Improving Therapist Fidelity During EBP Implementation

在 EBP 实施过程中提高治疗师的忠诚度

基本信息

批准号：
7254232
负责人：
CAROLYN H WEBSTER-STRATTON
金额：
$ 49.58万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
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/7254232
关键词：
Adherence Affect Aid to Families with Dependent Children Attention Behavior California Caring Child Communities Competence Condition Consultations Control Groups Development Discipline Disease Educational workshop Effectiveness Elements Evidence based practice Family Future Health system Healthcare Intervention Laboratory Research Learning Life Low income Measures Medicaid Mental Health Methods Modeling Numbers Outcome Parenting behavior Parents Pharmaceutical Preparations Population Poverty Principal Investigator Procedures Process Programmed Learning Public Health Randomized Randomized Controlled Trials Range Recording of previous events Relative (related person)Reporting Research Risk Sampling Services Site Standards of Weights and Measures Supervision Technology Testing Therapeutic Time Training Violence anti social cost early onset externalizing behavior improved programs skills treatment program trial comparing

项目摘要

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）：当前研究的目的是通过实验测试两种实施模型，以实现难以置信的岁月（IY）家长计划中的治疗保真度以及积极的儿童和家长成果。最终，在社区心理健康环境中有效实施 EBP 干预（例如 IY）取决于治疗师学习新计划并遵循治疗方法和过程中的内容和能力来实施该计划。即使对于有据可查的干预措施，例如国际年，它拥有强大的物质支持和提供补充培训研讨会的悠久历史，有效的实施可能需要更深入的努力来支持高保真度的实施。提高对影响有效实施和忠实于循证实践 (EBP) 的因素的理解是国家医疗保健的重要优先事项。这项随机对照试验将比较两种实施 Incredible Years 治疗计划的模型与常规护理对照条件。根据标准化实施模型 (SIM) 实施该计划的组织将收到支持“难以置信的岁月”的详细材料，并将参加一次性强化培训。增强实施模型 (EIM) 包括 SIM 的所有要素，加上初始组织支持、促进治疗师和组织之间的价值观契合度，以及对治疗师和机构主管的持续培训、技术支持和咨询。本研究将以 720 名有品行问题的儿童为样本，测试这两种 IY 实施模式，这些儿童的家庭正在加州接受贫困家庭临时援助 (TANF)。被选中参加研究的家庭中的三分之二将被随机分配参加“难以置信的岁月”育儿计划，该计划将由医疗补助支付费用，而三分之一的家庭将被自然地跟踪，他们所接受的正常服务不会发生变化通过贫困家庭临时援助 (TANF)（对照）。在参与“难以置信的岁月”条件的家庭中，有一半的家庭将接受随机分配的机构中的治疗师提供的服务，以实施 SIM 下的实践。另一半将在 EIM 下随机实施的机构中接受治疗师的服务。将评估两种实施模式下的父母和孩子的结果以及每种情况下治疗师实施的保真度。