Developing and Testing the Feasibility of Voice Over Internet Protocol Delivered

开发并测试基于互联网协议的语音的可行性

• 批准号: 8257211
• 负责人: EMILY JULIA RICKETTS
• 金额: $ 3.8万
• 依托单位: UNIVERSITY OF WISCONSIN MILWAUKEE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-01-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8257211
• 关键词: Acute; Adherence; Adult; Age; Area; Behavior; Behavior Therapy; Behavioral; Child; Chronic; Clinic; Computers; Cues; Diagnosis; Disease; Educational process of instructing; Effectiveness; Equipment; Family; Funding; Gilles de la Tourette syndrome; Goals; Health Personnel; Health Services Accessibility; Home environment; Impairment; Internet; Intervention; Intervention Studies; Manuals; Modality; Modification; Motor; Movement; National Institute of Mental Health; Outcome Measure; Participant; Patients; Protocols documentation; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Services; Severities; Speed; Testing; Tic disorder; Training; Treatment Efficacy; Treatment outcome; United States National Institutes of Health; Videoconferences; Videoconferencing; Voice; base; blind; computer studies; control trial; cost; effectiveness research; efficacy trial; experience; innovation; medical specialties; neuropsychiatry; portability; prevent; primary outcome; randomized trial; transmission process; treatment duration; usability; user-friendly; vocalization

A Comprehensive Behavioral Intervention for Tics (CBIT) is an emerging treatment for children with Tourette Syndrome (TS) and has been shown to be efficacious in separate randomized trials with children and adults; however, many families of children with TS are prevented from accessing it due to limited availability of adequately trained treatment providers. Recent research has shown that videoconference-delivered CBIT is as effective as face to face delivery, and that both modalities are efficacious. Despite its effectiveness, traditional videoconferencing has limitations including lack of portability, ease of access, the need for third party clinics, and cost. A newer, more convenient alternative to increase access is the use of Voice over Internet Protocol (VoIP) transmission, allowing for the direct delivery of CBIT to patients' homes. Therefore the broad, long-term objective of the proposed research is to increase access to CBIT through developing and testing the feasibility and preliminary efficacy of VoIP-delivered CBIT. Specifically, this project seeks to modify the existing CBIT protocol for tics to be administered via VoIP, assess the cross-modality reliability of a tic severity rating scale, the Yale Global Tic Severity Scale (YGTSS) administered via VoIP and face to face, determine the acceptability, usability, and feasibility of the VoIP-modified version of CBIT, and establish the preliminary efficacy of VoIP-modified CBIT for reducing tics in children with TS compared to a waitlist control condition. As an exploratory aim, the current study will investigate potential correlates of treatment outcome, including home computer equipment available (i.e., web camera type, microphone type, internet upload speed, and type of internet connection), prior computer experience, and comfort with study computer equipment. The original CBIT manual will be adapted for use with VoIP. The VoIP-modified treatment will then be pilot tested with 4 children to determine initial effectiveness, and whether further modifications are needed. Prior to the trial, the cross-modality reliability of the primary outcome measure, the Yale Global Tic Severity Scale, will be assessed. To test preliminary efficacy of the intervention, 20 children (ages 9-17) with TS or Chronic Tic Disorder as a primary diagnosis will be recruited for a randomized, observer-blind, waitlist controlled trial of VoIP-delivered CBI. Participants will be randomly assigned to 8 weekly sessions of CBIT-VoIP through Skype(c) over a 10- week acute treatment period, or waitlist control condition. The proposed research is consistent with the areas of high priority outlined by the NIMH Division of Services and Intervention Research, as the proposed research seeks to adapt a treatment for use in an innovative service delivery modality, and test the intervention through both effectiveness research and a preliminary efficacy trial.

抽动综合行为干预（CBIT）是一种治疗抽动秽语综合征（TS）儿童的新兴疗法，在儿童和成人的单独随机试验中已被证明是有效的;然而，由于训练有素的治疗提供者有限，许多TS儿童家庭无法获得它。最近的研究表明，视频会议提供的CBIT是有效的面对面交付，这两种方式都是有效的。尽管其有效性，传统的视频会议具有局限性，包括缺乏便携性，易于访问，需要第三方诊所和成本。一种更新、更方便的增加访问的替代方案是使用互联网协议语音（VoIP）传输，允许将CBIT直接传送到患者家中。因此，拟议研究的广泛，长期目标是通过开发和测试VoIP交付CBIT的可行性和初步功效来增加CBIT的访问。具体而言，该项目旨在修改现有的CBIT协议，用于通过VoIP管理抽搐，评估抽搐严重程度评定量表的跨模态可靠性，通过VoIP和面对面管理的耶鲁全球抽搐严重程度量表（YGTSS），确定CBIT VoIP修改版本的可接受性，可用性和可行性，并确定与等待名单对照条件相比，VoIP改良CBIT在减少TS儿童抽搐方面的初步疗效。作为探索性目的，本研究将调查治疗结果的潜在相关性，包括可用的家用计算机设备（即，网络摄像头类型、麦克风类型、互联网上传速度和互联网连接类型）、先前的计算机使用经验和对研究计算机设备的舒适度。最初的CBIT手册将适用于VoIP。然后将对4名儿童进行试点测试，以确定初始有效性，以及是否需要进一步修改。在试验之前，将评估主要结局指标（耶鲁整体抽动严重程度量表）的跨模态可靠性。为了测试干预的初步疗效，将招募20名TS或慢性抽动障碍作为主要诊断的儿童（9-17岁）进行VoIP交付CBI的随机、双盲、等待名单对照试验。参与者将通过Skype（c）在10周的急性治疗期或等待列表控制条件下随机分配到8个每周CBIT-VoIP会话。拟议的研究与NIMH服务和干预研究部概述的高度优先领域一致，因为拟议的研究旨在适应用于创新服务提供模式的治疗，并通过有效性研究和初步疗效试验来测试干预措施。