Internet-based Fidelity Enhancement of MTFC

基于互联网的MTFC保真度增强

• 批准号: 8196163
• 负责人: EDWARD GUSTAV FEIL
• 金额: $ 27.47万
• 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 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8196163
• 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的“概念验证”的努力，其中创建了基于互联网的治疗保真度监测系统的基本组成部分，ITFMS，以协助MTFC顾问和执行机构，通过更有效地走向和保持计划实施的保真度来改善临床结果。ITFMS的可行性，社区机构，养父母，和计划顾问使用也进行了审查（请参阅第一阶段报告）。第二阶段的目标是完成ITFMS系统和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成果，以实现实施保真度的标准。信息技术管理系统的完成目标将包括：1）根据审查人员和第一阶段β测试人员的要求，改进和加强现有的信息技术管理系统基本系统组成部分，以便执行机构能够远程和更有效地输入和查看满足中期财务协调委员会保真度标准和认证要求所需的全套现场数据; 2）增加一个集成系统组件，该组件将获取在每个实施站点内收集的日常数据，并自动集成和显示，和开发人员更有意识地了解机构向MTFC忠诚度的转变，并在与支持网站实施的积极变化有关的反馈和讨论中更加积极主动; 3）增加专业沟通系统，不仅允许项目顾问和现场之间，而且允许实施现场之间的项目想法和实施信息的自由流动，以便能够以持续、高效和有意义的方式收集问题、难题和支持;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，将首先提供给目前正在使用的MTFC站点，对整个系统进行β测试和反馈。来自这些研究中心的反馈将被整合到ITFMS系统中，然后将征集新的和正在开发的实施研究中心参与随机对照试验。该试验将涉及随机分配研究中心到标准或基于互联网的MTFC顾问支持的实施服务。由于ITFMS是为了促进社区机构实现MTFC的保真度，因此将评估保真度管理和有效性研究得出的重要保真度领域，包括实施过程、实施效率和实施有效性的结果指标。据推测，ITFMS机构将报告更高的水平，在每个这些实施保真度域相比，传统实施的MTFC计划。我们还将评估反映信息技术管理系统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，儿童福利和少年司法机构共同面临着减少青少年反社会行为流行的挑战，但可悲的是，即使有经过验证的方案，并广泛传播，在社区环境中复制研究结果仍然缓慢和有问题。传播工作不成功的一个关键因素是干预开发人员/顾问对密集监测的需求过高;随着这些个人与社区机构之间距离的增加，这一困难加剧，试图实现和保持实施的保真度。目前的项目提出了解决这一问题的一个可能办法，即为方案顾问、临床监督员和干预人员建立一个基于互联网的忠实反馈机制，作为经实践验证的方案的数据收集和报告功能的一部分;将通过直接，立即，高质量的数据，使地方服务组织更有可能以尽可能高的保真度提供服务，并取得更有力的社区干预成果。