1/2 Effectiveness of a Multi-Level Implementation Strategy for ASD Interventions

1/2 ASD 干预措施多层次实施策略的有效性

• 批准号: 9795649
• 负责人: LAUREN BROOKMAN-FRAZEE
• 金额: $ 7.01万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9795649
• 关键词: Adoption; Attention; Attitude; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Child Behavior; Child Care; Climate; Clinical; Collaborations; Community Services; Consultations; Data; Education; Educational Intervention; Educational process of instructing; Effectiveness; Ensure; Evidence based intervention; Funding; Hybrids; Individual; Intervention; Leadership; Link; Mediating; Mediator of activation protein; Mental Health; Mental Health Services; Methods; Modeling; Motivation; Organizational Change; Outcome; Participant; Patients; Population; Process; Provider; Public Health; Quality of Care; Randomized; Recording of previous events; Research; Research Project Grants; Role; Sample Size; Schools; Services; Site; Symptoms; System; Target Populations; Testing; Training; Translating; autism spectrum disorder; autistic children; behavior change; care systems; cost; design; implementation science; implementation strategy; improved; mental health education; motivational enhancement therapy; organizational climate; organizational structure; programs; provider intervention; response; routine care; scale up; school district; teacher; treatment as usual

12. PROJECT SUMMARY The Centers for Disease Control (CDC) estimates that 1 in 68 children have autism spectrum disorder (CDC, 2014) and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. We propose to conduct two, coordinated studies testing the effectiveness of the “Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy” (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes – provider training completion and ASD EBI fidelity, and subsequent child outcomes. The TEAMS– LEAD module applies the LOCI (“Leadership and Organizational Change for Implementation”)1 strategies, and the TEAMS-PROV module applies MI (Motivational Interviewing) strategies to facilitate individual provider and organizational behavior change. These studies will use a randomized implementation/effectiveness Hybrid, Type 3, trial. Study #1 will test the TEAMS model with the AIM HI intervention (“An Individualized Mental Health Intervention for ASD”) in publicly-funded mental health services. Study #2 will test TEAMS with the CPRT intervention (“Classroom Pivotal Response Teaching”) in education settings. AIM HI and CPRT data indicate that (1) provider attitudes towards EBI and (2) implementation leadership are promising targets of implementation interventions. TEAMS will target these specific mechanisms of change. This study will randomize 37 MH programs and 37 school districts to one of four groups (TEAMS PROV+LEAD; TEAMS- LEAD; TEAMS-PROV; EBI training only) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. A dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Implementation outcomes including provider training completion, fidelity and child behavior change will be examined for 295 MH providers, 295 teachers and 590 children (combined across studies). This implementation intervention has the potential to increase quality of care for ASD in publicly-funded settings by improving effectiveness of EBI implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services.

12. 项目总结