现场数据；2)增加一个综合系统组件，它将获取在每个实施地点收集的日常数据，并自动整合和显示这些数据，使地点、计划顾问和开发人员能够更正式地了解机构向MTFC忠诚度的转变，并在他们的反馈和讨论中更积极地支持现场实施中的积极变化；3)增加一个专业沟通系统，允许计划想法和实施信息不仅在计划顾问和地点之间，而且在实施地点之间自由流动，从而能够以持续、有成效和有意义的方式获得问题、问题和支持；以及4)具有资源和适度的对等支持的父母支持组件。一旦ITFMS系统开发完成，将首先将其提供给目前活跃的MTFC站点，以便对整个系统进行Beta测试和反馈。这些地点的反馈将被纳入创新技术和金融监测系统，然后将征集新的和正在开发的实施地点参加随机对照试验。试验将涉及随机将地点分配给标准的或基于互联网的MTFC顾问支持的实施服务。由于信息技术和金融管理系统旨在促进社区机构向MTFC保真执行迈进，因此将对保真度管理和有效性研究衍生的重要保真领域进行评估，包括执行过程、执行效率和执行效果的成果指标。据推测，与传统实施的MTFC计划相比，ITFMS各机构将报告这些实施保真领域中的更高水平。我们还将评估反映ITFMS使用情况和执行机构内部系统满意度的商业化指标。 公共卫生相关性：心理健康、儿童福利和青少年司法机构共同面临着降低青少年反社会行为流行率的挑战，但遗憾的是，尽管有经经验验证的项目可用并广泛传播，但在社区环境中复制研究结果仍然缓慢且存在问题。不成功的传播努力的一个关键因素是迫切需要干预开发人员/顾问进行密集监测；随着这些个人与试图实现和保持执行保真度的社区机构之间的距离增加，这一困难加剧。目前的项目提出了一种可能的解决方案，通过为项目顾问、临床主管和干预者开发基于互联网的保真度反馈机制，作为经验证的项目数据收集和报告功能的一部分；该机制将通过直接、即时、高质量的数据将当地临床项目和全国传播团队联系起来，并使当地服务组织更有可能以尽可能高的保真度实施服务，并实现更强大的基于社区的干预结果。