Web-based Dissemination Tool (WDT) for Community Mental Health

描述（由申请人提供）：虽然针对儿童和青少年心理健康（MH）问题的多种心理干预措施在研究环境中已经确立了疗效，但在社区MH环境中的日常实践中很少使用基于行为的干预措施（EBI）。这是一个关键问题，特别是考虑到最近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方案。即使在那些在严格的研究条件下被证明有效的干预措施在“现实世界“中被提供的情况下，它们也往往无法达到预期的结果。对这种差异的一种解释是，EBI的实施与研究环境中的治疗模型的保真度水平不同（Curtis，罗南和Borduin，2004）。越来越多的文献表明，实施的质量直接关系到的可能性，EBI将被采用和持续的社区MH设置以及其治疗效果的强度。在这种情况下，实施质量是指按预期提供干预措施的程度，即，与治疗模型保持一致。已经发现三个关键领域直接影响EBI实施的质量：（1）培训支持（包括持续的实施援助）;（2）结构化的、用户友好的资源材料;（3）用于监测、跟踪和报告核心干预特征的问责制工具。拟议的SBIR项目的目标是开发和测试一个基于网络的传播工具箱（WDT），支持以社区为基础的青年心理健康EBI的质量实施。拟议的WDT将建立在研究文献的建议基础上，以创建一套工具和服务，可用于支持大规模传播大多数基于社区的EBI。目前，在基于社区的干预措施方面没有可比产品。拟议的WDT将吸收3-C ISD的技术专长和经验，以创建一个灵活的、可扩展的网络工具，该工具将减少社区卫生服务设置和干预开发人员的成本（时间、财务、人员），提高在社区卫生服务设置中实施EBI的完整性，并增加EBI在“真实的世界”日常实践中的传播。最终产品将具有高度创新性，提供将WDT应用于广泛的EBI的独特能力，这将确保广泛的可销售性。本项目的第一阶段将实现三个具体目标：（1）将根据项目咨询委员会的意见创建WDT的原型;（2）利益相关者团体将评估原型，以测试拟议WDT的可行性，可用性和价值;以及（3）将根据第一阶段的调查结果和建议制定第二阶段的全面发展计划。公共卫生相关性：随着心理健康研究实践的日益明显，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，总统的新自由委员会报告（2003年）;卫生局局长关于精神健康的报告（美国卫生与公众服务部，1999年）、关于青年暴力的报告（美国卫生与公众服务部，2001年a）、关于文化、种族和族裔的报告（美国卫生与公众服务部，2001年b）;以及关于全国儿童行动呼吁的报告（美国卫生与公众服务部，2000年）]。在“加强临床和转化科学学科”会议（2005年5月）期间，临床和研究社区成员的建议的基础上，美国国立卫生研究院（NIH）确定了将科学与实践联系起来的研究工作作为NIH路线图的主要目标。拟议的研究直接涉及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MH护理，每年花费超过110亿美元。此外，每年NIMH和其他基金会资助超过3亿美元用于青年MH研究，其中大部分用于治疗研究。从拟议的研究结果将推进我们的理解如何成功地将EBI纳入日常实践中的社区MH服务设置为青年。提高EBI在日常实践中被采用、按预期使用和持续的可能性，反过来也会增加青年和整个社会从循证实践中受益的可能性。

DESCRIPTION (provided by applicant): While multiple psychological interventions for mental health(MH)problems in children and youth have established efficacy in research settings, empirically-based interventions (EBIs) are rarely used in everyday practice in community-based MH settings. This is of critical concern, particularly given the recent accountability movement and federal financial incentives for use of programs supported by empirical evidence. Even in those instances in whichinterventionsthathaveproveneffectiveunderstrictresearchconditionsaredeliveredinthe"realworld,"they often fail to achieve their intended outcomes. One explanation for this discrepancy is that the EBIs are not implemented with the same level of fidelity to the treatment model as in the research setting (Curtis, Ronan, and Borduin, 2004). 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 community MH setting as well as the strength of its treatment effects. Quality implementation in this instance refers to the degree to which an intervention is delivered as intended, i.e., with fidelity to the treatment model. Three key areas have been found to directly impact the quality of EBI implementation: (1) training support (including on-going implementation assistance); (2) structured, user-friendly resource materials; and (3) accountability tools for monitoring, tracking, and reporting fidelity to core intervention features. The goal of the proposed SBIR project is to develop and test a web-based dissemination toolbox (WDT) that supports quality implementation of community-based mental health EBIs for youth. The proposed 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 the majority of community-based EBIs on a broad scale. Currently, no comparable product exists for community-based interventions. The proposed WDT will leverage3-C ISD's technological expertise and experience to create a flexible, scalable web tool that will decrease costs (time, financial, personnel) to both community MH settings and intervention developers, enhance the integrity with which EBIs are implemented in community MH settings, and increase dissemination of EBIs into "real world" everyday practice. The final product will be highly innovative, providing the unique ability to apply the WDT to a wide array of EBIs, which will ensure broad-based marketability. Three specific aims will be accomplished through Phase I of this project: (1) the prototype of the WDT will be created with input from the project Advisory Board; (2) the prototype will be evaluated by stakeholder groups to test the feasibility, usability, and value of the proposed WDT; and (3) a full development plan for Phase II will be generated based on Phase I findings and recommendations. PUBLIC HEALTH RELEVANCE: As the mental health research-practice a phas 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 Mental Health (U.S. Department of Health and Human Services, 1999), Youth Violence (HHS, 2001a), and Culture, Race, and Ethnicity (HHS, 2001b); and the National Children's Call to Action (HHS,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. The proposed research directly addresses NIH's Roadmap priorities as well as these federal calls for action. Each year, about 6 percent of America's children and adolescents receive some form of MH care, at an annual cost of more than $11 billion. In addition, 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 the proposed research will advance our understanding of how to successfully integrate EBIs into everyday practice within community MH service settings for youth. Increasing the likelihood that EBIs will be adopted, used as intended, and sustained in everyday practice, in turn, increases the likelihood that youth and society at large will benefit from evidence-based practices.