Increasing accuracy and efficiency of fidelity measurement in CBT

提高 CBT 保真度测量的准确性和效率

• 批准号: 9008530
• 负责人: Rinad Sary Beidas
• 金额: $ 60.78万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9008530
• 关键词: Adherence; Affordable Care Act; Behavior; Behavioral; Caring; Child; Cities; Client; Clinic; Code; Cognitive Therapy; Collaborations; Communities; Competence; Data; Ensure; Evidence based practice; Family; Future; Goals; Gold; Intervention; Interview; Measurement; Measures; Mediating; Mental Health; Methodology; Methods; Monitor; National Institute of Mental Health; Outcome; Patient Self-Report; Patients; Philadelphia; Play; Process; Protocols documentation; Psychotherapy; Public Health; Quality Indicator; Randomized; Research; Research Support; Resources; Role; Scientist; Strategic Planning; Techniques; Time; Training; Work; arm; base; community setting; cost; cost effective; cost effectiveness; economic cost; evidence base; implementation science; improved; innovation; psychosocial; public health relevance; rehearsal; standard measure; stem; tool; willingness

 DESCRIPTION (provided by applicant): The goal of proposed project is to strengthen the public health impact of psychosocial interventions by identifying fidelity measurement methods that can be used for research and practice. To date, fidelity has posed a thorny measurement quandary because few reliable, valid, and efficient fidelity measurement methods exist. The gold standard for measuring fidelity to psychosocial interventions, direct observation of therapist behavior, requires extensive resources. When fidelity is measured in the community, the most commonly used and least resource intensive method is self-report. Unfortunately, concordance between observation and self-report is low. There is a critical need to identify and evaluate methods of fidelity measurement that are accurate (i.e., measure what they intend) and cost-effective. Our objective in this measurement proposal is to compare the accuracy and cost-effectiveness of self-report (fidelity measurement- as-usual) and two innovative methods (chart stimulated recall and behavioral rehearsal) in assessing fidelity to cognitive-behavioral therapy, an established evidence-based practice. We will randomize 135 therapists, trained in cognitive-behavioral therapy through an initiative to implement evidence-based practices in the City of Philadelphia, to 3 conditions: self-report (N = 45), chart stimulated recall (N = 45), and behavioral rehearsal (N = 45). All conditions will include direct observation using the Therapy Process Observational Coding System as the gold-standard comparison. In Aim 1, we will identify the most accurate fidelity measurement method. In Aim 2, we will estimate the economic costs and cost-effectiveness of the proposed fidelity measurement methods. In Aim 3, we will compare stakeholders' willingness to use each method, as well as identify their perceived barriers and facilitators to use of each method. The proposed work is consistent with the NIMH strategic plan, specifically Objective 4, to strengthen the public health impact of NIMH-supported research. This study will have a significant positive impact by producing fidelity measurement methods that can then be used by implementation scientists for research and community mental health clinics to monitor therapist fidelity, an indicator of therapy quality.

 描述（由适用提供）：拟议项目的目的是通过识别可用于研究和实践的保真度测量方法来增强社会心理干预的公共卫生影响。迄今为止，由于很少有可靠，有效和有效的保真度测量方法，因此已经提供了棘手的测量。衡量对社会心理干预措施的忠诚度，直接观察治疗师行为的金标准需要广泛的资源。当在社区中衡量忠诚时，最常用和资源最少的方法是自我报告。不幸的是，观察和自我报告之间的一致性很低。迫切需要识别和评估准确的忠诚度测量方法（即测量他们打算的内容）和具有成本效益的方法。我们在这项测量建议中的目标是比较自我报告（Fidelity）测量的准确性和成本效益 - 通常）和两种创新的方法（图表刺激召回和行为排练），以评估对认知行为治疗的忠诚度，这是一种基于循证的循证实践。我们将通过一项在费城市实施基于证据的实践的倡议，将135名治疗师随机培训，以实施基于证据的实践为3个条件：自我报告（n = 45），图表刺激召回（n = 45）和行为彩排（n = 45）（n = 45）。所有条件将包括使用治疗过程观察编码系统作为金标准比较的直接观察。在AIM 1中，我们将确定最准确的保真度测量方法。在AIM 2中，我们将估算拟议的保真度测量方法的经济成本和成本效益。在AIM 3中，我们将比较利益相关者使用每种方法的意愿，并确定他们的障碍和促进者使用每种方法。拟议的工作与NIMH战略计划，特别是目标4一致，以增强NIMH支持的研究的公共卫生影响。这项研究将通过产生忠诚度测量方法产生重大的积极影响，然后将科学家用于研究和社区心理健康诊所来监测治疗师的忠诚度，这是治疗质量的指标。