Optimizing CBT Implementation among Community Providers Through Internet-based Consultation and Networking (i-CAN)

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PROJECT SUMMARY The goal of this exploratory/developmental (R21) project is to advance the uptake of cognitive- behavioral therapy (CBT), an evidence-based intervention (EBI) for youth anxiety problems, by community-based providers. Using readily available, commercial-grade software, we will develop a highly replicable remote (online) peer consultation and support hub. This hub, termed Internet-based Consultation and Networking [i-CAN], will be developed with input from stakeholders, including community providers, using a participatory implementation workgroup approach. We will then test the feasibility and preliminary impact of i-CAN in the context of a pilot randomized controlled trial with a diverse sample of providers. The purpose of program announcement PAR-19-275 is to “support innovative approaches to identifying, understanding, and developing strategies for overcoming barriers to the adoption…of evidence-based interventions.” Although clinical anxiety is one of the most impairing and common mental health problems seen among children and adolescents1, and CBT is considered an established EBI for anxiety disorders2, most youth do not receive high-quality CBT in their home communities. This implementation gap is especially prominent for youth who live in rural areas, communities of color, and low-resources settings.3–5 We are testing i-CAN in a large community that is characterized by rurality and poverty, and which is highly racially diverse, because remote peer consultation may be especially beneficial for providers who cannot otherwise access in-person support to improve their skills. As such, this project addresses disparities by improving access to EBI resources and tools among the providers who work in under-served communities. In addition to high