Finalizing and Testing an Online Therapist Training and Assistance Program to Facilitate Implementation of Comprehensive Behavioral Intervention for Tic Disorders (CBIT-Trainer)

最终确定并测试在线治疗师培训和援助计划，以促进抽动障碍综合行为干预的实施（CBIT-Trainer）

• 批准号: 10679070
• 负责人: Michael B Himle
• 金额: $ 88.34万
• 依托单位: PSYC TECH, LTD
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-16 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10679070
• 关键词: Address; Adopted; Adoption; Affect; Aftercare; Attitude; Behavior Disorders; Behavior Therapy; Behavioral tic; Benchmarking; Childhood; Clinical; Collection; Computers; Consultations; Continuing Education; Data; Development; Distress; Effectiveness; Enrollment; Evaluation; Evidence based intervention; Evidence based practice; Evidence based treatment; Feedback; Gilles de la Tourette syndrome; Happiness; Impairment; Individual; International; Intervention; Letters; Measures; Modality; Motor; Neurodevelopmental Disorder; Outcome; Patient-Focused Outcomes; Patients; Persons; Pharmacotherapy; Phase; Population; Process; Protocols documentation; Provider; Qualitative Methods; Quality of life; Randomized, Controlled Trials; Recommendation; Reporting; Research; Research Methodology; Risk; Self Administration; Self Efficacy; Severities; Small Business Innovation Research Grant; Speed; Techniques; Technology; Testing; Tic disorder; Training; Training Programs; Treatment outcome; Vocal Tic Disorders; blind; disability; effectiveness/implementation design; effectiveness/implementation hybrid; follow-up; health care model; human capital; implementation facilitation; implementation framework; implementation process; impression; improved; innovation; neuropsychiatric disorder; nondrug therapy; optimism; patient response; peer support; phase 1 study; phase 1 testing; pilot test; preference; prevent; primary outcome; programs; psychoeducation; psychoeducational; repetitive behavior; satisfaction; side effect; skills; social; technology development; treatment response; trial comparing

Project Summary/Abstract Tic disorders (TD) are a class of childhood-onset neuropsychiatric disorders that occur in 1-3% of the population and often cause significant impairment in physical, social, academic, and interpersonal functioning and reduce quality of life. There is currently no cure for TD, however large-scale randomized controlled trials have shown that a non-drug treatment known as Comprehensive Behavioral Intervention for Tics (CBIT) can reduce tics without the adverse side effects associated with pharmacotherapy. Although CBIT is now recommended as a first-line intervention for TD, most patients cannot get CBIT due to a lack of trained therapists. Given the need and desire for CBIT among individuals with TD, high demand for therapist trainings, and the lack of therapists adequately trained in CBIT, there is a clear need for innovative ways to train more providers in this evidence-based treatment. The current proposal partners two of the primary developers of CBIT with PsycTech, a company that specializes in developing effective computer-based products for repetitive behavior disorders. In the proposed project, we will first finalize development of an innovative online program for training therapists to deliver CBIT (called CBIT-Trainer). Throughout the development process, we will engage multiple stakeholders in order to identify provider- and organizational-level factors shown to influence adoption and implementation of adapted interventions in other health-care models and settings. Upon completion, CBIT-Trainer will be tested against an intensive in-person therapist training program in a randomized controlled trial. This Phase II project will accomplish five aims: (1) to use a stakeholder-informed feedback process to complete the development of CBIT-Trainer, (2) to compare CBIT-Trainer to traditional in- person training on therapists’ ability to administer CBIT, (3) to compare CBIT-Trainer to in-person training on patient outcomes when they are treated by a CBIT-trained therapist, (4) to identify and address therapist factors that will improve (or limit) adoption and use of CBIT-Trainer, and (5) to identify therapist factors likely to influence therapists’ continued use of CBIT in their practice after training. To test these aims, we utilize an effectiveness-implementation hybrid design to conduct a randomized controlled trial comparing CBIT-Trainer to the Tourette Association of America’s Behavior Therapy Training Institute (BTI), which is the current gold- standard for training CBIT therapists. We plan to enroll 234 CBIT-naïve therapist-patient dyads to participate in the study. Our primary therapist outcomes will be therapist skill in delivering CBIT, which will be assessed at post-training (Week 0), after administering CBIT with a patient (Week 10), and at 6-month follow-up (Week 34). Our primary patient outcomes will be overall clinical improvement assessed at pre-treatment (Week 0), post- treatment (Week 10), and 6-month follow up (Week 34). As a secondary aim, we will also assess therapist- level facilitators and barriers to adopting CBIT-Trainer, as well as implementing and sustaining CBIT in their practice, after training. If CBIT-Trainer is effective for training therapists to deliver CBIT with fidelity, it has the potential to increase the number of therapists available to treat TD. In addition, the technology itself could be leveraged easily to advance the technological development and testing of similar training programs for other evidence-based interventions (EBIs), thereby speeding dissemination and availability of EBIs for other clinical problems. Moreover, CBIT-Trainer is proposing a unique research methodology that could be readily applied to similar projects seeking to expand the evaluation of training and treatment outcomes for EBIs that have historically relied too heavily on a human-capital intensive training approach.

项目总结/文摘