Fidelity, Assessment and Clinical Effectiveness Tracking (FACET) System: Making EBTs Feasible and Sustainable

在治疗青少年药物滥用和相关问题方面的进展导致 强调将资源重新定向，以将循证治疗(EBTS)转移到“现实世界”环境中，但 科学与实践的差距仍然是一个紧迫的问题。由于高度复杂和多方面的过程 参与将循证技术转化为实践环境和许多扩散障碍，包括缺乏资源， 基础设施、技术和质量保证能力，只有一小部分人在接受治疗 对于物质使用障碍(SUD)，接受EBTS。此外，在疗效试验中取得的显著成果是 如果不加强对保真度的监测，就很难在实际实践中复制，而保真度是成功的一个重要组成部分。 缺乏可行的成本效益高的保真度监测工具和上层建筑，以确保以社区为基础 从业者坚持提供称职和坚守的服务是传播的主要障碍； 迫切需要创新的方法和程序。拟议的第二期SBIR将完成 开发商业上可行的理论指导、经验为基础、用户友好的在线反馈和 监测系统，“保真度、评估和临床效果跟踪”(方面)，以指导和维持 EBTS的实施，并在随机试验中对该系统进行评估。Facet旨在培养临床医生的 自我调节治疗依从性，并为社区计划提供更直接的质量途径 与保持忠诚和实现积极的青年和家庭治疗有关的保证信息 结果。这项随机试验将在交错的队列中进行，并顺序推出针对 队列内的临床医生(n=60；每个队列20名)，以提高研究的可行性。临床医生将接受培训，以提供 功能性家庭治疗(FFT)，一种针对青少年药物滥用和共生的既定治疗方法 有问题。在每个队列中，治疗地点将被随机分为照常实施(IAU)或 分面辅助实施(FAI)和临床医生将参与其雇用现场的条件。 测量将涉及多方法、多源数据收集。临床医生将完成五项评估 超过9个月的时间。与IAU相比，FAI对执行成果的影响将使用以下方法进行评估 临床医生EBT知识和疗效的测量、临床医生EBT技能和工作的行为观察 与为潜在客户节省员工时间相关的流程改进。采用刻面是意料之中的 弥合科学与实践的鸿沟，增强快速傅立叶变换的吸引力、用户友好性和市场化程度 LIFFT，Co.向青少年门诊药物治疗计划提供的宣传服务 该项目将产生一个基于证据的监测系统，该系统可以在可重复和可扩展的 商业模式。该项目的主要长期目标是为市场营销建立一个数据驱动的基础 商业方面的系统与EBT的传播相结合，并为以下方面建立潜力 其他域。

Advances in treating adolescent substance abuse and related problems have resulted in an increased emphasis on redirecting resources to transport evidence-based treatments (EBTs) into “real-world” settings, yet the science-practice gap remains a pressing problem. Due to highly complex and multifaceted processes involved in translating EBTs to practice settings and to a host of diffusion barriers, including lack of resources, infrastructure, and technology-based and quality assurance capacity, only a fraction of individuals in treatment for substance use disorder (SUD) receive EBTs. Further, the significant gains achieved in efficacy trials are difficult to replicate in actual practice without intensive monitoring of fidelity, an essential component of success. The lack of feasible cost efficient fidelity monitoring tools and superstructures to ensure community-based practitioners sustain competent and adherent service delivery represents a major impediment for dissemination; innovative methods and procedures are urgently needed. The proposed Phase II SBIR will complete the development of a commercially viable theory-guided, empirically based, and user-friendly online feedback and monitoring system, “Fidelity, Assessment, and Clinical Effectiveness Tracking” (FACET), to guide and sustain the implementation of EBTs and evaluate the system in a randomized trial. FACET is designed to foster clinicians' self-regulation of treatment adherence and provide community programs with more direct access to quality assurance information pertinent to maintaining fidelity and achieving positive youth and family treatment outcomes. The randomized trial will be conducted in staggered cohorts, with a sequential roll-out of training for clinicians within cohorts (n=60; 20 per cohort) to enhance study feasibility. Clinicians will be trained to deliver Functional Family Therapy (FFT), an established treatment for adolescent substance abuse and co-occurring problems. Within each cohort, treatment sites will be randomized to either Implementation as Usual (IAU) or FACET-assisted implementation (FAI) and clinicians will participate in the condition of their employing site. Measurement will involve multi-method, multi-source data collection. Clinicians will complete five assessments over a 9-month period. The impact of FAI, compared to IAU on implementation outcomes will be assessed using measures of clinician EBT knowledge and efficacy, behavioral observations of clinician EBT skills, and work process improvements linked to staff time savings for potential customers. The adoption of FACET is expected to bridge the science-practice gap and enhance the appeal, user-friendliness, and marketability of FFT dissemination services delivered to adolescent outpatient drug treatment programs by LIFFT, Co. The proposed project will result in an evidence-based monitoring system that can be marketed within a repeatable and scalable business model. The primary long-term goal of this project is to establish a data-driven foundation for marketing the commercial FACET system in conjunction with EBT dissemination and establish the potential for FACET for other domains.