Identifying Effective Organizational Climate Embedding Mechanisms for Autism Interventions

确定自闭症干预的有效组织氛围嵌入机制

• 批准号: 10825089
• 负责人: Elizabeth Rangel
• 金额: $ 4.04万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-06 至 2025-09-05
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10825089
• 关键词: Caring; Centers for Disease Control and Prevention (U.S.); Child; Climate; Clinical; Community Services; Complement; Data; Development; Education; Educational process of instructing; Evidence based intervention; Evidence based practice; Exploration, Preparation, Implementation, and Sustainment; Fostering; Funding; Goals; Health; Health Services Research; Hybrids; Individual; Intervention; Interview; Investigational Therapies; Leadership; Link; Literature; Measures; Mediating; Mental Health; Mentors; Methods; Modeling; National Institute of Mental Health; National Research Service Awards; Organizational Change; Organizational Culture; Outcome; Parents; Perception; Provider; Randomized, Controlled Trials; Reporting; Research; Role; Schools; Scientist; Service setting; Services; Source; Strategic Planning; Structure; System; Testing; Time; Training; Translating; United States; autism spectrum disorder; autistic children; career; child mental health service; community setting; effective intervention; effectiveness testing; implementation determinants; implementation facilitation; implementation intervention; implementation outcomes; implementation science; implementation strategy; improved; medical specialties; meetings; organizational climate; programs; prospective; routine care; school district; telephone coaching; tool; training opportunity

PROJECT SUMMARY /ABSTRACT The Centers for Disease Control and Prevention estimates that 1 in 44 children have autism. Implementing evidence-based practices (EBPs) is crucial for their meeting their needs. However, there are challenges to delivering EBPs for autistic children in routine services. This proposal leverages data from the TEAMS (Translating Evidence-based Interventions for Autism: A Multi-Level Implementation Strategy) Hybrid Type III trials. TEAMS aimed to improve implementation of EBPs by testing multi-level implementation strategies in children’s mental health services (Study 1 PI: Brookman-Frazee, R01-MH111950) and schools (Study 2 PI: Stahmer, R01-MH111981). Specifically, the TEAMS trials applied the Exploration, Preparation, Implementation, Sustainment (EPIS) framework and utilized the Leadership and Organizational Change for Implementation (LOCI) strategy to test the effectiveness of two multi-component implementation strategies. TEAMS targeted organizational and provider level mechanisms. The organization level implementation strategy (TEAMS Leadership Institute, TLI), an adapted version of the Leadership and Organizational Change for Implementation (LOCI) strategy, targeted organizational implementation leadership and climate as mechanisms. The proposed study will supplement the primary study aims by exploring a new potential mechanism of TLI – climate embedding mechanisms (CEM). The construct of CEM refers to tools that leaders utilize to teach their organizations how to perceive, think, feel, and behave. This study aims to identify which individual CEM are most impactful to promote successful implementation and whether use of specific CEM mediates the associations between TLI and implementation and child outcomes. The objective of this NRSA application is to foster my development as an implementation scientist with a focus on organizational implementation factors and autism services research. The proposed project will examine climate embedding mechanisms as potential mechanisms of action of an organizational implementation strategy within two linked randomized controlled trials. Specifically, Aim 1 will identify individual climate embedding mechanisms associated with implementation (provider) and clinical (child) outcomes. Aim 2 will utilize quantitative methods to examine whether the individual climate embedding mechanisms identified in Aim 1 mediate the effects of TLI on implementation and clinical outcomes. Lastly, Aim 3 will use qualitative and mixed methods to complement and expand quantitative findings on additional climate embedding mechanisms and explain how individual mechanisms facilitated implementation of autism EBPs. The present proposal represents an important step in further understanding mechanisms of organizational implementation strategies. With support of my mentoring team, this proposal will launch my development toward a career as an independent implementation scientist focusing on organizational level strategies and mechanisms to improve EBP implementation in autism services settings.

项目摘要 /摘要 疾病控制与预防中心估计有44名儿童患有自闭症。 实施循证实践（EBP）对于满足他们的需求至关重要。但是，有 为有效的儿童提供日常服务的EBP面临的挑战。该建议利用了 团队（翻译基于证据的自闭症干预措施：一种多级实施策略）混合动力 III型试验。旨在通过测试多级实施来改善EBP的实施的团队 儿童心理健康服务的策略（研究1 PI：Brookman-Frazee，R01-MH111950）和学校 （研究2 PI：Stahmer，R01-MH111981）。具体而言，团队试验应用了探索，准备工作， 实施，维持框架（EPIS）框架并利用领导和组织变革 实施（LOCI）策略，以测试两种多组分实施策略的有效性。 团队针对组织和提供者级别机制。组织级实施 战略（TLI团队领导力研究所），这是领导力和组织变革的改编版本 为了实施（LOCI）战略，将组织实施领导和气候作为目标 机制。拟议的研究将通过探索新的潜力来补充主要研究的目的 TLI的机制 - 气候嵌入机制（CEM）。 CEM的结构是指领导者的工具 利用他们的组织如何感知，思考，感觉和行为。这项研究旨在确定哪个 个人CEM对促进成功实施以及是否使用特定CEM最有影响力 调解TLI与实施与儿童成果之间的关联。 该NRSA应用的目的是促进我作为一名实施科学家的发展 专注于组织实施因素和自闭症服务研究。拟议的项目将 研究气候嵌入机制作为组织的潜在作用机制 在两个链接的随机对照试验中实施策略。具体来说，AIM 1将确定个人 与实施者（提供者）和临床（儿童）结局相关的气候嵌入机制。目标2 是否会利用定量方法来检查是否在 目标1介导TLI对实施和临床结果的影响。最后，AIM 3将使用定性和 在其他气候嵌入机制上补充和扩展定量发现的混合方法 并解释单个机制如何准备自闭症EBP的实施。目前的提议 代表了进一步理解组织实施策略机制的重要一步。 在我的心理团队的支持下，这项建议将使我的发展成为职业 独立实施科学家专注于组织级别的战略和机制 自闭症服务设置中的EBP实现。