Integrating implementation science and cultural adaptation to understand intervention modifications within school-based mental health

整合实施科学和文化适应，以了解学校心理健康中的干预措施修改

• 批准号: 9769519
• 负责人: Stephanie K Brewer
• 金额: $ 6.57万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769519
• 关键词: Address; Adolescent; Advocate; Affect; Area; Attitude; Audiotape; Characteristics; Child; Client; Code; Cognitive Therapy; Community Services; Data; Development; Education; Effectiveness; Evidence based treatment; Family; Foundations; Frequencies; Goals; Grant; Health; Health Personnel; Individual; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Literature; Manuscripts; Measures; Mental Health; Mental Health Services; Methods; Modeling; Modification; Names; National Institute of Mental Health; National Research Service Awards; Outcome; Patient-Focused Outcomes; Population; Procedures; Process; Public Health; Qualitative Methods; Reaction; Research; Research Methodology; Research Personnel; Scheme; Schools; Services; Structure; Students; System; Testing; Theoretical model; Training; Training Activity; Trauma; United States; United States National Institutes of Health; Writing; Youth; base; contextual factors; design; deviant; experience; implementation research; implementation science; improved; individualized medicine; insight; knowledge base; lens; novel; overtreatment; practice setting; programs; research based treatment; routine practice; school district; service delivery; skills

Project Summary/Abstract The goal of this Ruth L. Kirschstein National Research Service Award is to support the applicant in developing the specialized skills necessary to build an independent program of research with the goal of improving the implementation of contextually relevant and culturally responsive evidence-based treatments (EBTs) in schools, and thereby promoting equitable mental health services for historically underserved youth. This F32 application proposes research to address NIMH strategic priority 4.1: Improve the efficiency and effectiveness of existing mental health services through research, specifically by contributing to the budding knowledgebase on the modifications made to EBTs in practice, and thereby optimizing the effective implementation of EBTs in real-world contexts. The research component of this F32 responds to a call to action by leaders of the NIH Implementation Science Team, who have advocated for the compilation of a comprehensive body of knowledge identifying the modifications that are made to EBTs in practice and explaining their impacts on relevant outcomes. The proposed research will be conducted in two stages: Study 1 will develop a novel coding scheme that integrates theoretical models from implementation science and cultural adaptation, using modified Delphi procedures with an expert panel comprised of implementation science researchers and cultural adaptation researchers (Research Aim 1). Using this coding scheme, Study 2 will examine the modifications made to an EBT being implemented within schools, through the use of mixed quantitative and qualitative methods. Specifically, data will be collected from school-based mental health providers via quantitative measures and semi-structured interviews, and the coding scheme developed in Study 1 will be used to identify which modifications are being made to an EBT as it is implemented in schools, and why they are being made (Research Aim 2). Finally, a set of hypotheses will be tested in order to estimate the construct validity of the coding scheme developed in Study 1 by examining expected associations between types of EBT modifications and clinician- and school-level variables (Research Aim 3). In combination, these two studies will provide a strong foundation for a Career Development Award focused on the impact of EBT modifications on child/adolescent mental health outcomes. In addition, by designing and engaging in a three-year progression of targeted training activities, the applicant will develop expertise in school-based mental health research, while gaining critical knowledge and skills in implementation science, cultural adaptation, and mixed methods research. Specific training goals to be achieved are to: 1) Build expertise in contextually relevant intervention research, with a particular emphasis on school-based mental health research; 2) Expand conceptual knowledge of the modifications made to EBTs in practice settings by integrating two pertinent, yet disparate, literatures—implementation science and cultural adaptation; 3) Develop experience and expertise in mixed methods research; and 4) Strengthen grant-writing and manuscript-writing skills.

项目总结/摘要 这个Ruth L的目标。Kirschstein国家研究服务奖旨在支持申请人开发 建立一个独立的研究计划所需的专业技能，其目标是提高 实施情境相关和文化响应的循证治疗（EBT）， 学校，从而促进为历史上得不到充分服务的青年提供公平的心理健康服务。F32 申请提出研究，以解决NIMH战略优先事项4.1：提高效率和有效性 通过研究，特别是通过为萌芽的知识库做出贡献， 在实践中对EBT所做的修改，从而优化EBT的有效实施， 真实世界的背景。F32的研究部分响应了NIH领导人的行动号召 执行科学小组，该小组主张汇编一份全面的 识别在实践中对EBT所做的修改并解释其影响的知识 相关成果。本研究将分两个阶段进行：研究1将开发一种新的 编码方案整合了实施科学和文化适应的理论模型，使用 修改德尔菲程序与专家小组组成的实施科学研究人员和 文化适应研究者（研究目标1）。使用这种编码方案，研究2将检查 通过使用混合定量和 定性方法。具体而言，数据将通过以下方式从学校心理健康提供者那里收集： 定量测量和半结构化访谈，以及研究1中开发的编码方案， 用于确定在学校实施EBT时对EBT进行了哪些修改，以及为什么 研究目的（2）。最后，将测试一组假设，以估计结构 研究1中开发的编码方案的有效性，通过检查EBT类型之间的预期关联 修改和临床医生和学校水平的变量（研究目标3）。结合起来，这两项研究将 为职业发展奖提供坚实的基础，重点关注EBT修改对 儿童/青少年心理健康结果。此外，通过设计和参与为期三年的 有针对性的培训活动，申请人将发展校本精神健康研究的专业知识， 获得实施科学，文化适应和混合方法的关键知识和技能 research.具体的培训目标是：1）建立背景相关干预的专业知识 研究，特别强调以学校为基础的心理健康研究; 2）扩大概念 通过整合两个相关但不同的， 文献-实施科学和文化适应; 3）发展混合的经验和专业知识 方法研究; 4）加强赠款和论文写作技能。