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: 10820054
• 负责人: Erin Cecilia Accurso
• 金额: $ 5万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10820054
• 关键词: Adoption; Anorexia Nervosa; Caregivers; Clinical; County; Data; Dissemination and Implementation; Doctor of Philosophy; E-learning; Eating Disorders; Effectiveness; Environment; Evidence based treatment; Family; Funding; Goals; Health Disparities Research; Health Services Accessibility; Health system; Hospitalization; Improve Access; Individual; Interview; K-Series Research Career Programs; Knowledge acquisition; Learning; Mental Health; Mental Health Services; Mentors; Mentorship; Methodology; Methods; Modeling; National Institute of Mental Health; Partnership Practice; Persons; Population; Provider; Public Sector; Research; Research Activity; Resources; Scientist; Structure; Techniques; Technology; Testing; Training; Training Activity; Training Support; Underserved Population; Youth; career development; clinical care; cost; cost effective; design; evidence base; experience; high risk; implementation barriers; implementation outcomes; implementation science; improved; improved outcome; medical complication; minority health; minority health disparity; mortality; pilot test; skills; theories

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.

项目摘要/摘要 该职业发展奖的目标是获取知识，发展技能并获得实用 使应用程序能够在传播和实施方面进行独立研究的经验 （D＆I）在水资源不足的饮食失调症中的基于证据的治疗（EBT）（EDS）（eds）， 特别是利用技术来增加EBT采用。 ED的年轻人在公众中供应不佳 部门由于缺乏EBT培训，使这些年轻人容易受到医疗并发症，住院和 长时间的疾病。在实施科学家约瑟夫·盖迪什（Joseph Guydish）博士的心态下，MPH 申请人将由专业的联合和顾问团队进行培训，旨在学习1） 实施科学模型，方法和分析技术以增加EBT采用， 实施和为服务不足的年轻人的可持续性； 2）在开发和测试方面获得专业知识 改善EBT实施的技术； 3）在少数民族健康和健康分配中建立专业知识 研究。拟议的研究包括两个相互基础以支持这些培训目标的目标。 AIM 1将研究针对厌食症和非典型厌食症的青年对基于家庭的治疗的适应（FBT） 通过检查五名县心理健康中有15个家庭的五名临床医生的实施，通过检查厌食症 系统。主要的实施结果是忠诚和适应，将用于进一步适应 AIM 2的FBT。半结构化访谈将在实施FBT时探索提供者的经验（n = 5） EDS的青年（例如，实施挑战，治疗适应的理由）以及照料者 经验（n = 8）接收FBT。这些项目支持AIM 2的治疗改进和改编， 它将开发和试行测试基于网络的可接受性，利用和初步有效性 与适应的FBT模型中的面对面训练（n = 9）相比，训练（n = 9）。研究结果将服务 作为R01研究的试验数据，重点是具有成本效益的培训模型，以支持EBT实施 具有EDS的青年，特别是为了改善潜水员，服务不足的青年获得护理的努力。 该提案与NIMH战略目标（4.1，4.2）保持一致，以提高“现有心理的有效性 卫生服务”和“传播，实施和持续改进基于证据的 通过研究和研究实践伙伴关系，心理健康服务”，特别是“服务不足的 人口。“精心组装的心理团队，卓越的科学环境，并提议 培训和研究活动将支持候选人的职业发展，以最终公开改善 为高风险的临床护理提供资金，了解了EDS的青年。

项目成果

A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders.

• DOI: 10.1186/s40337-021-00461-1
• 发表时间: 2021-10-18
• 期刊: Journal of eating disorders
• 影响因子: 4.1
• 作者: Vogel EN;Singh S;Accurso EC
• 通讯作者: Accurso EC

A brief session-by-session measure of eating disorder psychopathology for children and adolescents: Development and psychometric properties of the Eating Disorder-15 for Youth (ED-15-Y).

• DOI: 10.1002/eat.23449
• 发表时间: 2021-04
• 期刊: The International journal of eating disorders
• 作者: Accurso EC;Waller G
• 通讯作者: Waller G

The Impact of Inpatient Multimodal Treatment or Family-Based Treatment on Six-Month Weight Outcomes in Youth with Anorexia Nervosa: A Naturalistic, Cross-Continental Comparison.

• DOI: 10.3390/nu14071396
• 发表时间: 2022-03-27
• 期刊: NUTRIENTS
• 影响因子: 5.9
• 作者: Nadler, Janine;Correll, Christoph U.;Le Grange, Daniel;Accurso, Erin C.;Haas, Verena
• 通讯作者: Haas, Verena