OC-Go: Facilitating fidelity and dissemination of evidence based treatment for childhood OCD via an interactive crowd-sourced patient-provider tool

项目摘要 OC-Go：促进儿童强迫症循证治疗的忠实性和传播 通过一个互动的众包病人提供者工具。 该项目的长期目标是利用移动的技术和众包， 在这方面，需要强调循证治疗提供和传播的范例，因为目前的方法往往不足。 该项目旨在完善和评估OC-Go，这是一个符合HIPAA的基于网络的临床医生门户网站和患者方 移动的应用程序，旨在提高患者对强迫症循证治疗（EBT）的依从性 强迫症（OCD），一种常见的损害性疾病，以及提供者有效实施 EBT OC-Go允许临床医生在他们的移动的设备上创建并向患者推送定制的分配 具有优化的用户界面，包括患者责任和支持功能。因此，委员会认为， 患者可以被引导在会话之间自己做作业， 疗程OC-Go还直接使临床医生能够通过 可搜索的众包（即，临床医生来源的）曝光库、多媒体任务，以及 与特定症状或检索词相关的评估。交互式分配由临床医生创建，或 管理员使用拖放工具包，并可以包括一步一步的书面或音频说明，病人 暴露的视频捕捉，写作作业，口语作业，焦虑线索刺激，暴露- 定向拼图，卡通，游戏模板，联合儿童家长作业，以及许多其他类型的 创造性的技术活动。一旦创建并共享到公共图书馆，任何临床医生都可以分配 任何任务，任何病人的家庭作业或在会话中使用一个触摸。众包图书馆被评为 临床医生和策划的质量控制。OC-Go的使用预计将增加患者的参与度， 依从性、治疗效率、EBT的传播以及治疗师的信心和专业知识。 第一阶段具体目标：完成OC-Go的开发：1）通过协作协商优化用户界面 和用户验收测试（UAT）与社区临床医生从几个治疗环境， 加州大学洛杉矶分校强迫症专科诊所的专家临床医生; 2）优化众包图书馆的可用性，扩大搜索 工具，并使策展; 3）评估优势和劣势，并根据临床改进关键功能- 相关的结果和UAT在临床试点与强迫症诊断的儿童（N=50届/6治疗师）。 II期具体目标：持续开发/患者和临床医生产品测试：1）进行 随机试验（N=32），以测试治疗分配（主要结局）和治疗的依从性 有效性定义为EBT中6次治疗过程中临床改善的斜率（次要结局） 使用和不使用OC-Go; 2）同时继续使用UAT进行迭代改进并播种人群- 通过与三家著名的儿童强迫症诊所合作采购图书馆; 3）然后依次合作 与该领域的社区用户（N=100）一起检查可采用性措施、产品教育价值和 在生态有效的环境中，考虑到大量用户，继续迭代产品改进。

Project Summary OC-Go: Facilitating fidelity and dissemination of evidence based treatment for childhood OCD via an interactive crowd-sourced patient-provider tool. The long-term objective of this project is to leverage mobile technologies and crowdsourcing to create a new paradigm of evidence-based treatment delivery and dissemination, as current methods are often insufficient. The project seeks to refine and assess OC-Go, a HIPAA-compliant web-based clinician portal and patient-side mobile application designed to increase patient adherence to evidence-based treatment (EBT) for Obsessive Compulsive Disorder (OCD), a common and impairing condition, and provider ability to effectively implement EBTs. OC-Go allows clinicians to create and push tailored assignments to patients on their mobile devices with an optimized user interface that includes patient accountability and support features. Accordingly, patients can be guided to do assignments by themselves between sessions with increased fidelity over the course of treatment. OC-Go also directly empowers clinicians to learn from and teach one another via a searchable crowd-sourced (i.e., clinician-sourced) library of exposures, multimedia assignments, and assessments related to specific symptoms or search terms. Interactive assignments are created by clinicians or supervisors using a drop and drag toolkit and can include step-by-step written or audio instructions, patient video capture of exposures, writing assignments, speaking assignments, anxiety-cuing stimuli, exposure- oriented puzzles, cartoons, gaming templates, joint child-parent assignments, and many other types of creative technology-enabled activities. Once created and shared to the public library, any clinician can assign any task to any patient for homework or in-session use with one touch. The crowd-sourced library is rated by clinicians and curated for quality control. Use of OC-Go is expected to increase patient engagement, compliance, treatment efficiency, dissemination of EBTs, and therapist confidence and expertise. Phase I Specific Aims: Complete development of OC-Go: 1) Refine user interface via collaborative consultation and user acceptance testing (UAT) with community clinicians drawn from several treatment contexts and expert clinicians at a UCLA OCD specialty clinic; 2) Refine crowd-sourced library usability, expand search tools, and enable curating; 3) Assess strengths and weaknesses and refine key functions based on clinically- relevant outcomes and UAT in clinical piloting with OCD-diagnosed children (N=50 sessions/6 therapists). Phase II Specific Aims: Continued Development/Patient and clinician product testing: 1) Conduct randomized trial (N=32) to test compliance with therapeutic assignments (primary outcome), and treatment efficiency as defined by slope of clinical improvement over course of 6 sessions (secondary outcome) in EBT with and without OC-Go; 2) Simultaneously continue iterative improvements with UAT and seed the crowd- sourced library via partnership-sourcing with three prominent Child OCD clinics; 3) Then sequentially partner with community users in the field (N=100) to examine adoptability measures, product educational value, and to continue iterative product improvement given a large volume of users in ecologically valid settings.