Redesigning an Autism Evidence-Based Practice Implementation Toolkit for Middle and High Schools- Administrative Supplement

项目总结 作为对PAR-21-235的响应，我们建议系统地和迭代地重新设计一个自闭症实现 工具包，题为自闭症社区工具包：衡量和采用基于研究的治疗的系统(ACT 智能)，用于初中和高中，以满足社区确定的工具需求，从而实现适当的 自闭症循证实践(EBPS)的识别和选择。未得到满足的服务需求和护理 自闭症青少年普遍存在差异，导致结果不佳，危害公共健康。 效果。公立学校是自闭症青少年最常使用的服务系统，而学校是 受命为自闭症学生提供研究支持的实践。然而，EBPS的常规使用是有限的 学校节目的质量很低。教育工作者在识别和选择自闭症方面得到的支持有限 EBPS，可能导致执行和维持不力，对青少年产生下游影响 结果。到目前为止，大多数学校的实施工作都集中在较后的实施阶段。 (积极实施)与对实施成功至关重要的早期阶段(采用-决策)的对比。那里 是公立学校针对自闭症、EBP选择和决策的系统支持的迫切需要。 该建议通过迭代重新设计针对以下目标的自闭症实施工具包来解决这些差距 EBP决策。在NIMH(K01MH093477)的资助下，ACT智能实施工具包 开发并显示了在社区环境中针对自闭症EBP采用和决策的有效。 ACT SMART具有巨大的潜力，可以改善自闭症EBP的决策、采用和实施 学校；然而，有必要进行系统和迭代的重新设计，以使其最大限度地适应 公立学校。探索、准备、实施和维持(EPIS)和发现、设计、 构建和测试框架(DDBT)将被应用于重新设计ACT SMART。埃皮斯被选中 鉴于其具体发展为公共儿童服务的设置和应用，原来的发展 聪明行事，而DDBT提供关于实施战略发展的必要指导，以 增强可用性和环境匹配性。拟议的研究高度响应NIMH(例如，战略4.2C 开发决策支持工具，以提高公共服务环境中的干预效果)和 IACC(例如，需要扩大对自闭症青少年的研究和翻译Effacous 对社区的干预)研究优先事项。具体目标是：目标1.让利益相关者参与进来 确定ACT智能重新设计的目标，以优化其适合与以下合作的初中和高中提供商 自闭症青少年。目标2.对改进的ACT SMART和 反复改进以确保可用性、可行性、可接受性和学校使用的适当性。 拟议研究的完成将使ACT SMART能够在公立学校进行大规模试验， 提高全国自闭症青少年接受的服务质量的潜力。

PROJECT SUMMARY In response to PAR-21-235, we propose to systematically and iteratively redesign an autism implementation toolkit, entitled Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments (ACT SMART), for middle and high schools to meet the community-identified need for tools enabling the appropriate identification and selection of autism evidence-based practices (EBPs). Unmet service needs and care disparities are common for autistic adolescents, contributing to poor outcomes and deleterious public health effects. Public schools are the most frequently accessed service system for autistic youth and schools are mandated to provide research-supported practices for autistic students. Yet, routine use of EBPs is limited and the quality of school programming is low. Educators receive limited support in identifying and selecting autism EBPs, likely contributing to poor implementation and sustainment, with downstream effects on adolescent outcomes. To date, most school implementation efforts have focused on the later implementation phases (active implementation) versus the earlier phases (adoption-decision) critical to implementation success. There is a critical need for systematic supports targeting autism EBP selection and decision making in public schools. This proposal addresses these gaps through iteratively redesigning an autism implementation toolkit targeting EBP decision-making. Funded by NIMH (K01MH093477), the ACT SMART implementation toolkit was developed and shown effective in targeting autism EBP adoption and decision-making in community settings. ACT SMART has immense potential to improve autism EBP decision-making, adoption, and implementation in schools; however, systematic and iterative redesign is necessary to optimize its fit to the unique context of public schools. The Exploration, Preparation, Implementation and Sustainment (EPIS) and Discover, Design, Build, and Test Framework (DDBT) frameworks will be applied to redesign ACT SMART. EPIS was selected given its specific development for public child service settings and application to the original development of ACT SMART, while DDBT provides the necessary guidance regarding implementation strategy development to enhance the usability and contextual fit. The proposed study is highly responsive to NIMH (e.g., Strategy 4.2C developing decision-support tools that increase intervention effectiveness in public service settings) and the IACC (e.g., the need to expand research with autistic adolescents and the translation of efficacious interventions to the community) research priorities. The specific aims are: Aim 1. Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers that work with autistic adolescents. Aim 2. Conduct prototyping and usability field testing of the refined ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools. Completion of the proposed study will allow for a large-scale trial of ACT SMART in public schools, with the potential to improve the quality of services that autistic adolescents receive across the country.