IMPROVING THE IMPLEMENTATION AND SUSTAINMENT OF EBPS IN MENTAL HEALTH: DEVELOPING AND PILOTING THE COLLABORATIVE ORGANIZATIONAL APPROACH TO SELECTING AND TAILORING IMPLEMENTATION STRATEGIES (COAST-IS

项目总结 儿童和青少年经历创伤的速度令人震惊，这可能导致严重的精神健康问题。 以创伤为中心的认知行为治疗(TF-CBT)是一种循证实践(EBP)，适用于 经历与创伤相关的情绪或行为困难。然而，就像其他EBP一样，TF-CBT是 未得到充分利用，即使当组织和系统采用它时，实现问题也会限制其 有效性。实施和维持TF-CBT和其他EBP可能需要多个 选择并量身定做实施战略，以解决多层次、特定于背景的决定因素 (障碍和促进者)。理想情况下，执行战略的选择和调整应以 理论、证据和来自相关利益相关者的投入；然而，指导选择和调整的方法 许多战略都不是很完善。此K01的目的是与SAMHSA资助的国家 儿童创伤应激网络(NCTSN)开发和试点合作组织方法，以 选择和定制实施战略(COSTAR-IS)。海岸-IS的干预将涉及 指导组织领导人和治疗师使用干预映射来选择和定制策略。 干预测绘是一个多步骤的过程，本质上是生态的，并结合了理论、证据和 利益相关者观点，以确保干预组成部分有效地解决以下关键决定因素 变化。在第一年合作开发海岸-IS之后，我们将进行一项随机试点试验 NCTSN学习协作内的干预，随机分配八个组织进行学习 只有协作性条件或学习协作性加海岸条件。然后我们将评估 COSTORY-IS的目标如下：1)评估可接受性、适当性、可行性和实用性 2)评价组织利益相关者对干预地图核心要素的忠诚度； (3)在更大规模的有效性试验中论证了STARTY-IS测试的可行性。要实现这些目标 旨在为更大规模的混合方法有效性试验做准备，申请者将在1) 干预研究，2)合作研究，3)实用随机对照试验，4)混合试验 方法在Morris Weinberger、Greg Aarons、Loretta Jones和Ken Wells博士的指导下进行研究。 这项工作意义重大，因为它将产生一种系统的方法，将理论、证据和 从利益攸关方的角度来提高执行战略的有效性和精确度。最终， COSTORY-IS可能有潜力改进广泛的EBPS的实施和维持 精神卫生和其他卫生部门。

PROJECT SUMMARY Children and youth experience trauma at alarming rates, which can lead to serious mental health problems. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based practice (EBP) for those who experience emotional or behavioral difficulties related to trauma. However, much like other EBPs, TF-CBT is underutilized, and even when organizations and systems adopt it, implementation problems can limit its effectiveness. Implementing and sustaining TF-CBT and other EBPs with fidelity may require that multiple implementation strategies be selected and tailored to address multilevel, context-specific determinants (barriers and facilitators). Ideally, the selection and tailoring of implementation strategies would be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. The purpose of this K01 is to partner with the SAMHSA-funded National Child Traumatic Stress Network (NCTSN) to develop and pilot the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS). The COAST-IS intervention will involve coaching organizational leaders and therapists to use Intervention Mapping to select and tailor strategies. Intervention Mapping is a multistep process that is inherently ecological and incorporates theory, evidence, and stakeholder perspectives to ensure that intervention components effectively address key determinants of change. After collaboratively developing COAST-IS in Year 1, we will conduct a randomized pilot trial of the intervention within an NCTSN learning collaborative, randomly assigning eight organizations to the learning collaborative-only condition or the learning collaborative plus COAST-IS condition. We will then evaluate COAST-IS in the following aims: 1) to assess the acceptability, appropriateness, feasibility, and utility of COAST-IS; 2) to evaluate organizational stakeholders' fidelity to the core elements of Intervention Mapping; and 3) to demonstrate the feasibility of testing COAST-IS in a larger effectiveness trial. To accomplish these aims and prepare for a larger mixed methods effectiveness trial, the applicant will receive training in 1) intervention development, 2) partnered research, 3) pragmatic randomized controlled trials, and 4) mixed methods research under the direction of Drs. Morris Weinberger, Greg Aarons, Loretta Jones, and Ken Wells. This work is significant because it will yield a systematic method that integrates theory, evidence, and stakeholder perspectives to improve the effectiveness and precision of implementation strategies. Ultimately, COAST-IS may have the potential to improve implementation and sustainment of a wide-range of EBPs in mental health and other health sectors.