Administrative Supplement for COVID-19 Impact on K23 Effectiveness and Implementation of Brief Cognitive-Behavioral Therapy for Health Anxiety in Primary Care

项目摘要 本申请为指导患者为导向的研究职业发展奖（K23）的目的是 为申请人提供必要的培训，以推动他进入一个富有成效的职业生涯，作为一个实施 一位科学家专注于克服限制获得有效的焦虑心理干预的障碍 和相关疾病。申请人是一名临床心理学家，具有大量数据分析的现有技能， 实验设计，以及在识别和解决获取障碍方面的新兴能力 在意职业发展计划由干预发展、评估和 实施，致力于确保申请人获得以下方面的专业知识：1）临床有效性 试验方法，2）实施科学，3）团队科学，以测试最佳的实施策略， 精神病患者。这些先进的技能领域将是他作为一个独立的成功至关重要 调查员作为一个独立的调查员，在这些方法方面的专业知识将提高 通过确定和消除实施认知行为干预措施的障碍， 循证实践。 在过去的五年里，认知行为疗法获得了前所未有的实证支持。 几十年尽管在开发和测试认知行为疗法方面取得了成功， 将认知行为疗法引入医疗环境并没有得到来自 科学界。认知行为疗法作为一种技术在治疗 健康焦虑症进一步复杂化，这些疾病的特征导致排斥， 对治疗投入不足。这种复杂性提供了利用实施科学的机会 制定更有效的战略，向民众提供基于证据的做法。 申请人已经制定了一个详细的研究项目，使研究目标与职业相匹配 发展技能领域。该研究提案包括1）混合有效性-实施试验， 评估短期CBT治疗健康焦虑的可行性、可接受性和初步有效性， MA对患者参与和患者结局的初级护理，2）发展形成性评价， 进一步确定促进者和障碍，在日常实践中实施干预，使用定性 与临床实践工作人员的访谈，以及3）在实践环境中实施策略的试点， 修改干预措施，以解决障碍并利用促进者。计划的后续试验将提供 有机会展示申请人在有效性试验方法，实施科学， 和团队科学，因为他建立了一个科学团队，能够进行一个集群随机试验， 在这个项目中试行的执行战略。

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.