Web Tool to Disseminate Empirically-based Interventions to Schools

简介（由申请人提供）：学校是青少年主要的心理健康服务机构。以学校为基础的MH项目的有效性已被反复证明适用于广泛的儿童行为和情绪障碍，包括多动症、自杀、情绪障碍和行为障碍。然而，不幸的是，青年MH护理和青年MH研究的世界几乎没有重叠。尽管在学校环境中有基于经验的MH干预措施，以及最近教育中的问责运动和联邦财政激励措施，以使用由经验证据支持的项目，但基于经验的干预措施（ebi）很少在学校的日常实践中使用。此外，在严格的研究条件下证明有效的以学校为基础的干预措施，在“现实世界”中往往无法实现预期的结果。越来越多的文献表明，实施的质量与EBI在学校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。拟议的SBIR项目的目标是开发和测试一种基于网络的传播工具（WDT），以支持以学校为基础的青年MH ebi的高质量实施。拟议的基于网络的传播工具（WDT）将基于研究文献的建议创建一套工具和服务，可用于支持广泛传播以学校为基础的ebi。目前，没有类似的产品存在。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，这将降低学校和干预开发人员的成本（时间、财务和人员），提高在学校环境中实施ebi的完整性，并将ebi推广到“现实世界”的日常实践中。该项目的第一阶段将实现三个具体目标：(1)创建基于网络的传播工具（WDT）的原型；(2)通过利益相关方小组对原型进行评估，以测试拟议WDT的可行性、可用性和价值；(3)根据第一阶段的研究结果和建议，制订第二阶段的全面实施计划。随着心理健康研究与实践的差距越来越明显，许多联邦报告呼吁采取行动，更好地将研究结果与临床实践联系起来[例如，总统新自由委员会报告（2003年）；外科医生关于心理健康（美国公共卫生服务局，1999年）、青少年暴力（美国公共卫生服务局，2001年a）和文化、种族和族裔（美国公共卫生服务局，2001年b）的报告；和全国儿童行动呼吁（USPHS, 2000）]。在“加强临床和转化科学的学科”会议（2005年5月）期间，临床和研究界成员的建议为基础，美国国立卫生研究院（NIH）确定了将科学和实践连接起来的研究努力作为NIH路线图的主要目标。这项研究直接解决了NIH的路线图优先事项以及这些联邦行动呼吁。每年，大约6%的美国儿童和青少年接受某种形式的医院护理，每年花费超过110亿美元。每年，NIMH和其他基金会为青少年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融入青少年初级保健服务环境（即学校）的日常实践的理解。提高ebi被采用、按预期使用并在学校日常实践中持续的可能性，反过来又增加了青年从循证实践中受益的可能性。

DESCRIPTION (provided by applicant): Schools are the primary mental health (MH) service setting for youth. The effectiveness of school-based MH programs has been repeatedly demonstrated for a wide array of child behavioral and emotional disorders, including ADHD, suicidality, mood disorders, and conduct disorders. Unfortunately, however, the worlds of youth MH care and youth MH research show remarkably little overlap. Despite availability of empirically-based MH interventions for the school setting, as well as the recent accountability movement in education and federal financial incentives for use of programs supported by empirical evidence, empirically-based interventions (EBIs) are rarely used in everyday practice by schools. In addition, school-based interventions that have proven effective under strict research conditions often fail to achieve their intended outcomes when delivered in the "real world." 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 school setting as well as the strength of its treatment effects. The goal of the proposed SBIR project is to develop and test a web-based dissemination tool (WDT) that supports quality implementation of school-based EBIs for youth MH. The proposed web-based dissemination tool (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 school-based EBIs on a broad scale. Currently, no comparable product exists. The proposed WDT will leverage 3-C ISD's technological expertise and experience to create a flexible, scalable web tool that will decrease costs (time, financial, personnel) to both schools and intervention developers, enhance the integrity with which EBIs are implemented in the school setting, and increase dissemination of EBIs into "real world" everyday practice. Three specific aims will be accomplished through Phase I of this project: (1) the prototype of the web-based dissemination tool (WDT) will be created; (2) the prototype will be evaluated through stakeholder groups to test the feasibility, usability, and value of the proposed WDT; and (3) a full implementation plan for Phase II will be generated based on Phase I findings and recommendations. PUBLIC HEALTH RELEVANCE As the mental health research-practice gap has 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 MentalHealth (U.S. Public Health Service, 1999), Youth Violence (USPHS, 2001a), and Culture, Race, and Ethnicity (USPHS, 2001b); and the National Children's Call to Action (USPHS, 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. This research directly addresses NIH's Roadmap priorities as well as these federal calls for action. Each year, about 6% of America's children and adolescents receive some form of MH care, at an annual cost of more than $11 billion. And 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 this research will advance our understanding of how to successfully integrate EBIs into everyday practice within the primary MH service setting for youth, i.e., schools. Increasing the likelihood that EBIs will be adopted, used as intended, and sustained in everyday practice in schools, in turn, increases the likelihood that youth will benefit from evidence-based practices.