Using the Theory of Change framework to map active ingredients and mechanisms of change underlying an early parent-implemented intervention for autism spectrum disorder

使用变革理论框架来绘制早期家长实施的自闭症谱系障碍干预措施背后的活性成分和变化机制

• 批准号: 10237163
• 负责人: Kyle Michele Frost
• 金额: $ 3.61万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10237163
• 关键词: Address; Adopted; Affect; Behavior Therapy; Behavioral; Caregiver support; Caregivers; Child; Clinical; Communities; Complex; Data; Development; Developmental Disabilities; Dissemination and Implementation; Early Intervention; Educational process of instructing; Effectiveness; Elements; Evaluation; Exposure to; Goals; Home; Individual; Intellectual functioning disability; Intervention; Intervention Trial; Interview; Learning; Link; Literature; Maps; Mental Health; Mentorship; Methods; Modeling; National Institute of Child Health and Human Development; Neurodevelopmental Disability; Outcome; Parents; Pathway interactions; Perception; Phase; Population; Process; Protocols documentation; Provider; Public Health; Quality of life; Research; Research Methodology; Research Personnel; Research Priority; Research Support; Resources; Science; Supervision; Techniques; Testing; Theory of Change; Training; United States; Work; archive data; archived data; autism spectrum disorder; autistic children; clinical care; community setting; cost; disability impact; economic cost; evidence base; experience; implementation science; improved; improved outcome; innovation; provider factors; psychosocial; public health relevance; skills; social communication; stakeholder perspectives; theories; treatment optimization; treatment trial

PROJECT SUMMARY Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disability that affects 1 in 59 children in the United States. Early intervention is crucial for improving outcomes in this population. A growing body of early intervention research supports the use of Naturalistic Developmental Behavioral Interventions (NDBIs), which integrate developmental and behavioral techniques. A focus on caregiver involvement in early intervention led to the development of parent-implemented NDBIs (PI-NDBIs), in which parents are taught to deliver NDBI techniques with their children. However, more research is needed to understand how best to support caregivers in promoting their children’s learning at home. While PI-NDBIs have a growing evidence base for improving child outcomes, these complex interventions have not been widely adopted in community settings. The long-term goal of this research is to inform the optimization of PI-NDBIs in order to maximize efficacy, enable more widespread community implementation, and support planned adaptation of these interventions in community settings. These align with NICHD research priorities to promote the development, dissemination, and implementation of treatments for developmental disabilities that will impact clinical care in community settings and improve quality of life. Recent advances in the evaluation of complex interventions emphasize the utility of mixed method approaches for understanding how complex treatments work. The study objective is to use a mixed methods approach to elucidate potential active ingredients and associated mechanisms of change of an empirically supported early intervention which addresses core deficits of ASD. First, interviews with key stakeholders and subsequent qualitative analysis will be used to develop a comprehensive Theory of Change describing the potential active ingredients and mechanisms of change underlying Project ImPACT, an evidence-based PI-NDBI. This will clarify how parent- and provider-level factors may impact intervention outcomes. Next, a triangulation protocol will be used to integrate theory and research evidence with data from stakeholders. These results will be visualized in a Theory of Change model. Last, we will provide proof-of-concept of the Theory of Change by testing select pathways using archival data from intervention trials of Project ImPACT. The proposed research and multifaceted training plan include ongoing mentorship with experts in intervention and implementation science, advanced training in qualitative and mixed methods research, exposure to the field of evaluation science, supervised clinical experience, and experience engaging community stakeholders in research. Identification of active ingredients and associated mechanisms of change has the potential to optimize effectiveness and streamline interventions to increase access for those with limited resources and the greatest need for high fidelity treatments. This would help address the long-term public health impacts of early social communication deficits in ASD.

项目概要 自闭症谱系障碍 (ASD) 是一种终生神经发育障碍，影响着美国每 59 名儿童中就有 1 名 美国。早期干预对于改善该人群的预后至关重要。早期的身体正在不断成长 干预研究支持使用自然发展行为干预（NDBI）， 整合发展和行为技术。注重护理人员参与早期干预 发展家长实施的 NDBI（PI-NDBI），其中教导家长实施 NDBI 与他们的孩子一起学习技巧。然而，需要更多的研究来了解如何最好地支持 照顾者促进孩子在家学习。虽然 PI-NDBI 的证据基础不断增长 尽管这些复杂的干预措施虽然改善了儿童的结局，但尚未在社区环境中得到广泛采用。 这项研究的长期目标是为 PI-NDBI 的优化提供信息，以最大限度地提高功效， 促进更广泛的社区实施，并支持有计划地调整这些干预措施 社区设置。这些与 NICHD 的研究重点相一致，以促进发展， 传播和实施将影响临床的发育障碍治疗方法 社区环境中的护理并提高生活质量。复杂性评估的最新进展 干预措施强调混合方法的实用性，以了解复杂的治疗方法 工作。研究目标是使用混合方法来阐明潜在的活性成分和 解决核心缺陷的经验支持的早期干预的相关变革机制 自闭症谱系障碍。首先，将利用对主要利益相关者的访谈和随后的定性分析来制定 描述潜在活性成分和变化机制的综合变化理论 ImPACT 项目是一个基于证据的 PI-NDBI。这将阐明家长和提供者层面的因素如何 可能会影响干预结果。接下来，将使用三角测量协议来整合理论和研究 来自利益相关者的数据证据。这些结果将在变革理论模型中可视化。最后，我们 将通过使用来自的档案数据测试选定的路径来提供变革理论的概念验证 ImPACT 项目的干预试验。拟议的研究和多方面培训计划包括正在进行的 干预和实施科学专家的指导、定性和混合方面的高级培训 方法研究、接触评估科学领域、监督临床经验和经验 让社区利益相关者参与研究。活性成分的鉴定和相关机制 变革有可能优化有效性并简化干预措施，以增加那些 资源有限且最需要高保真治疗。这将有助于解决长期问题 自闭症谱系障碍 (ASD) 早期社交沟通缺陷对公共卫生的影响。