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.

项目概要/摘要自闭症谱系障碍 (ASD) 是一种终生神经发育障碍，每 54 名儿童中就有 1 人患有自闭症谱系障碍 (ASD) 美国。已经制定了许多基于证据的干预措施来改善儿童的结局患有自闭症谱系障碍的儿童。然而，研究与实践之间存在 17 年的差距，其中循证实践 (EBP) 在实验室环境中开发的产品最终到达社区环境。咨询模型通常包括多个组件的组合，这可能会对提供商的行为产生不同的影响。这个单例实验设计将通过实验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) 机构的录音课程、案例支持和技能演练），以便确定咨询模式的潜在积极成分。磋商将集中于远程医疗服务的提供对自闭症谱系障碍儿童进行实证支持的手动家长介导干预（Project ImPACT）。将从与区域签订合同的 4 个机构（总共约 20 个提供商）中招募 3-5 个提供商组成的小组密歇根州医疗补助自闭症福利中的社区心理健康机构，该福利提供了应用为参加医疗补助的患有自闭症谱系障碍 (ASD) 的青少年提供行为分析服务。提供商将完成在线自我指导 ImPACT 项目教程。每个提供者将在其案例中登记至少一名有孩子的护理人员参加了密歇根医疗补助自闭症福利（N = ~20 名护理人员）。接下来各机构将随机抽取分配给 a) 基线期的长度（3-6 周之间）和 b) 他们将收到的订单咨询组成部分。提供者将每周与其登记的家庭录制一次会议，并通过以下方式提交：符合 HIPAA 要求的 Dropbox 链接。他们还将每周完成有关实施情况的在线调查问卷结果。将通过每周会议的观察编码来评估实施结果治疗依从性和能力，以及每周有关病例的提供者调查问卷分析 ImPACT 项目和 3 个项目的渗透率、可行性、可接受性和适当性咨询阶段。提供者将在 8 周后提交最终录制的会话和调查问卷咨询。护理人员将通过在线方式为孩子完成一定程度的社交沟通基线时、咨询期间两次以及咨询后 8 周后进行问卷调查。数据分析包括多层次建模和可视化分析。结果将确定咨询的活性成分该模型稍后将用于开发协商改进机制的因果模型实施成果。培训计划包括指导、课程、研讨会和体验式学习并将发展自闭症领域功效和实施研究的专业知识。