Computerized Self Administered Behavioral Intervention for Tics in Children

儿童抽动的计算机化自我管理行为干预

• 批准号: 8251975
• 负责人: Suzanne Mouton-Odum
• 金额: $ 15万
• 依托单位: PSYC TECH, LTD
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8251975
• 关键词: Address; Adherence; Adoption; Adrenergic Agonists; Adult; Adverse effects; Age; Area; Behavior Disorders; Behavior Therapy; Child; Chronic; Computers; Development; Disease; Disease remission; Dose; Family; Feedback; Gilles de la Tourette syndrome; Habits; Health Services Accessibility; Health Services Research; Impairment; Improve Access; Individual; Internet; Intervention; Knowledge; Lead; Marketing; Mental Health; Methods; Mission; Modeling; Monitor; Online Systems; Parents; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacotherapy; Phase; Population Group; Problem behavior; Process; Protocols documentation; Provider; Public Health; Publishing; Quality of life; Questionnaires; Randomized Controlled Trials; Reporting; Respondent; School-Age Population; Self Administration; Self-Administered; Services; Small Business Innovation Research Grant; Strategic Planning; Surveys; Symptoms; Test Result; Testing; Therapeutic; Tic disorder; Training; Treatment Cost; Treatment Protocols; atypical antipsychotic; base; computerized; cost; indexing; innovation; neuropsychiatry; novel; programs; prototype; psychoeducation; response; satisfaction; social; usability

DESCRIPTION (provided by APPLICANT): This Phase I SBIR proposes to develop and demonstrate the feasibility of an innovative computer-based treatment-delivery product for children with Chronic Tic Disorders (CTD; including Tourette's Disorder) and their families. CTD represents a class of neuropsychiatric disorders, occurring in 1-3 percent of school-aged children that can lead to significant impairments in physical, social, academic, and interpersonal functioning and reduced quality of life. There is currently no cure for CTD, however in large-scale randomized controlled trials; a non- pharmacological treatment known as Comprehensive Behavioral Interventions for Tics (CBIT) has been shown to reduce tics without the adverse side effects associated with pharmacotherapy. A therapist-guided, empirically validated CBIT protocol is available; however the vast majority of individuals who desire CBIT do not have access to therapists trained in the delivery of this intervention. Given the NEED for nonpharmacological treatment options for children with CTD, a desire for such treatments by potential end- users, and the absence of practitioners adequately trained in the treatment, there is a clear NEED for innovative modes of dissemination. The current proposal partners two of the primary developers of the CBIT intervention with PsycTech Ltd., a company that specializes in developing effective computer-based, self-administered treatment delivery products for repetitive behavior disorders. This Phase I project proposes to adapt three core components of the CBIT treatment protocol for self-administration via an interactive web-based computer platform. The resulting product (Computerized Comprehensive Behavioral Intervention for Tics; C-CBIT) will be tested for feasibility, usability, and end-user satisfaction. This Phase I project ill accomplish three aims: (1) to adapt three core components of the therapist-guided CBIT protocol (psychoeducation about tics, self- monitoring, and habit reversal training) into a self-administered format that is appropriate for use with children and their families, (2) Integrate these self-administered CBIT components into an interactive, online computer delivery platform, and (3) establish the feasibility, usability, and acceptability of the preliminary C-CBIT intervention with experts as well as children (ages 8-18) with a CTD and their families. PUBLIC HEALTH RELEVANCE: Chronic tic disorders (CTD) occur in 1-3 percent of school-aged children and are often associated with significantly diminished quality of life and impairments in physical, social, academic, and interpersonal functioning. There is currently no cure for CTD and they are often managed with pharmacotherapies which, although moderately effective for reducing tics in some individuals, have high rates of adverse side effects which limi their use and often result in poor adherence and discontinuation. A non-pharmacological treatment, known as Comprehensive Behavioral Interventions for Tics (CBIT), has shown results similar to those achieved with pharmacotherapy. However, it is not widely available to those who want it. Surveys of families with CTD show that only 6 percent of treatment-seeking children/families and 4 percent of treatment seeking adults had received CBIT. While most respondents desired CBIT, several barriers were identified that restricted access to care including a LACK of providers (especially in underserved areas) and the costs associated with weekly therapy. Clearly there is a NEED for novel dissemination strategies capable of reaching more people and lowering costs associated with treatment. The proposed program, C-CBIT, will offer a novel dissemination strategy that will address treatment barriers. In addition to being universally available to anyone with Internet access, C-CBIT has the potential to significantly lower the cost of treatment. An average course of face-to-face treatment lasts 8-12 sessions and costs $120 - $150 per session with totals exceeding $2,000. In comparison, computerized products for managing other repetitive behavior problems are marketed at $29.95 per month with subscriptions averaging 5 months of use for a total cost of treatment of $150; roughly the cost of a single face-to-face treatment session. As such, the proposed program, C-CBIT, has the potential to address known accessibility problems by offering a novel dissemination strategy that will increase accessibility, reduce delivery burden, and lower the cost of treatment.

