Project 3

项目总结 尽管目前高达80%的青少年心理健康服务是在学校提供的，但很少有学生获得 循证实践(EBPS)。即使在组织支持到位的情况下，最终也要实施 这取决于供应商的变革动机。个别提供商行为的改变是实现高质量的关键 执行情况和对青年的积极成果。让公众从几十年来投入的研究中受益 在EBP开发中，需要针对提供商动机的实施战略。 在学校成功实施的信念和态度(基础)是一个四小时的促进小组- 旨在加强标准EBP培训和咨询的基于混合的实施战略 通过提高提供商的参与度和积极性来制定流程。利用战略教育、激励 访谈和社会影响战略，基础旨在影响关键的、理论上衍生的、个人层面的 与临床医生行为改变相关的机制--态度、社会规范和感知行为 控制--提高治疗质量(即保真度)和青年结果。在之前的两次试验中，Basis提供了 面对面展示了可行性、适当性和有效性的证据，但它可以优化为 更大的可扩展性和效率，因此它可以被广泛使用，以积极影响临床医生的敬业度。 与Impact Center的目标一致，当前项目将专注于提高基础可扩展性 通过(1)优化基础，仅包括激活其目标机制的最基本组件和 (2)将其交付调整为支持网络的数字平台。我们将用理论和方法建立因果关系路径 利益相关者输入(实践社区、青年)，招募有代表性的最终用户，并使用快速模拟方法 (RAM)有效地识别和测试基本组件，并为数字部署确定它们的优先级。 这项研究的目的是应用影响中心方法，以便：(1)确定基础并确定优先级 通过因果路径图对组件进行测试；(2)使用RAM对优先的基本组件进行测试 为基础(EBASIS)的优化电子健康适应的开发提供信息；以及(3)测试 EBASIS在一项随机对照试验(RCT)中对EBP忠诚度和青年结局的影响。关键组织因素 (例如，领导力、执行环境、学校特点)将作为协变量在区域专题审查期间进行衡量。 有希望的发现将支持R01申请进行验证性试验，评估eBASIS对 忠诚度和青年成果。我们预计eBASIS实施战略将易于扩展和 可以加强EBP整合努力的影响，以改善青少年的治疗质量和结果 教育部门和其他低资源社区环境。

PROJECT SUMMARY Although up to 80% of mental health services for youth are currently provided in schools, few students receive evidence-based practices (EBPs). Even when organizational supports are in place, implementation ultimately rests with providers' motivation for change. Individual provider behavior change is critical to achieve high-quality implementation and positive outcomes for youth. For the public to benefit from the decades of research invested in EBP development, implementation strategies that target provider motivation are needed. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a four-hour, facilitated, group- based, blended implementation strategy designed to augment standard EBP training and consultation procedures by improving provider engagement and motivation. Using strategic education, motivational interviewing, and social influence strategies, BASIS aims to impact key, theoretically-derived, individual-level mechanisms associated with clinician behavior change—attitudes, social norms, and perceived behavioral control—to improve treatment quality (i.e., fidelity), and youth outcomes. In two previous trials, BASIS delivered in-person demonstrated evidence of feasibility, appropriateness, and efficacy, but it could be optimized for greater scalability and efficiency, so that it can be used widely to positively impact clinicians' engagement. Consistent with the goals of the IMPACT Center, the current project will focus on increasing BASIS scalability by (1) optimizing BASIS to include only the most essential components for activating its target mechanisms and (2) adapting its delivery to a web-enabled digital platform. We will build causal pathways using theory and stakeholder input (practice community, youth), enroll representative end users, and use rapid analogue methods (RAM) to efficiently identify and test BASIS components, as well as prioritize them for digital deployment. Aims of this study are to apply IMPACT Center methods in order to: (1) Identify and prioritize BASIS components via causal pathway diagramming; (2) Conduct tests of prioritized BASIS components using RAM to inform the development of an optimized eHealth adaptation of BASIS (eBASIS); and (3) Test the impact of eBASIS on EBP fidelity and youth outcomes in a randomized controlled trial (RCT). Key organizational factors (e.g., leadership, implementation climate, school characteristics) will be measured as covariates during the RCT. Promising findings would support an R01 application for a confirmatory trial evaluating the impact of eBASIS on fidelity and youth outcomes. We anticipate that the eBASIS implementation strategy will be readily scalable and could enhance the impact of EBP integration efforts to improve treatment quality and outcomes for youth in the education sector and other low-resource community settings.