A Technology-Enhanced Approach for Implementing Evidence-Based Practices in Child

描述（由申请人提供）：参与儿童福利的受虐待儿童患精神健康问题的风险是一般儿童的2.5倍。在减少儿童虐待和儿童福利中的心理健康风险方面，很少有成功实施循证做法（ebp）的案例，成功实施的障碍也有据可查。工作需求资源模型（JD- R）是考虑如何在要求苛刻、混乱和资源不足的环境（如儿童福利）中提高ebp吸收的有用方法。JD-R认为，感知到高工作要求和低资源的员工可能会出现消极的工作绩效和抗拒变革，但高工作要求可以被高感知资源所缓冲。该建议侧重于开发和试点测试一种创新技术增强的实施方法，该方法将在实施过程中增加向儿童福利提供者提供的资源，同时减少相关需求，目标是提高提供者的忠诚度和实施成功率。在种子基金资助的基础上，我们建议开发和测试一种以计算机为媒介的SafeCare方法，这是一种针对CM预防的EBP。在计算机中介方法的开发和验证之后（第一年的第一部分），将对30名新培训的安全护理提供者进行可行性试验，这些提供者将随机分配到常规实施（IAU-SC）或技术增强安全护理实施（TE-SC）。分配给IAU-SC的供应商将按照设计提供SafeCare。分配给TE-SC的供应商将把计算机带到会议现场，并利用安装的软件协助向家长提供安全护理。在可行性试验期间，供应商将分别为两个家庭（N=60）提供服务。供应商感兴趣的结果是SafeCare的保真度，在EBP实施过程中对工作需求和资源的感知，以及TE-SC软件的可行性/满意度评级。父母和孩子的行为改变，以及父母的满意度，也将在两个实施条件下进行测量。这些数据将构成R01应用程序的基础，该应用程序将检查技术增强的实施方法对项目有效性、培训成本和附加ebp的提供者保真度的影响。因此，该项目是朝着创新的实施方法迈出的第一步，这种方法可以扩大ebp的覆盖范围，从而对慢性疾病和相关的心理健康后果产生积极的公共卫生影响。

DESCRIPTION (provided by applicant): Maltreated children involved with child welfare have 2.5 times greater risk for developing mental health problems than children in the general population. There have been few successful implementations of evidence-based practices (EBPs) that reduce child maltreatment (CM) and mental health risk in child welfare, and the barriers to successful implementation are well documented. The Job-Demands Resource Model (JD- R) is a useful approach for considering how to enhance the uptake of EBPs in demanding, chaotic, and under- resourced environments, such as child welfare. JD-R suggests that employees who perceive high job demands and low resources may experience negative job performance and resist change, but that high job demands can be buffered by high levels of perceived resources. This proposal focuses on the development and pilot testing of an innovative-technology enhanced implementation approach, which will increase the resources offered to child welfare providers during implementation, while also reducing associated demands, with the goal of improving provider fidelity and implementation success. Building on seed grant funding, we propose to develop and test a computer-mediated approach for SafeCare, an EBP targeting CM prevention. Following development and validation of the computer-mediated approach (first part of Year1), a feasibility trial will be conducted with 30 newly trained SafeCare providers who will be randomly assigned to either Implementation as usual (IAU-SC) or Technology-Enhanced SafeCare Implementation (TE-SC). Providers assigned to IAU-SC will deliver SafeCare as designed. Providers assigned to TE-SC will bring computers to sessions and utilize the installed software to assist in the delivery of SafeCare to parents. During the feasibility trial, providers will serve two families each (N=60). Provider outcomes of interest are SafeCare fidelity, perceptions of job demands and resources during EBP implementation, and feasibility/satisfaction ratings for the TE-SC software. Parent and child behavior change, and parent satisfaction, will also be measured in the two implementation conditions. These data will form the basis for an R01 application that will examine the impact of the technology-enhanced implementation approaches on program effectiveness, training costs, and provider fidelity with additional EBPs. Thus, this project is the first step towards an innovative implementation approach that can enhance the reach of EBPs, and consequently, make a positive public health impact on CM and related mental health consequences.