描述(由申请人提供)：第一阶段SBIR建议开发和展示一种创新的基于计算机的治疗-交付产品的可行性，该产品适用于患有慢性抽动障碍(CTD；包括抽动障碍)的儿童及其家庭。CTD是一种神经精神障碍，发生在1%-3%的学龄儿童中，可导致身体、社会、学习和人际功能的严重障碍，并降低生活质量。然而，在大规模的随机对照试验中，目前还没有治愈CTD的方法；一种被称为抽搐综合行为干预(CBIT)的非药物治疗已被证明可以减少抽搐，而不会出现与药物治疗相关的不良副作用。治疗师指导的、经验性验证的CBIT方案是可用的；然而，绝大多数希望CBIT的人无法接触到接受过这种干预提供培训的治疗师。鉴于CTD儿童的非药物治疗方案的必要性，潜在最终用户对这种治疗的渴望，以及缺乏接受过充分治疗培训的从业人员，显然需要创新的传播模式。目前的提案是CBIT干预的两名主要开发商与心理技术有限公司的合作伙伴，心理技术有限公司是一家专门为重复行为障碍开发有效的基于计算机的自我管理治疗交付产品的公司。这一第一阶段项目建议调整CBIT治疗方案的三个核心组成部分，以便通过一个基于网络的交互式计算机平台进行自我管理。由此产生的产品(计算机化的抽搐综合行为干预；C-CBIT)将接受可行性、可用性和最终用户满意度的测试。该第一阶段项目将实现三个目标：(1)将治疗师指导的CBIT方案的三个核心部分(有关抽搐的心理教育、自我监测和习惯逆转训练)调整为适合儿童及其家庭使用的自我管理形式，(2)将这些自我管理的CBIT部分整合到一个互动的在线计算机交付平台，以及(3)与专家以及患有CTD的8-18岁儿童(8-18岁)一起建立初步的C-CBIT干预的可行性、可用性和可接受性。 公共卫生相关性：慢性抽动障碍(CTD)发生在1%-3%的学龄儿童中，通常与生活质量显著下降以及身体、社会、学习和人际功能障碍有关。目前CTD尚无治愈方法，通常采用药物疗法治疗，虽然对某些人减少抽搐适度有效，但副作用发生率高，限制了它们的使用，并经常导致依从性差和停用。一种名为抽搐综合行为干预(CBIT)的非药物治疗已显示出与药物治疗相似的结果。然而，想要它的人并没有广泛地获得它。对患有CTD的家庭的调查显示，只有6%的寻求治疗的儿童/家庭和4%的寻求治疗的成年人接受了CBIT。虽然大多数受访者希望获得CBIT，但确定了几个限制获得护理的障碍，包括缺乏提供者(特别是在服务不足的地区)和与每周治疗相关的费用。显然，需要有新的传播战略，能够接触到更多的人，并降低与治疗相关的成本。拟议的C-CBIT计划将提供一种新的传播战略，解决治疗障碍。除了向所有有互联网接入的人提供C-CBIT外，C-CBIT还有可能显著降低治疗成本。面对面治疗的平均疗程为8-12个疗程，每个疗程的费用为120-150美元，总费用超过2000美元。相比之下，用于管理其他重复行为问题的计算机化产品的销售价格为每月29.95美元，订阅平均使用5个月，总治疗费用为150美元；大致相当于一次面对面治疗的费用。因此，拟议的C-CBIT计划有可能通过提供一种新的传播战略来解决已知的可及性问题，该战略将增加可及性，减少交付负担，并降低治疗成本。