Redesigning an Autism Evidence-Based Practice Implementation Toolkit for Middle and High Schools- Administrative Supplement

项目摘要 作为对PAR-21-235的回应，我们建议系统地和迭代地重新设计自闭症实现 一个名为《自闭症社区工具包：衡量和采用基于研究的治疗方法的系统》（ACT SMART），以满足社区确定的对工具的需求， 自闭症循证实践（EBP）的识别和选择。未满足的服务需求和护理 自闭症青少年的差异很常见，导致了不良结果和有害的公共卫生 方面的影响.公立学校是自闭症青少年最常获得的服务系统，学校是 被授权为自闭症学生提供研究支持的实践。然而，EBP的常规使用是有限的， 学校课程的质量很低。教育工作者在识别和选择自闭症方面得到的支持有限 经强化的做法，可能导致执行和维持不力，对青少年产生下游影响 结果。到目前为止，大多数学校的实施工作都集中在较后的实施阶段 （积极实施）与早期阶段（采纳-决策）之间的差异对实施成功至关重要。那里 是一个关键需要系统的支持，针对自闭症EBP的选择和决策在公立学校。 该提案通过迭代地重新设计自闭症实施工具包来解决这些差距， EBP决策。由NIMH（K 01 MH 093477）资助，ACT SMART实施工具包 开发并显示出有效的针对自闭症EBP的采用和社区环境中的决策。 ACT SMART在改善自闭症EBP决策、采用和实施方面具有巨大潜力， 然而，系统和迭代的重新设计是必要的，以优化其适合独特的背景下， 公立学校。探索，准备，实施和维持（EPIS）和发现，设计， 将应用构建和测试框架（DDBT）框架重新设计ACT SMART。选择EPIS 鉴于其在公共儿童服务机构的具体发展和对原始发展的应用， ACT SMART，而DDBT提供了关于实施战略制定的必要指导， 增强可用性和上下文适应性。拟议的研究对NIMH高度敏感（例如，战略4.2C 开发决策支持工具，提高公共服务环境中干预措施的有效性）， IACC（例如，需要扩大对自闭症青少年的研究， （三）研究重点。具体目标是：目标1。让利益攸关方参与， 确定ACT SMART重新设计的目标，以优化其对与以下机构合作的初中和高中提供者的适应性： 自闭症青少年目标二。对改进后的ACT SMART进行原型设计和可用性现场测试， 反复改进，以确保学校使用的可用性、可行性、可接受性和适当性。 完成拟议的研究将允许在公立学校进行ACT SMART的大规模试验， 提高全国自闭症青少年接受服务质量的潜力。

PROJECT SUMMARY In response to PAR-21-235, we propose to systematically and iteratively redesign an autism implementation toolkit, entitled Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments (ACT SMART), for middle and high schools to meet the community-identified need for tools enabling the appropriate identification and selection of autism evidence-based practices (EBPs). Unmet service needs and care disparities are common for autistic adolescents, contributing to poor outcomes and deleterious public health effects. Public schools are the most frequently accessed service system for autistic youth and schools are mandated to provide research-supported practices for autistic students. Yet, routine use of EBPs is limited and the quality of school programming is low. Educators receive limited support in identifying and selecting autism EBPs, likely contributing to poor implementation and sustainment, with downstream effects on adolescent outcomes. To date, most school implementation efforts have focused on the later implementation phases (active implementation) versus the earlier phases (adoption-decision) critical to implementation success. There is a critical need for systematic supports targeting autism EBP selection and decision making in public schools. This proposal addresses these gaps through iteratively redesigning an autism implementation toolkit targeting EBP decision-making. Funded by NIMH (K01MH093477), the ACT SMART implementation toolkit was developed and shown effective in targeting autism EBP adoption and decision-making in community settings. ACT SMART has immense potential to improve autism EBP decision-making, adoption, and implementation in schools; however, systematic and iterative redesign is necessary to optimize its fit to the unique context of public schools. The Exploration, Preparation, Implementation and Sustainment (EPIS) and Discover, Design, Build, and Test Framework (DDBT) frameworks will be applied to redesign ACT SMART. EPIS was selected given its specific development for public child service settings and application to the original development of ACT SMART, while DDBT provides the necessary guidance regarding implementation strategy development to enhance the usability and contextual fit. The proposed study is highly responsive to NIMH (e.g., Strategy 4.2C developing decision-support tools that increase intervention effectiveness in public service settings) and the IACC (e.g., the need to expand research with autistic adolescents and the translation of efficacious interventions to the community) research priorities. The specific aims are: Aim 1. Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers that work with autistic adolescents. Aim 2. Conduct prototyping and usability field testing of the refined ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools. Completion of the proposed study will allow for a large-scale trial of ACT SMART in public schools, with the potential to improve the quality of services that autistic adolescents receive across the country.