Examining the active ingredients of consultation to improve implementation of a parent-mediated intervention for children with autism in the community mental health system.

检查咨询的有效成分，以改善社区心理卫生系统中自闭症儿童家长介导的干预措施的实施。

基本信息

批准号：
10469331
负责人：
Diondra Straiton
金额：
$ 3.9万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-16 至 2023-07-15
项目状态：
已结题

项目摘要

PROJECT SUMMARY/ABSTRACT Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disability that affects 1 in 54 children in the United States. Many evidence-based interventions have been developed that improve child outcomes for children with ASD. Yet there is a 17-year research-to-practice gap in which evidence-based practices (EBPs) developed in laboratory settings finally reach community settings. Consultation models are typically comprised of multiple components, which may differentially influence provider behavior. This single-case experimental design will experimentally manipulate three potential active ingredients of a consultation model (feedback on taped sessions, case support, and skill rehearsal) in 4 applied behavior analysis (ABA) agencies in order to identify potential active ingredients of the consultation model. Consultation will focus on telehealth delivery of an empirically supported manualized parent-mediated intervention for children with ASD (Project ImPACT). Groups of 3-5 providers will be recruited from 4 agencies (N = ~20 providers in total) that contract with regional community mental health agencies within the Michigan Medicaid Autism Benefit, which provides applied behavior analysis services to Medicaid-enrolled youth with ASD. Providers will complete a self-directed online tutorial on Project ImPACT. Each provider will enroll at least one caregiver on their caseload who has a child enrolled in the Michigan Medicaid Autism Benefit (N = ~20 caregivers). Next, each agency will be randomly assigned to a) the length of the baseline period (between 3-6 weeks) and b) the order that they will receive the consultation components. Providers will record one session per week with their enrolled family and submit it via a HIPAA compliant Dropbox link. They will also complete weekly online questionnaires on implementation outcomes. Implementation outcomes will be assessed via observational coding of weekly sessions for treatment adherence and competence, and analysis of weekly provider questionnaires regarding case penetration, and feasibility, acceptability, and appropriateness of Project ImPACT and each of the 3 consultation phases. Providers will submit a final recorded session and questionnaire 8-weeks post- consultation. Caregivers will complete a measure of social communication for their child via online questionnaire at baseline, twice during consultation, and after 8 weeks post-consultation. Data analysis includes multilevel modeling and visual analysis. Results will identify active ingredients of the consultation model which will later be used to develop a causal model of the mechanism by which consultation improves implementation outcomes. The training plan consists of mentorship, courses, workshops, and experiential learning and will develop expertise in efficacy and implementation research within the autism field.

项目摘要/摘要自闭症谱系障碍（ASD）是一种终生的神经发育障碍，影响54名儿童中有1个美国。已经开发了许多基于证据的干预措施有ASD的孩子。然而，有一个17年的研究差距，其中循证实践（EBP）在实验室环境中开发的最终达到了社区环境。咨询模型通常包括多个组件，这可能会影响提供者行为。这个单例实验设计将在实验中操纵咨询模型的三种潜在活性成分（反馈 4个应用行为分析（ABA）机构中的录音会议，案例支持和技能彩排）确定咨询模型的潜在活跃成分。咨询将集中于远程医疗交付对ASD的儿童（项目影响）的经验支持的手动父母介导的干预措施。将从4个机构（总共n = 〜20个提供商）招募3-5个提供商的组，与区域合同密歇根州医疗补助自闭症福利的社区心理健康机构，该机构提供了适用的为ASD提供医疗补助注册的青年的行为分析服务。提供者将在线完成一个自我指导的有关项目影响的教程。每个提供商将至少注册一个有孩子的案件的照顾者加入密歇根州医疗补助自闭症福利（n = 〜20名护理人员）。接下来，每个机构将是随机的分配给a）基准期的长度（在3-6周之间）和b）他们将收到的顺序咨询组件。提供者将每周与入学家记录一次会议，并通过符合HIPAA的Dropbox链接。他们还将完成有关实施的每周在线问卷结果。实施结果将通过每周会议的观察编码进行评估治疗依从性和能力，以及有关案件的每周提供者问卷的分析渗透以及项目影响的可行性，可接受性和适当性以及3个咨询阶段。提供者将提交最终记录的会议，并提出问卷8周咨询。护理人员将通过在线完成对孩子的社交交流的衡量标准基线的问卷调查，两次在咨询期间，并在征求后8周后。数据分析包括多级建模和视觉分析。结果将确定咨询的积极成分稍后将用于开发咨询改善机制的因果模型的模型实施结果。培训计划包括指导，课程，讲习班和体验式学习并将在自闭症领域内发展功效和实施研究方面的专业知识。