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

在公共资助的环境中调整和实施针对神经性厌食症青少年的家庭治疗

• 批准号: 10228739
• 负责人: Erin Cecilia Accurso
• 金额: $ 19.91万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10228739
• 关键词: Adoption; Anorexia Nervosa; Area; Caregivers; Chronic; Clinic; Clinical; Code; Collaborations; Communities; Consultations; County; Data; Development; Disease; Dissemination and Implementation; Doctor of Philosophy; E-learning; Eating Disorders; Economics; Effectiveness; Environment; Evidence based treatment; Face; Family; Family Study; Funding; Future; Goals; Health Services Accessibility; Health system; Healthcare; Hospitalization; Improve Access; Individual; Intervention; Interview; K-Series Research Career Programs; Knowledge; Learning; Letters; Libraries; Medicaid; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methodology; Methods; Modeling; Modification; National Institute of Mental Health; Outcome; Partnership Practice; Persons; Population; Provider; Psychopathology; Public Health; Public Sector; Research; Research Activity; Research Support; Resources; Risk; San Francisco; Scientist; Services; Structure; Techniques; Technology; Testing; Training; Training Activity; Training Support; Treatment Effectiveness; Treatment Factor; Treatment outcome; Underrepresented Minority; Underserved Population; Videotape; Vulnerable Populations; Weight; Work; Youth; barrier to care; base; career development; clinical care; cost; cost effective; design; effective therapy; ethnic diversity; evidence base; experience; flexibility; health disparity; health equity; high risk; implementation barriers; implementation outcomes; implementation science; improved; improved outcome; learning community; medical complication; minority health; mortality; racial and ethnic; skills; sociodemographics; socioeconomic disadvantage; suicide rate; theories; treatment response

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.

项目概要/摘要 该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) 在资源贫乏地区针对饮食失调 (ED) 青少年的循证治疗 (EBT)， 特别是通过利用技术来提高 EBT 的采用率。患有 ED 的青少年在公众中得不到良好的服务 由于缺乏 EBT 培训，这些年轻人很容易出现医疗并发症、住院治疗和 病程较长。在实施科学家 Joseph Guydish 博士、公共卫生硕士的指导下 以及由专家共同导师和顾问组成的团队，申请人将接受旨在 1) 学习的培训 实施科学模型、方法论和分析技术，以提高 EBT 的采用率， 服务不足的青年的实施和可持续性； 2）获得开发和测试方面的专业知识 改善 EBT 实施的技术； 3) 建立少数民族健康和健康差异方面的专业知识 研究。拟议的研究包括两个相互促进的目标，以支持这些培训目标。 目标 1 将研究神经性厌食症和非典型性厌食症青少年对家庭治疗 (FBT) 的适应情况 通过检查某县心理健康中心 15 个家庭的 5 名临床医生的实施情况来研究神经性厌食症 系统。主要的实施成果是保真度和适应性，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，实施挑战、治疗调整的理由）以及护理人员的 接受 FBT 的经历 (n = 8)。这些项目支持目标 2 的治疗细化和调整， 它将开发和试点测试基于网络的可接受性、利用率和初步有效性 培训 (n = 9) 与改编后的 FBT 模型中的现场培训 (n = 9) 相比。研究成果将服务于 作为 R01 研究的试点数据，该研究重点关注具有成本效益的培训模型，以支持 EBT 的实施 患有 ED 的青少年，特别是为改善不同的、服务不足的青少年获得护理的机会提供信息。 该提案与 NIMH 战略目标（4.1、4.2）相一致，旨在提高“现有心理治疗的有效性”。 卫生服务”和“基于证据的传播、实施和持续改进” 通过研究和研究实践伙伴关系提供“精神卫生服务”，特别是针对“服务不足的群体” 人口。”精心组建的导师团队、优越的科研环境、 培训和研究活动将支持候选人的职业发展，最终提高公共- 为患有 ED 的高风险、未充分研究的青少年提供临床护理资助。