Improving Therapist Fidelity During EBP Implementation

在 EBP 实施过程中提高治疗师的忠诚度

• 批准号: 6955540
• 负责人: CAROLYN H WEBSTER-STRATTON
• 金额: $ 55.34万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-29 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6955540
• 关键词: behavior therapy; behavioral /social science research tag; child rearing; clinical research; health care personnel performance; health services research tag; human subject; human therapy evaluation; outcomes research; patient oriented research; training

DESCRIPTION (provided by applicant): The aim of the current study is to experimentally test two implementation models for achieving treatment fidelity and positive child and parent outcomes in the delivery of the Incredible Years (IY) parent program. Ultimately, effective implementation of an EBP intervention, such as IY, in community mental health settings depends upon therapists learning the new program and delivering it with adherence to the content and competence in the therapeutic methods and processes. Even for well documented interventions, such as the IY, which has strong material support and a long history of providing complementary training workshops, effective implementation may require more intensive efforts to support high fidelity implementation. Improving understanding of factors that influence effective implementation and fidelity to evidence-based practices (EBP) is an important national health care priority. This randomized, controlled trial will compare two models for implementing the Incredible Years treatment program with a usual care control condition. Organizations delivering the program under the Standardized Implementation Model (SIM) will receive detailed materials supporting the Incredible Years and will participate in one-time intensive training. The Enhanced Implementation Model (EIM) includes all elements of SIM plus initial organizational support, promotion of values fit between therapist and organization, and ongoing training, technical support and consultation for therapists and agency supervisors. This study will test these two IY implementation models in a sample of 720 children with conduct problems whose families are receiving Temporary Assistance for Needy Families (TANF) in California. Two-thirds of families selected for the study will be randomly assigned to participate in the Incredible Years parenting program, which will be paid for by Medicaid, while one-third of families will be followed naturalistically with no changes made to the normal services they receive through TANF (CONTROL). Among families participating in the Incredible Years conditions, half will receive these services from therapists in an agency randomized to implement the practice under the SIM. The other half will receive services from therapists in an agency randomized to implement under the EIM. Parent and child outcomes under the two-implementation models will be assessed as well as therapist implementation fidelity under each condition.

描述（由申请人提供）：当前研究的目的是实验测试两个实施模型，以实现治疗忠诚度，并在交付令人难以置信的年份（IY）父母计划的过程中取得积极的子女和父母的结果。最终，在社区心理健康环境中的有效实施EBP干预措施（例如IY）取决于治疗师学习新计划并遵守治疗方法和过程中的内容和能力。即使有据可查的干预措施，例如IY，它具有强大的物质支持和提供互补培训讲习班的悠久历史，有效的实施也可能需要更深入的努力来支持高保真实施。 提高对影响有效实施的因素的理解和对循证实践（EBP）的忠诚是重要的国家卫生保健优先事项。这项随机对照试验将比较两个模型，用于实施具有常规护理控制条件的令人难以置信的年份治疗计划。根据标准化实施模型（SIM）提供该计划的组织将获得支持令人难以置信的年份的详细材料，并将参加一次性的密集培训。增强的实施模型（EIM）包括SIM的所有要素以及最初的组织支持，促进治疗师和组织之间的价值观以及持续的培训，治疗师和机构主管的技术支持和咨询。这项研究将在720个有行为问题的儿童样本中测试这两个IY实施模型，他们的家庭正在为有需要的家庭（TANF）在加利福尼亚州获得临时援助。被选为研究的家庭中有三分之二将被随机分配参加令人难以置信的育儿计划，该计划将由医疗补助支付，而三分之一的家庭将受到自然主义的遵循，而没有对他们通过TANF（Control）获得的正常服务进行任何更改。在参加令人难以置信的几年条件的家庭中，一半将从一个随机实施SIM的机构中的治疗师那里获得这些服务。另一半将收到一家机构中随机实施EIM的治疗师的服务。将评估两次实施模型下的父母和子女结果，并在每种情况下进行治疗师的实施保真度。