Exploring and Developing Implementation Strategies to Support Parent Coaching

项目主管/首席研究员（最后，第一，中）：Pellecchia, Melanie & Mandell, David Samuel

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