Online PCT Training for Clinicians

描述（由申请人提供）：惊恐发作（PA）影响社区样本中约23%的成年人。惊恐障碍伴或不伴广场恐怖症（PDA）往往是一种慢性疾病，终生患病率为4.7%。如果不治疗，惊恐障碍（PD）往往会导致衰弱的问题，严重的经济和人际关系的成本。惊恐控制治疗（PCT）是PD的有效治疗方法。该项目的总体目标是通过创建临床医生在线PCT培训（PCT奥尔特），促进PCT（又名MAP;掌握您的焦虑和恐慌）向治疗PD的临床医生的传播。在第一阶段，我们根据目标最终用户和PCT专家的反馈，采用迭代开发过程生产了由143个屏幕组成的创新奥尔特原型。然后进行随机对照试验（RCT; N=31），比较PCT奥尔特与对照奥尔特。PCT奥尔特受试者在所有结局变量（包括知识、回忆和自我效能）上均显著优于对照组。结果在一周随访时保持不变。拟议的第二阶段项目通过扩大奥尔特及其在第二阶段的评估来扩展这项工作。具体而言，我们将纳入PCT手册中的所有剩余内容，并添加其他临床场景和基于性能的交互。我们将在一项随机对照试验（N=180）中使用三种训练方法的加法研究设计来测试该计划的有效性：文本（n=60），文本+ PCT奥尔特（PCT奥尔特; n=60），与文本+ PCT奥尔特+专家每周咨询（混合; n= 60）。结果变量将再次包括PCT知识，以及在治疗PDA客户与PCT的自我效能。我们将扩大评估范围，包括计算机生成的临床应用能力测试和对PCT的忠诚度以及课程完成情况。将在培训前和培训后对受试者进行评估，然后在培训后30天和60天随访时再次进行评估。 公共卫生相关性：虽然对被诊断患有惊恐障碍（PD）的人确实存在基于药物的治疗，但只有相对较小比例的这类人群会接受这种治疗。惊恐控制治疗（又名焦虑和惊恐的掌握; MAP）是PD的有效治疗方法。该项目的目的是开发一个独特的全面和互动的MAP在线培训，以帮助传播这种循证治疗，以改善PD患者的临床结局。

DESCRIPTION (provided by applicant): Panic attacks (PA) impact about 23% of adults in community samples. Panic disorder with or without agoraphobia (PDA) tends to be a chronic condition with a lifetime prevalence of 4.7%. When untreated, panic disorder (PD) often leads to debilitating problems, with severe financial and interpersonal costs. Panic Control Treatment (PCT) is an efficacious treatment for PD. The overarching goal of this project is to facilitate the dissemination of PCT (aka MAP; Mastery of Your Anxiety and Panic) to clinicians who treat PD by creating the Online PCT Training for Clinicians (PCT OLT). In Phase I, we produced an innovative OLT prototype comprised of 143 screens using an iterative process of development with feedback from target end-users and PCT experts. A randomized controlled trial (RCT; N=31) was then conducted comparing the PCT OLT to a control OLT. PCT OLT subjects significantly outperformed controls on all outcome variables, including knowledge, recall, and self-efficacy. Results were maintained at the one week follow up. The proposed Phase II project extends this work by expanding the OLT and its evaluation in Phase II. Specifically, we will include all remaining content from the PCT manuals and add additional clinical scenarios and performance-based interactivities. We will test the program's efficacy in a RCT (N=180) using an additive research design of three training approaches: text (n=60), text + PCT OLT (PCT OLT; n=60), vs. text + PCT OLT + expert weekly consultation (Hybrid; n= 60). Outcome variables will again include PCT knowledge, as well as self-efficacy in treating PDA clients with PCT. We will expand the assessments to include a computer- generated clinical application test of competence and fidelity to PCT and course completion. Subjects will be assessed pre- and post-training, then again at 30-day and 60-day post-training follow-ups. PUBLIC HEALTH RELEVANCE: Although empirically-based treatments do exist for people diagnosed with panic disorder (PD), only a relatively small percentage of this population will receive such treatments. Panic Control Treatment (aka Mastery of Anxiety and Panic; MAP) is an efficacious treatment for PD. The intent of this project is to develop a uniquely comprehensive and interactive online training in MAP, to aid in the dissemination of this evidence based treatment, in order to improve clinical outcomes for patients suffering from PD.