Adapting and Implementing Family-Based Treatment for Youth with Anorexia Nervosa in Publicly-Funded Settings

项目总结/摘要 这个职业发展奖的目标是获得知识，发展技能，并获得实际的 使申请人能够在传播和实施方面进行独立研究的经验 （D&I）在资源不足的环境中为患有饮食失调（ED）的青年提供循证治疗（EBT）， 特别是通过利用技术来增加EBT的采用。患有ED的青少年在公共场所的服务很差 由于缺乏EBT培训，这些年轻人容易出现医疗并发症，住院治疗， 长期的病程在实施科学家Joseph Guydish博士的指导下， 以及一个由专家共同导师和顾问组成的团队，申请人将接受旨在1）学习 实施科学模型、方法和分析技术，以提高EBT的采用率， 为服务不足的青年提供实施和可持续性; 2）获得开发和测试方面的专业知识 改善EBT实施的技术;以及3）建立少数民族健康和健康差异方面的专业知识 research.拟议的研究包括两个目标，建立在对方，以支持这些培训目标。 目的1将研究适应以家庭为基础的治疗（FBT）的青年神经性厌食症和非典型性厌食症。 神经性厌食症的检查实施由5名临床医生与15个家庭在一个县的精神卫生 系统主要的实施成果是忠实性和适应性，这将用于进一步适应 目标2的FBT。半结构化访谈将探讨提供者在实施FBT方面的经验（n = 5）， 患有ED的青少年（例如，实施方面的挑战，治疗调整的理由），以及护理人员的 接受FBT的经验（n = 8）。这些项目支持为实现目标2而改进和调整治疗方法， 该机构将开发并试点测试基于网络的可接受性、利用率和初步有效性 训练（n = 9）与在适应的FBT模型中的亲自训练（n = 9）相比。研究结果将用于 作为R 01研究的试点数据，该研究侧重于支持EBT实施的成本效益培训模式， 这份报告旨在帮助患有ED的青年，特别是为改善各种服务不足的青年获得护理的机会提供信息。 该建议与NIMH战略目标（4.1，4.2）一致，以提高“现有心理健康的有效性”。 卫生服务”和“传播，实施，并不断改进的循证 通过研究和研究实践伙伴关系，特别是为“服务不足”的人提供“精神卫生服务” 人口”。精心组建的指导团队，特殊的科学环境， 培训和研究活动将支持候选人的职业发展，最终提高公众- 为高风险、未被充分研究的ED青少年提供临床护理。

PROJECT SUMMARY/ABSTRACT The objectives of this career development award are to acquire knowledge, develop skills, and gain practical experience that enable the applicant to pursue independent research in dissemination and implementation (D&I) of evidence-based treatments (EBTs) in underresourced settings for youth with eating disorders (EDs), particularly by leveraging technology to increase EBT adoption. Youth with EDs are poorly served in the public sector due to lack of EBT training, leaving such youth vulnerable to medical complications, hospitalization, and a prolonged course of illness. Under the mentorship of implementation scientist Joseph Guydish, PhD, MPH and a team of expert co-mentors and consultants, the applicant will pursue training designed to 1) learn implementation science models, methodology, and analytic techniques to increase EBT adoption, implementation, and sustainability for underserved youth; 2) gain expertise in developing and testing technologies that improve EBT implementation; and 3) build expertise in minority health and health disparities research. The proposed research includes two aims that build on each other to support these training goals. Aim 1 will study adaptations to family-based treatment (FBT) for youth with anorexia nervosa and atypical anorexia nervosa by examining implementation by five clinicians with fifteen families in a county mental health system. The primary implementation outcomes are fidelity and adaptations, which will be used to further adapt FBT for Aim 2. Semi-structured interviews will explore provider experiences (n = 5) in implementing FBT for youth with EDs (e.g., implementation challenges, rationale for treatment adaptations), as well as caregivers' experiences (n = 8) receiving FBT. These projects support treatment refinement and adaptations for Aim 2, which will develop and pilot test the acceptability, utilization, and preliminary effectiveness of a web-based training (n = 9) compared to in-person training (n = 9) in the adapted FBT model. The study results will serve as pilot data for an R01 study focused on cost-effective training models to support EBT implementation for youth with EDs, particularly informing efforts to improve access to care across diverse, underserved youth. This proposal aligns with NIMH Strategic Objectives (4.1, 4.2) to improve the “effectiveness of existing mental health services” and the “dissemination, implementation, and continuous improvement of evidence-based mental health services” through research and research-practice partnerships, particularly for “underserved populations.” The carefully-assembled mentoring team, exceptional scientific environment, and proposed training and research activities will support the candidate's career development to ultimately improve publicly- funded clinical care for high-risk, understudied youth with EDs.