Web-Based Dissemination Tool for Community Mental Health (WDT-C)

描述(申请人提供)：在过去的几十年里，大量的精神健康实践和干预措施已经通过随机对照试验进行了严格的测试，并被证明是有效的。然而，尽管可用，循证干预(EBI)在社区卫生服务环境中的日常实践中很少被采用。此外，即使采用了MH EBI，也很少实施严格遵守原始设计的方案，而且往往无法随着时间的推移而持续下去。越来越多的文献表明，实施质量如何与EBI被嵌入日常临床实践的可能性以及EBI实现预期治疗结果的可能性直接相关。正如NIMH的战略计划中概述的那样，迫切需要创新的方法来帮助缩小经研究检验的干预措施的开发与其广泛使用之间的差距。这一第二阶段SBIR项目将继续研究和开发基于网络的社区精神卫生传播工具(WDT-C)，这是一种灵活的技术基础设施，专门设计用于在广泛的社区卫生服务环境中促进MH EBI的高质量实施。WDT-C将提供一套可定制的在线工具和服务，包括具有成本效益的高质量培训和监督资源、为提供商提供的持续实施援助、遵守情况监测和结果跟踪。在第一阶段，与主要利益攸关方成功地完成了原型开发和可行性测试，为产品提供了实质性支持，并为第二阶段的开发提出了具体建议。通过这一二期工程将实现三个具体目标。第一个目标是利用第一阶段反馈开发完整的技术基础设施，并将其应用于第三个独立的MH EBI。为了确保最大的质量并在产品测试之前做出任何必要的调整，社区MH管理员和供应商将评估这一新的WDT-C应用程序的可用性。第二个目的是对WDT-C进行科学评估。三个WDT-C支持的EBI中的每一个都将由社区MH提供商实施，这些提供商随机分配到实施照常(不支持WDT-C)或增强实施(支持WDT-C的实施)条件。将在五个实施成果领域检验不同条件之间的差异：(A)实施干预措施的组织准备情况；(B)遵守干预方案；(C)对干预措施和执行支助的满意度；(D)干预措施的可持续性；(E)治疗惠益。最终目标是根据第二阶段的调查结果和评估，最后确定所有产品组成部分，为第三阶段的商业化做准备。这个SBIR项目将产生一个灵活的、可扩展的技术基础设施，它可以应用于任何社区MH EBI，以有效地降低提供者和干预开发商的成本(时间、财务、人员)，提高在社区环境中实施EBI的质量，并增加EBI在“现实世界”日常实践中的传播。

DESCRIPTION (provided by applicant): Over the past several decades, a large number of mental health (MH) practices and interventions have been rigorously tested through randomized control trials and shown efficacious. However, despite availability, evidence-based interventions (EBIs) are rarely adopted in everyday practice within community MH service settings. Further, even when adopted, MH EBIs are seldom implemented with strong adherence to the original design and often fail to be sustained over time. A growing body of literature demonstrates how implementation quality is directly related to the likelihood an EBI will be embedded into everyday clinical practice as well as the likelihood that EBI achieves its intended treatment outcomes. As outlined in NIMH's Strategic Plan, innovative methods to help close the gap between development of research-tested interventions and their widespread use are critically needed. This Phase II SBIR project will continue research and development of the Web- Based Dissemination Tool for Community Mental Health (WDT-C), a flexible technology infrastructure specifically designed to foster quality implementation of MH EBIs within community MH service settings on a broad scale. WDT-C will offer a suite of customizable online tools and services, including cost-efficient high quality training and supervision resources, ongoing implementation assistance for providers, adherence monitoring, and outcomes tracking. Prototype development and feasibility testing with key stakeholders were successfully completed in Phase I, providing substantial support for the product as well as specific recommendations for Phase II development. Three specific aims will be accomplished through this Phase II project. The first aim is to develop the full technology infrastructure utilizing Phase I feedback, and apply it to a third, independent MH EBI. To ensure maximal quality and make any needed adjustments prior to product testing, usability of this new WDT-C application will be assessed by community MH administrators and providers. The second aim is to conduct a scientific evaluation of WDT-C. Each of the three WDT-C supported EBIs will be implemented by community MH providers randomly assigned to either Implementation-As-Usual (no WDT-C support) or Enhanced Implementation (WDT-C supported implementation) conditions. Differences between conditions will be tested in five implementation outcome areas: (a) organizational readiness for intervention implementation, (b) adherence to intervention protocol, (c) satisfaction with intervention and implementation support, (d) sustainability of intervention, and (e) treatment benefits. The final aim is to finalize all product components based on Phase II findings and evaluations in preparation for Phase III commercialization. This SBIR project will yield a flexible, scalable technology infrastructure that can be applied to any community MH EBI to effectively decrease costs (time, financial, personnel) to both providers and intervention developers, enhance the quality with which EBIs are implemented in community settings, and increase dissemination of EBIs into "real world" everyday practice.