Fidelity, Assessment and Clinical Effectiveness Tracking: Making FFT Sustainable

在治疗青少年药物滥用和相关问题方面的进展导致了 强调重新分配资源，将循证治疗（EBT）转移到“现实世界”环境中， 然而，科学与实践之间的差距仍然是一个紧迫的问题。由于高度复杂和多方面的过程， 参与将EBT转化为实践环境和一系列传播障碍，包括缺乏资源， 基础设施、技术基础和质量保证能力，只有一小部分人在接受治疗 对于物质使用障碍（SUD），接受EBT。此外，在疗效试验中取得的显著进展是 如果不对保真度进行密集监测，就难以在实际实践中复制，保真度是 成功缺乏可行的具有成本效益的保真度监测工具和上层建筑，以确保社区- 基于从业人员维持能力和坚持提供服务是一个主要障碍， 传播;迫切需要创新的方法和程序。拟议的第一阶段SBIR将 涉及开发原型理论指导，经验为基础，用户友好的在线反馈， 指导和支持青少年功能性家庭治疗（FFT）实施的监测系统 药物滥用，一种行之有效的治疗方法，可减少药物使用和相关问题， 加强青年和家庭的适应功能。跟踪系统“依从性和临床有效性” (ACE)旨在促进临床医生对治疗依从性的自我调节，并为社区提供 更直接地获得与保持保真度有关的质量保证信息的计划， 实现积极的青年和家庭治疗成果。该系统的采用预计将弥合 科学与实践之间的差距，增强FFT传播服务的吸引力、用户友好性和市场性 提供给青少年门诊药物治疗计划的LIFFT公司，第一阶段将重点放在创造 内容，并开发和测试基于网络的ACE原型的功能和可行性 系统第二阶段将完成一个功能齐全、功能齐全、商业上可行的程序的开发 并在随机对照试验中评价ACE用于增强 治疗环境的可持续性。具体目标是：目标1：基于FFT为ACE开发内容 理论，经验证据，以及我们之前广泛的FFT培训，监督和传播经验。 目标2：编写ACE在线框架的Alpha原型，其中包含以下基本要素： 文本、图形和交互功能。原型将包括一个安全的网站和可填写的电子表格 以及用于数据收集、存储和检索的其他机制，用于仪表板数据汇总和临床 报道目标3：通过独立的试点样本测试ACE原型的功能和可行性， 15名FFT临床医生和主管。功能测试将包括登录程序、导航、上传 音频文件（即，“代理”治疗记录）和在线表单提交。

Advances in treating adolescent substance abuse and related problems have resulted in an increased emphasis on redirecting resources to transport evidence-based treatments (EBTs) into “real-world” settings, yet the science-practice gap remains a pressing problem. Due to highly complex and multifaceted processes involved in translating EBTs to practice settings and to a host of diffusion barriers, including lack of resources, infrastructure, and technology-based and quality assurance capacity, only a fraction of individuals in treatment for substance use disorder (SUD) receive EBTs. Further, the significant gains achieved in efficacy trials are difficult to replicate in actual practice without intensive monitoring of fidelity, an essential component of success. The lack of feasible cost efficient fidelity monitoring tools and superstructures to ensure community- based practitioners sustain competent and adherent service delivery represents a major impediment for dissemination; innovative methods and procedures are urgently needed. The proposed Phase I SBIR will involve the development of a prototype theory-guided, empirically based, and user-friendly online feedback and monitoring system to guide and sustain the implementation of Functional Family Therapy (FFT) for adolescent substance abuse, a well-established treatment shown to reduce substance use and related problems and enhance youth and family adaptive functioning. The tracking system “Adherence and Clinical Effectiveness” (ACE) will be designed to foster clinicians' self-regulation of treatment adherence and provide community programs with more direct access to quality assurance information pertinent to maintaining fidelity and achieving positive youth and family treatment outcomes. The adoption of the system is expected to bridge the science-practice gap, enhancing the appeal, user-friendliness, and marketability of FFT dissemination services delivered to adolescent outpatient drug treatment programs by LIFFT, Co. Phase I will focus on creating content, and developing and testing the functionality and feasibility of a prototype of the web-based ACE system. Phase II will complete the development of a fully functional, full-featured, commercially viable program and evaluate, in a randomized controlled trial, the acceptability and effectiveness of ACE for enhancing sustainability in treatment settings. The specific aims are: Aim 1: Develop content for ACE, based on FFT theory, empirical evidence, and our prior extensive FFT training, supervision, and dissemination experiences. Aim 2: Program an Alpha prototype of the ACE online framework that contains the basic essential elements of text, graphics, and interactive features. The prototype will include a secure website and fillable electronic forms and other mechanisms for data collection, storage, and retrieval for dashboard data summary and clinical reports. Aim 3: Test the functionality and feasibility of the ACE prototype with an independent pilot sample of 15 FFT clinicians and supervisors. Functionality testing will include login procedures, navigation, uploading of audio files (i.e., “proxy” therapy recordings), and online form submission.