OC-Go: Facilitating fidelity and dissemination of evidence based treatment for childhood OCD via an interactive crowd-sourced patient-provider tool

项目摘要 OC-GO：促进儿童强迫症循证治疗的保真度和传播 通过互动的众包患者提供者工具。 该项目的长期目标是利用移动技术和众包创造一个新的 提供和传播循证治疗的范例，因为目前的方法往往是不够的。 该项目旨在完善和评估OC-GO，这是一个符合HIPAA标准的基于Web的临床医生门户和患者端 旨在提高强迫症患者对循证治疗(EBT)依从性的移动应用程序 强迫症(OCD)，一种常见的损害条件，以及提供者有效实施的能力 EBTS。OC-GO允许临床医生在他们的移动设备上创建和推送为患者量身定做的任务 具有优化的用户界面，其中包括患者责任和支持功能。因此， 可以指导患者在两次治疗之间自行完成任务，并提高保真度 疗程。OC-GO还直接使临床医生能够通过 可搜索的众包(即，临床医生源)曝光库、多媒体作业和 与特定症状或搜索词相关的评估。交互式作业由临床医生或 使用拖放工具包的主管，可以包括逐步的书面或音频说明，患者 曝光的视频捕获，写作作业，演讲作业，焦虑提示刺激，曝光- 定向拼图、卡通、游戏模板、孩子-家长联合作业以及许多其他类型的 创造性的科技活动。创建并共享到公共图书馆后，任何临床医生都可以分配 将任何任务交给任何患者进行家庭作业或会议期间使用，只需一次触摸。众包图书馆被评为 临床医生和质量控制的策划人。OC-GO的使用有望增加患者的参与度， 依从性、治疗效率、EBTS的传播以及治疗师的信心和专业知识。 第一阶段具体目标：完成OC-GO的开发：1)通过协作协商改进用户界面 和来自多个治疗环境的社区临床医生的用户接受度测试(UAT) 加州大学洛杉矶分校强迫症专科诊所的专家临床医生；2)改进众包图书馆的可用性，扩大搜索 工具，并支持管理；3)评估优势和劣势，并基于临床- 强迫症诊断儿童临床试验的相关结果和UAT(N=50次/6名治疗师)。 第二阶段具体目标：持续开发/患者和临床医生产品测试：1)进行 随机试验(N=32)，以测试治疗分配(主要结果)的依从性，以及治疗 根据6个疗程的临床改善斜率来定义EBT的有效率(次要结果) 使用和不使用OC-GO；2)同时使用UAT继续迭代改进，并为人群提供种子- 通过合作伙伴关系采购图书馆-与三家著名的儿童强迫症诊所采购；3)然后顺序合作 与该领域的社区用户(N=100)一起检查采用措施、产品教育价值和 在生态有效的环境下，在大量用户的情况下，继续迭代产品改进。

Project Summary OC-Go: Facilitating fidelity and dissemination of evidence based treatment for childhood OCD via an interactive crowd-sourced patient-provider tool. The long-term objective of this project is to leverage mobile technologies and crowdsourcing to create a new paradigm of evidence-based treatment delivery and dissemination, as current methods are often insufficient. The project seeks to refine and assess OC-Go, a HIPAA-compliant web-based clinician portal and patient-side mobile application designed to increase patient adherence to evidence-based treatment (EBT) for Obsessive Compulsive Disorder (OCD), a common and impairing condition, and provider ability to effectively implement EBTs. OC-Go allows clinicians to create and push tailored assignments to patients on their mobile devices with an optimized user interface that includes patient accountability and support features. Accordingly, patients can be guided to do assignments by themselves between sessions with increased fidelity over the course of treatment. OC-Go also directly empowers clinicians to learn from and teach one another via a searchable crowd-sourced (i.e., clinician-sourced) library of exposures, multimedia assignments, and assessments related to specific symptoms or search terms. Interactive assignments are created by clinicians or supervisors using a drop and drag toolkit and can include step-by-step written or audio instructions, patient video capture of exposures, writing assignments, speaking assignments, anxiety-cuing stimuli, exposure- oriented puzzles, cartoons, gaming templates, joint child-parent assignments, and many other types of creative technology-enabled activities. Once created and shared to the public library, any clinician can assign any task to any patient for homework or in-session use with one touch. The crowd-sourced library is rated by clinicians and curated for quality control. Use of OC-Go is expected to increase patient engagement, compliance, treatment efficiency, dissemination of EBTs, and therapist confidence and expertise. Phase I Specific Aims: Complete development of OC-Go: 1) Refine user interface via collaborative consultation and user acceptance testing (UAT) with community clinicians drawn from several treatment contexts and expert clinicians at a UCLA OCD specialty clinic; 2) Refine crowd-sourced library usability, expand search tools, and enable curating; 3) Assess strengths and weaknesses and refine key functions based on clinically- relevant outcomes and UAT in clinical piloting with OCD-diagnosed children (N=50 sessions/6 therapists). Phase II Specific Aims: Continued Development/Patient and clinician product testing: 1) Conduct randomized trial (N=32) to test compliance with therapeutic assignments (primary outcome), and treatment efficiency as defined by slope of clinical improvement over course of 6 sessions (secondary outcome) in EBT with and without OC-Go; 2) Simultaneously continue iterative improvements with UAT and seed the crowd- sourced library via partnership-sourcing with three prominent Child OCD clinics; 3) Then sequentially partner with community users in the field (N=100) to examine adoptability measures, product educational value, and to continue iterative product improvement given a large volume of users in ecologically valid settings.