Project 3

项目3

• 批准号: 10549716
• 负责人: Aaron Robert Lyon
• 金额: $ 9.86万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-04-08
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10549716
• 关键词: Attitude; Behavior Control; Belief; Characteristics; Client; Climate; Clinical; Cognitive Therapy; Community Practice; Consultations; Development; Education; Effectiveness; Enrollment; Evidence based practice; Family; Feedback; Funding; Goals; Happiness; Hour; Individual; Intervention Studies; Leadership; Link; Measures; Mental Health; Mental Health Services; Methods; Modeling; Motivation; National Institute of Mental Health; Outcome; Pathway interactions; Persons; Procedures; Provider; Public Health; Randomized Controlled Trials; Research; Research Project Grants; Resource-limited setting; Resources; Rest; Schools; Science; Series; Students; Testing; Training; Trauma; Washington; Youth; analog; base; behavior change; clinical implementation; community setting; confirmatory trial; design; digital; eHealth; effective intervention; implementation efforts; implementation strategy; improved; innovation; motivational enhancement therapy; provider behavior; randomized trial; social influence; social norm; teacher; theories; universal prevention; web-enabled

PROJECT SUMMARY Although up to 80% of mental health services for youth are currently provided in schools, few students receive evidence-based practices (EBPs). Even when organizational supports are in place, implementation ultimately rests with providers' motivation for change. Individual provider behavior change is critical to achieve high-quality implementation and positive outcomes for youth. For the public to benefit from the decades of research invested in EBP development, implementation strategies that target provider motivation are needed. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a four-hour, facilitated, group- based, blended implementation strategy designed to augment standard EBP training and consultation procedures by improving provider engagement and motivation. Using strategic education, motivational interviewing, and social influence strategies, BASIS aims to impact key, theoretically-derived, individual-level mechanisms associated with clinician behavior change—attitudes, social norms, and perceived behavioral control—to improve treatment quality (i.e., fidelity), and youth outcomes. In two previous trials, BASIS delivered in-person demonstrated evidence of feasibility, appropriateness, and efficacy, but it could be optimized for greater scalability and efficiency, so that it can be used widely to positively impact clinicians' engagement. Consistent with the goals of the IMPACT Center, the current project will focus on increasing BASIS scalability by (1) optimizing BASIS to include only the most essential components for activating its target mechanisms and (2) adapting its delivery to a web-enabled digital platform. We will build causal pathways using theory and stakeholder input (practice community, youth), enroll representative end users, and use rapid analogue methods (RAM) to efficiently identify and test BASIS components, as well as prioritize them for digital deployment. Aims of this study are to apply IMPACT Center methods in order to: (1) Identify and prioritize BASIS components via causal pathway diagramming; (2) Conduct tests of prioritized BASIS components using RAM to inform the development of an optimized eHealth adaptation of BASIS (eBASIS); and (3) Test the impact of eBASIS on EBP fidelity and youth outcomes in a randomized controlled trial (RCT). Key organizational factors (e.g., leadership, implementation climate, school characteristics) will be measured as covariates during the RCT. Promising findings would support an R01 application for a confirmatory trial evaluating the impact of eBASIS on fidelity and youth outcomes. We anticipate that the eBASIS implementation strategy will be readily scalable and could enhance the impact of EBP integration efforts to improve treatment quality and outcomes for youth in the education sector and other low-resource community settings.

项目摘要 虽然目前有高达80%的青少年心理健康服务是在学校提供的， 循证实践（EBP）。即使组织支持到位，最终的实施 取决于提供者的改变动机。个体提供者的行为改变对于实现高质量 为青年人带来积极成果。为了让公众从数十年的研究中受益， 在EBP开发中，需要针对供应商动机的实施策略。 信念和态度在学校成功实施（基础）是一个四小时，促进，小组- 基于混合的实施策略，旨在增强标准EBP培训和咨询 通过提高提供者的参与度和积极性来改进程序。利用战略教育，激励 访谈和社会影响战略，BASIS旨在影响关键的，理论推导的，个人层面的 与临床医生行为改变相关的机制-态度、社会规范和感知行为 控制-为了提高治疗质量（即，忠诚度）和青年成果。在之前的两次试验中，BASIS提供了 亲自证明了可行性、适当性和有效性的证据，但可以进行优化， 更高的可扩展性和效率，因此它可以广泛用于积极影响临床医生的参与。 根据IMPACT中心的目标，目前的项目将侧重于提高BASIS的可扩展性 通过（1）优化BASIS以仅包括用于激活其目标机制的最基本的组分， (2)使其交付适应网络数字平台。我们将建立因果路径使用理论和 利益相关者投入（实践社区、青年），招募有代表性的最终用户，并使用快速模拟方法 (RAM)有效地识别和测试BASIS组件，并为数字化部署确定优先级。 本研究的目的是应用IMPACT中心的方法，以便：（1）识别和优先考虑BASIS （2）使用RAM对优先化的BASIS组件进行测试， 为BASIS（eBASIS）的优化电子卫生适应性开发提供信息;以及（3）测试 EBASIS对EBP保真度和青年结局的随机对照试验（RCT）。关键组织因素 (e.g.,领导力、实施氛围、学校特色）将作为RCT期间的协变量进行测量。 有希望的发现将支持R 01应用于验证性试验，以评估eBASIS对以下方面的影响： 忠诚和青年成果。我们预计eBASIS实施战略将易于扩展， 可以加强EBP整合工作的影响，以改善治疗质量和青年的结果， 教育部门和其他资源匮乏的社区环境。