Web-based Dissemination Tool (WDT) for Community Mental Health

描述(申请人提供)：虽然针对儿童和青少年心理健康问题的多种心理干预措施在研究环境中已确立效果，但基于经验的干预措施(EBI)很少在基于社区的MH环境中的日常实践中使用。这是一个令人严重关切的问题，特别是考虑到最近的问责运动和联邦政府对使用有经验证据支持的项目的财政激励。即使是在whichinterventionsthathaveproveneffectiveunderstrictresearchconditionsaredeliveredinthe“realworld，的那些情况下，他们也往往无法实现预期的结果。这种差异的一种解释是，EBI的实施不像在研究环境中那样对治疗模型具有相同的保真度(Curtis，Ronan和Borduin，2004)。越来越多的文献表明，实施的质量与EBI在社区卫生保健环境中被采用和维持的可能性以及其治疗效果的强度直接相关。在这种情况下，质量实施指的是按照预期提供干预的程度，即对治疗模型的保真度。已发现三个关键领域直接影响EBI实施的质量：(1)培训支持(包括正在进行的实施援助)；(2)结构化、用户友好的资源材料；(3)监测、跟踪和报告核心干预措施忠诚度的问责工具。拟议的SBIR项目的目标是开发和测试一个基于网络的传播工具箱(WDT)，以支持以社区为基础的青年心理健康EBI的高质量实施。拟议的WDT将以研究文献中的建议为基础，创建一套可用于支持在广泛范围内传播大多数基于社区的EBI的工具和服务。目前，还没有类似的社区干预产品。拟议的WDT将利用3-C ISD的技术专长和经验来创建一个灵活的、可扩展的网络工具，该工具将降低社区MH环境和干预开发人员的成本(时间、财务、人员)，增强在社区MH环境中实施EBI的完整性，并增加EBI在“现实世界”日常实践中的传播。最终产品将是高度创新的，提供独特的能力，将WDT应用于广泛的EBI，这将确保广泛的市场。该项目的第一阶段将实现三个具体目标：(1)将根据项目咨询委员会的意见创建WDT的原型；(2)利益攸关方团体将对原型进行评估，以测试拟议的WDT的可行性、可用性和价值；以及(3)将根据第一阶段的结果和建议制定第二阶段的完整发展计划。公共卫生相关性：随着精神健康研究-实践日益明显，许多联邦报告呼吁采取行动，更好地将研究成果与临床实践联系起来[例如，总统的新自由委员会报告(2003年)；卫生局局长关于精神健康的报告(美国卫生与公众服务部，1999年)；青年暴力(HHS，2001a)，以及文化、种族和族裔(HHS，2001b)；以及国家儿童行动呼吁(HHS，2000)]。在“加强临床和转化科学学科”会议(2005年5月)上临床和研究团体成员的建议基础上，美国国立卫生研究院(NIH)确定将连接科学和实践的研究努力确定为NIH路线图的主要目标。这项拟议的研究直接解决了NIH路线图的优先事项以及这些联邦政府呼吁采取行动的问题。每年，约有6%的美国儿童和青少年接受某种形式的MH护理，每年的费用超过110亿美元。此外，NIMH和其他基金会每年为青年MH研究提供超过3亿美元的资金，其中大部分用于治疗研究。这项研究的结果将促进我们对如何成功地将EBI整合到社区卫生服务环境中的日常实践的理解。增加EBI在日常实践中被采用、按预期使用和持续的可能性，进而增加青年和整个社会从循证实践中受益的可能性。

DESCRIPTION (provided by applicant): While multiple psychological interventions for mental health(MH)problems in children and youth have established efficacy in research settings, empirically-based interventions (EBIs) are rarely used in everyday practice in community-based MH settings. This is of critical concern, particularly given the recent accountability movement and federal financial incentives for use of programs supported by empirical evidence. Even in those instances in whichinterventionsthathaveproveneffectiveunderstrictresearchconditionsaredeliveredinthe"realworld,"they often fail to achieve their intended outcomes. One explanation for this discrepancy is that the EBIs are not implemented with the same level of fidelity to the treatment model as in the research setting (Curtis, Ronan, and Borduin, 2004). A growing body of literature indicates the quality of implementation is directly related to the likelihood that an EBI will be adopted and sustained within the community MH setting as well as the strength of its treatment effects. Quality implementation in this instance refers to the degree to which an intervention is delivered as intended, i.e., with fidelity to the treatment model. Three key areas have been found to directly impact the quality of EBI implementation: (1) training support (including on-going implementation assistance); (2) structured, user-friendly resource materials; and (3) accountability tools for monitoring, tracking, and reporting fidelity to core intervention features. The goal of the proposed SBIR project is to develop and test a web-based dissemination toolbox (WDT) that supports quality implementation of community-based mental health EBIs for youth. The proposed WDT will build on recommendations from the research literature to create a suite of tools and services that can be applied in support of disseminating the majority of community-based EBIs on a broad scale. Currently, no comparable product exists for community-based interventions. The proposed WDT will leverage3-C ISD's technological expertise and experience to create a flexible, scalable web tool that will decrease costs (time, financial, personnel) to both community MH settings and intervention developers, enhance the integrity with which EBIs are implemented in community MH settings, and increase dissemination of EBIs into "real world" everyday practice. The final product will be highly innovative, providing the unique ability to apply the WDT to a wide array of EBIs, which will ensure broad-based marketability. Three specific aims will be accomplished through Phase I of this project: (1) the prototype of the WDT will be created with input from the project Advisory Board; (2) the prototype will be evaluated by stakeholder groups to test the feasibility, usability, and value of the proposed WDT; and (3) a full development plan for Phase II will be generated based on Phase I findings and recommendations. PUBLIC HEALTH RELEVANCE: As the mental health research-practice a phas become increasingly evident, numerous federal reports have called for action to better connect research findings to clinical practice [e.g., The President's New Freedom Commission Report(2003);Reports of the Surgeon General on Mental Health (U.S. Department of Health and Human Services, 1999), Youth Violence (HHS, 2001a), and Culture, Race, and Ethnicity (HHS, 2001b); and the National Children's Call to Action (HHS,2000)]. Building on the recommendations of clinical and research community members during the "Enhancing the Discipline of Clinical and Translational Sciences" meeting (May, 2005), the National Institutes of Health (NIH) identified research efforts to bridge science and practice as a primary objective of NIH's Roadmap. The proposed research directly addresses NIH's Roadmap priorities as well as these federal calls for action. Each year, about 6 percent of America's children and adolescents receive some form of MH care, at an annual cost of more than $11 billion. In addition, each year NIMH and other foundations fund more than $300 million for youth MH research, much of it devoted to treatment studies. The findings from the proposed research will advance our understanding of how to successfully integrate EBIs into everyday practice within community MH service settings for youth. Increasing the likelihood that EBIs will be adopted, used as intended, and sustained in everyday practice, in turn, increases the likelihood that youth and society at large will benefit from evidence-based practices.