Feasibility, Preliminary Effectiveness, and Sustainability of a Cognitive-Behavioral Therapy Program Tailored for Youth with Autism and Anxiety Treated in Real-World Community-Based Clinics
为患有自闭症和焦虑症的青少年量身定制的认知行为治疗计划的可行性、初步有效性和可持续性,并在现实世界的社区诊所进行治疗
基本信息
- 批准号:10542409
- 负责人:
- 金额:$ 23.27万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-01-01 至 2023-12-31
- 项目状态:已结题
- 来源:
- 关键词:AccelerationAddressAdoptionAdvocateAffectAgeAnxietyAnxiety DisordersBehavioralChildClinicClinicalCognitive TherapyCollaborationsCommunitiesCommunity Mental Health CentersCommunity Mental Health ServicesComplexConsultDataDiagnosisDiagnosticDistressEffectivenessEmotionalEvidence based interventionEvidence based practiceExploration, Preparation, Implementation, and SustainmentFamilyFeedbackFundingFutureGoalsHealth systemHybridsImpairmentIndividualInterventionKnowledgeLearningMeasurementMedicalMental HealthMental Health ServicesMethodsModelingNeeds AssessmentNeurodevelopmental DisorderNorth CarolinaOutcomeParentsPhasePilot ProjectsPlayPopulation InterventionPreparationProtocols documentationPublic HealthQuality of lifeRandomized, Controlled TrialsRecommendationRural CommunitySamplingServicesSeveritiesSiteTexasTherapeutic InterventionTimeTrainingTranslatingTreatment outcomeUnderserved PopulationUnited States National Institutes of HealthUrban CommunityWorkYouthacceptability and feasibilityaccess disparitiesadolescent with autism spectrum disorderanxiety symptomsanxiety treatmentautism spectrum disorderautistic childrencommunity buildingcommunity settingcontextual factorsdesigneffectiveness/implementation trialefficacious interventionefficacy evaluationevidence baseexperiencefeasibility testingfunctional outcomesimplementation determinantsimplementation outcomesimplementation scienceimprovedindividuals with autism spectrum disordermental health centerpersonalized medicineprogramsrecruitresearch to practicerural areascale upstandard caretreatment as usualtreatment programtreatment responseuptakeurban area
项目摘要
PROJECT SUMMARY/ABSTRACT
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder affecting 1 in 54 U.S. children.
Co-occurring anxiety affects 40 to 50% of children with ASD, causing substantial distress and impairment.
Treatment of anxiety is a high priority for parents of children with ASD, and cognitive-behavioral therapy (CBT)
modified for ASD has demonstrated efficacy relative to standard care CBT and usual care. However, existing
protocols have been established for academic medical settings with limited stakeholder input and
correspondingly diminished potential for real-world uptake in community-based clinics. Accordingly, we propose
a study in which stakeholders from both rural and urban communities are fully engaged to develop a CBT
intervention and associated clinician training protocol - Community-based Anxiety Program Tailored for Autism
(CAPTA) - that is able to be readily employed in community mental health settings. We will then preliminarily
evaluate treatment response and mechanisms. In Aim 1, we will conduct a needs assessment with parents of
youth with ASD and co-occurring anxiety, community mental health clinicians, and community mental health
clinic leaders; we will also consult with an Advisory Board of experts in CBT for co-occurring anxiety in youth
with ASD and individuals with lived experience (i.e., parents and self-advocates). This feedback from
stakeholders and experts will directly inform adaptations to CAPTA. We will then conduct a small open trial
(N=10) with the goal of obtaining real-world experience and refining the treatment and measurement protocols.
Aim 2 involves a pilot randomized controlled trial in which CAPTA is compared to usual care in two different
community-based mental health centers (N=60). We will examine CAPTA’s preliminary effectiveness to improve
anxiety symptom severity and impairment, and we will also explore theoretically oriented treatment mechanisms.
Aim 3 focuses on implementation outcomes (fidelity, feasibility, acceptability) and contextual factors influencing
CAPTA implementation and sustainment. The proposed project is well-aligned with recommendations from the
Interagency Autism Coordinating Committee to scale up and implement evidence-based interventions in
community settings, expand the services workforce, and accelerate the pipeline from research to practice.
Specifically, this pilot study will establish the feasibility and acceptability of transporting CBT for youth with ASD
and co-occurring anxiety to community mental health clinics before progressing to a larger hybrid effectiveness-
implementation trial in an R01.
项目概要/摘要
自闭症谱系障碍 (ASD) 是一种常见的神经发育障碍,每 54 名美国儿童中就有 1 名受到影响。
40% 至 50% 的 ASD 儿童同时存在焦虑,造成严重的痛苦和损害。
治疗焦虑是 ASD 儿童家长的首要任务,认知行为疗法 (CBT)
相对于标准护理 CBT 和常规护理,针对 ASD 的改良已被证明有效。
已经为利益相关者投入有限的学术医疗环境制定了协议,
因此,我们建议现实世界中社区诊所的采用潜力相应减弱。
一项研究,其中农村和城市社区的利益相关者充分参与制定 CBT
干预和相关临床医生培训方案 - 为自闭症量身定制的基于社区的焦虑计划
(CAPTA) - 我们将初步在社区心理健康环境中使用。
评估治疗反应和机制 在目标 1 中,我们将与家长进行需求评估。
患有自闭症谱系障碍 (ASD) 并同时发生焦虑症的青少年、社区心理健康新移民和社区心理健康
诊所领导;我们还将就青少年同时发生的焦虑问题咨询 CBT 专家咨询委员会
自闭症谱系障碍患者和有生活经验的个人(即父母和自我倡导者)的反馈。
利益相关者和专家将直接通知 CAPTA 的调整,然后我们将进行小型公开试验。
(N=10) 的目标是获得现实世界的经验并完善治疗和测量方案。
目标 2 涉及一项试点随机对照试验,其中将 CAPTA 与两种不同的常规护理进行比较
我们将检查 CAPTA 改善社区精神卫生中心的初步效果。
焦虑症状的严重程度和损害,我们还将探索理论导向的治疗机制。
目标 3 侧重于实施结果(保真度、可行性、可接受性)和影响的背景因素
CAPTA 的实施和维持与建议的项目非常一致。
机构间自闭症协调委员会将扩大和实施基于证据的干预措施
社区设置,扩大服务劳动力,并加快从研究到实践的进程。
具体来说,这项试点研究将确定为患有 ASD 的青少年提供 CBT 的可行性和可接受性
在取得更大的混合效果之前,社区心理健康诊所会同时出现焦虑症 -
在 R01 中进行实施试验。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Brenna Maddox其他文献
Brenna Maddox的其他文献
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{{ truncateString('Brenna Maddox', 18)}}的其他基金
Feasibility, Preliminary Effectiveness, and Sustainability of a Cognitive-Behavioral Therapy Program Tailored for Youth with Autism and Anxiety Treated in Real-World Community-Based Clinics
为患有自闭症和焦虑症的青少年量身定制的认知行为治疗计划的可行性、初步有效性和可持续性,并在现实世界的社区诊所进行治疗
- 批准号:
10355838 - 财政年份:2022
- 资助金额:
$ 23.27万 - 项目类别:
Improving Community Mental Health Services for Adults with ASD and Co-Occurring Psychiatric Disorders
改善患有自闭症谱系障碍和并发精神疾病的成年人的社区心理健康服务
- 批准号:
9314174 - 财政年份:2017
- 资助金额:
$ 23.27万 - 项目类别:
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