Exploring and Developing Implementation Strategies to Support Parent Coaching

探索和制定支持家长辅导的实施策略

• 批准号: 9979976
• 负责人: David S Mandell
• 金额: $ 24.3万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-17 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9979976
• 关键词: Address; Adult; Affect; Application procedure; Attention; Attitude; Behavior; Behavioral; Belief; Child; Communities; Community Trial; Conflict (Psychology); Development; Early Intervention; Effectiveness; Environmental Risk Factor; Exhibits; Family; Feedback; Foundations; Funding; Goals; Grant; Guidelines; Intervention; Interview; Leadership; Learning; Measurement; Measures; Mediating; Methods; Modeling; Motivation; Organizational Culture; Outcome; Parents; Philadelphia; Planning Theory; Play; Principal Investigator; Procedures; Process; Provider; Qualitative Methods; Randomized; Request for Applications; Research Design; Research Institute; Research Methodology; Risk; Role; Sampling; Self Efficacy; Services; Structure; Surveys; System; Techniques; Testing; Time; Training; autism spectrum disorder; autistic children; base; behavior change; community setting; design; effectiveness evaluation; evidence base; expectation; field study; implementation strategy; improved; innovation; interest; novel; novel strategies; organizational climate; patient oriented; pedagogy; programs; prototype; provider intervention; psychologic; randomized trial; symptom treatment; theories

Program Director/Principal Investigator (Last, First, Middle): Pellecchia, Melanie & Mandell, David Samuel PROJECT SUMMARY The purpose of this R21 is to develop a toolkit of implementation strategies that increase early intervention (EI) providers' use of parent coaching for families of young children with or at risk for autism spectrum disorder (ASD). Many evidence-based parent-mediated interventions have been developed in recent years and share interven- tion components designed to 1) treat the symptoms of ASD, and 2) coach parents in the use of these treatments. While the intervention components used to treat children with ASD have received considerable attention with regard to their implementation in community settings, the strategies used to coach parents have not. Coaching is the active mechanism through which therapists change parent behavior, but comprises an understudied set of targets for implementation. Preliminary evidence shows that community-based EI providers spend most of their time working directly with the child, rather than coaching parents, despite calls from EI leaders to move from a model of direct service to one that incorporates coaching parents. Small studies suggest that this implementa- tion gap relates to providers' poor self-efficacy, conflicting pedagogical attitudes, and lack of clarity regarding expectations about using parent coaching. Organizational and systemic barriers also may inhibit the use of par- ent coaching by affecting clinicians' beliefs about its use or creating barriers that stop clinicians from acting on their intentions to coach parents. Implementation strategies that address barriers related to both psychological and organizational variables affecting the use of parent coaching are most likely to be effective. Using commu- nity-partnered participatory research (CPPR) methods offers a novel approach to developing strategies to sup- port the use of parent coaching. A new initiative in Philadelphia's EI system, through which EI providers will be trained in Project ImPACT, an evidence-based, parent-mediated treatment for young children with ASD, presents a rare opportunity to develop and pilot test these implementation strategies. Through this study, we will measure psychological and organizational constructs that influence EI providers' use of parent coaching through direct observations, quantitative surveys, and qualitative interviews. We then will partner with community stakeholders to iteratively develop and test implementation strategies to increase EI providers' use of parent coaching. We will rely on our recently funded ALACRITY center grant to support the use of innovative methods to rapidly develop and pilot test these implementation strategies. Successful completion of this project will result in a novel, easy-to-use toolkit of implementation strategies to help EI providers coach parents of children with ASD. These activities will lay the foundation for an R01 to evaluate the implementation and effectiveness of this toolkit in a later randomized community trial. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page

项目总监/首席研究员（最后，第一，中间）：Pellecchia，Melanie & Mandell，大卫塞缪尔 项目摘要 R21的目的是开发一套实施战略，以增加早期干预（EI） 提供者对患有自闭症谱系障碍（ASD）或有患自闭症谱系障碍风险的幼儿家庭的家长辅导。 近年来，许多以证据为基础的父母介导的干预措施已经开发出来，并分享了干预措施， 设计用于1）治疗ASD症状的治疗组件，以及2）指导父母使用这些治疗方法。 虽然用于治疗ASD儿童的干预成分受到了相当大的关注， 至于在社区环境中的执行情况，用于指导父母的战略还没有。教练 是治疗师改变父母行为的积极机制，但包括一个未充分研究的集合， 执行的目标。初步证据表明，社区EI提供者花费的大部分时间 他们的时间直接与孩子一起工作，而不是指导父母，尽管EI领导人呼吁从 一种直接服务于一个包括辅导父母的模式。小规模的研究表明，这一实施- 教育差距与提供者的自我效能差，相互冲突的教学态度，以及缺乏明确的 对使用家长指导的期望。组织和系统障碍也可能阻碍使用平价- 通过影响临床医生对其使用的信念或创造阻止临床医生采取行动的障碍来进行指导 指导父母的意图。实施战略，解决与心理和社会方面的障碍， 而影响父母辅导使用的组织变量最有可能是有效的。使用commu- 社区合作参与式研究（CPPR）方法提供了一种新的方法来制定战略， 使用家长指导。费城EI系统的一项新举措，通过该举措，EI提供者将 经过ImPACT项目培训，该项目是一项针对ASD幼儿的循证，父母介导的治疗方法， 这是制定和试点测试这些实施策略的难得机会。通过这项研究，我们将 心理和组织结构，影响EI提供者使用父母辅导，通过直接 观察、定量调查和定性访谈。然后，我们将与社区利益相关者合作 反复开发和测试实施策略，以增加EI提供者对父母辅导的使用。我们 我们将依靠我们最近资助的ALACRITY中心赠款，以支持使用创新方法， 制定并试行这些实施战略。这个项目的成功完成将导致一部小说， 易于使用的实施策略工具包，以帮助EI提供者指导ASD儿童的父母。这些 这些活动将为R 01评估该工具包的实施和有效性奠定基础， 后来的随机社区试验。 PHS 398/2590（Rev.06/09）

项目成果

Parent Coaching in Early Intervention for Autism Spectrum Disorder: A Brief Report.

自闭症谱系障碍早期干预的家长指导：简要报告。

• DOI: 10.1177/10538151221095860
• 发表时间: 2023
• 期刊: Journal of early intervention
• 影响因子: 1.4
• 作者: Pellecchia,Melanie;Mandell,DavidS;Beidas,RinadS;Dunst,CarlJ;Tomczuk,Liza;Newman,Jeannette;Zeigler,Lisa;Stahmer,AubynC
• 通讯作者: Stahmer,AubynC

Who gets coached? A qualitative inquiry into community clinicians' decisions to use caregiver coaching.

• DOI: 10.1177/13623613211059499
• 发表时间: 2022-04
• 期刊: Autism : the international journal of research and practice
• 作者: Tomczuk L;Stewart RE;Beidas RS;Mandell DS;Pellecchia M
• 通讯作者: Pellecchia M