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Effectiveness and Implementation of Brief Cognitive-Behavioral Therapy for Health Anxiety in Primary Care

初级保健中健康焦虑的简短认知行为疗法的有效性和实施

基本信息

批准号：
10001641
负责人：
Robert Edwin Brady
金额：
$ 15.11万
依托单位：
DARTMOUTH-HITCHCOCK CLINIC
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-28 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10001641
关键词：
Address Administrator Anxiety Anxiety Disorders Caring Chronic Disease Clinical Clinical effectiveness Cluster randomized trial Cognitive Therapy Communities DSM-V Data Data Analyses Development Development Plans Disease Effectiveness Effectiveness of Interventions Emotional Enrollment Ensure Equipment and supply inventories Evaluation Evidence based practice Evidence based treatment Expenditure Experimental Designs General Population Geographic Locations Goals Health Health Services Accessibility Health behavior Hybrids Intervention Interview Lead Measures Medical Medical Care Team Mental Health Mentored Patient-Oriented Research Career Development Award Mentors Methods Monitor Outcome Outpatients Participant Patient Care Patient Self-Report Patient-Focused Outcomes Patients Pilot Projects Population Prevalence Primary Health Care Process Psychologist Research Research Personnel Research Project Grants Research Proposals Resolution Science Scientist Severities Single-Blind Study Symptoms System Technology Testing Training Treatment outcome anxiety-related disorders anxious arm care providers career career development clinical practice cognitive testing cost design effectiveness clinical trial effectiveness implementation study effectiveness implementation trial effectiveness testing effectiveness trial experience follow up assessment follow-up formative assessment health care settings implementation research implementation science implementation strategy implementation trial improved novel patient engagement practice setting practice-based research network primary care setting psychosocial randomized controlled design recruit routine practice screening service utilization skill acquisition skills success therapy development treatment arm treatment as usual

项目摘要

PROJECT SUMMARY This application for a Mentored Patient-Oriented Research Career Development Award (K23) is designed to provide the applicant with the training needed to propel him into a productive career as an implementation scientist focused on overcoming the barriers that limit access to effective psychosocial interventions for anxiety and related disorders. The applicant is a clinical psychologist with existing skills in large data analyses and experimental design, and an emerging proficiency in the identification and resolution of impediments to access to care. The career development plan is mentored by experts in intervention development, evaluation, and implementation, who are dedicated to ensuring that the applicant gains expertise in 1) clinical effectiveness trials methods, 2) implementation science, and 3) team science to test optimal implementation strategies in a psychiatrically ill population. These advanced skill domains will be critical to his success as an independent investigator. Developing as an independent investigator with expertise in these methods will improve the delivery of cognitive-behavioral interventions by identifying and eliminating barriers to implementation of evidence-based practices. Cognitive-behavioral therapy has gained an unprecedented level of empirical support over the past five decades. Despite success in developing and testing cognitive-behavioral therapy, the dissemination of cognitive-behavioral therapy into healthcare settings has not matched empirical support and enthusiasm from the scientific community. The application of cognitive behavioral therapy as a technology in the treatment of disorders of health anxiety is further complicated by features of these disorders that lead to rejection and under-engagement with treatment. This complexity provides an opportunity to harness implementation science to develop more effective strategies to deliver evidence-based practices to the population. The applicant has developed a detailed research project that matches the research objectives to the career development skill domains. The research proposal consists of a 1) hybrid effectiveness-implementation trial to evaluate the feasibility, acceptability, and preliminary effectiveness of brief CBT for health anxiety delivered in primary care by MAs on patient engagement and patient outcomes, 2) developmental formative evaluation to further identify facilitators and barriers to implementation of the intervention in routine practice using qualitative interviews with clinical practice staff, and 3) pilot of the implementation strategy in a practice setting after modifying the intervention to address barriers and utilize facilitators. A planned follow-up trial will provide an opportunity to demonstrate the applicant's expertise in effectiveness trial methods, implementation science, and team science, as he builds a scientific team capable of conducting a cluster-randomized trial of the implementation strategy piloted in this project.

项目总结