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

项目摘要/摘要 这一职业发展奖的目标是获取知识，发展技能，并获得实践 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进食障碍的青少年开展循证治疗； 特别是通过利用技术来增加EBT的采用。患有急症的年轻人在公众中的服务很差 由于缺乏EBT培训，使这些青年容易出现医疗并发症、住院和 漫长的病程。在实施科学家Joseph Guyish的指导下，博士，公共卫生硕士 以及由专家共同导师和顾问组成的团队，申请者将接受旨在1)学习的培训 实施科学模型、方法和分析技术，以增加EBT的采用， 实施和服务不足青年的可持续性；2)在开发和测试方面获得专业知识 改善EBT实施的技术；以及3)在少数群体健康和健康差距方面建立专门知识 研究。拟议的研究包括两个相互建立在一起的目标，以支持这些培训目标。 目的1将研究以家庭为基础的治疗(FBT)对患有神经性厌食症和非典型厌食症的青少年的适应性 神经性厌食症的五名临床医生和15个家庭在某县精神卫生部门的实施情况调查 系统。实施的主要成果是保真度和适应性，这将用于进一步的适应性 AIM 2的FBT。半结构化访谈将探索提供商在实施FBT方面的经验(n=5) 患有急症的青年(例如，实施挑战、适应治疗的理由)，以及照顾者的 8例接受FBT治疗的经历。这些项目支持针对目标2的治疗改进和调整， 它将开发和试点测试基于Web的 在适应的FBT模型中，培训(n=9)与面对面培训(n=9)进行比较。研究结果将有助于 作为R01研究的试点数据，重点是经济高效的培训模式，以支持以下项目的EBT实施 向有急救服务的青年提供援助，特别是宣传努力改善不同、服务不足的青年获得护理的机会。 这项建议与NIMH战略目标(4.1，4.2)保持一致，以提高现有精神的有效性 《卫生服务》和《传播、实施和持续改进循证医学》 通过研究和研究--实践伙伴关系提供“精神健康服务”，特别是对“服务不足” 人口数量。“精心组建的指导团队，卓越的科学环境，并提出了 培训和研究活动将支持应聘者的职业发展，最终公开提高- 资助对患有急症的高危、未充分研究的青年的临床护理。

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.