Examining co-production as an implemntation strategy for autism early intervention delivered in Part C service systems

检验联合生产作为 C 部分服务系统中自闭症早期干预的实施策略

• 批准号: 10663459
• 负责人: Katherine Pickard
• 金额: $ 18.58万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663459
• 关键词: Address; Area; Caregivers; Caring; Cessation of life; Child; Child Development; Clinical; Clinical Trials; Clinical Trials Design; Communities; Complement; Complex; Cultural Diversity; Data; Doctor of Philosophy; Drops; Early Intervention; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Enrollment; Equilibrium; Evaluation; Event; Evidence based intervention; Evidence based treatment; Family; Funding; Goals; Housing; Hybrids; Inequity; Intervention; Intervention Studies; K-Series Research Career Programs; Knowledge acquisition; Mediating; Mediator; Mentors; Mentorship; Methods; Modeling; National Institute of Mental Health; Nobel Prize; Outcome; Parents; Patient-Focused Outcomes; Positioning Attribute; Postdoctoral Fellow; Process; Production; Provider; Quality of life; Reporting; Research; Research Personnel; Role; Scientist; Service delivery model; Services; Shapes; System; Testing; Training; Training Support; Translating; Translations; Underrepresented Populations; Work; access disparities; autism spectrum disorder; autistic children; career; clinical decision-making; community engaged research; community setting; design; evidence base; experience; flexibility; implementation evaluation; implementation strategy; improved; intervention delivery; marginalized community; randomized trial; response; service delivery; shared decision making; skills; social health determinants; success

PROJECT SUMMARY/ABSTRACT The purpose of this K23 Career Development Award is to support the applicant in acquiring the knowledge and skills needed for an independent research career as an implementation scientist who evaluates strategies that enhance the impact of early intervention for children with Autism Spectrum Disorder (ASD) when delivered in diverse service systems. It will achieve this by complementing the candidate’s background in community engaged research with expert mentorship in intervention fidelity and adaptation, clinical decision making, clinical trial design and evaluation, and [autism service inequities among underrepresented children]. Persistent disparities accessing early intervention compromise the quality of life of autistic children and their families and can be addressed by translating evidence-based treatments, such parent-mediated interventions (PMIs), into service systems that are an access point to care for young children. Although translation efforts are under way, high attrition has compromised the impact of PMIs when delivered win marginalized communities. This gap may reflect an emphasis on implementing PMIs in a manner that maintains fidelity while also at times conflicting with the complex needs of underrepresented families that inevitably arise in PMI. This K23 proposal will address this gap by evaluating co-production, or the balance between fidelity and family- centered care, within an evidence-based PMI for ASD, Project ImPACT, delivered in a state-funded Early Intervention system. Mixed-methods findings from the first research aim will be used by key stakeholders to develop and evaluate an implementation strategy that targets ideal co-production to enhance caregiver engagement within Project ImPACT. Under the primary mentorship of Lawrence Scahill, Ph.D., an expert in clinical trials for ASD, and co-mentorship from Aubyn Stahmer, Ph.D., Chris Sheldrick, Ph.D., [and Jennifer Singh, PhD.], the applicant will pursue training in: 1) early intervention fidelity and adaptation; 2) clinical and shared decision making; 3) the design and execution of clinical trials; and [4) cultural diversity and systemic inequities]. Training in these areas will enhance the applicant’s pursuit of the following research aims: 1) Evaluate co-production within Project ImPACT; 2) Develop an implementation strategy that targets ideal co- production within Project ImPACT by teaching the balance of fidelity and family-centered care; and 3) Conduct a pilot randomized trial to assess the feasibility of evaluating Project ImPACT training when paired with the co- production implementation strategy (Project ImPACT-C) in comparison to Project ImPACT training as usual (Project ImPACT-TAU). This proposal is aligned with NIMH’s strategic objective [4.3a to adapt evidence-based intervention to account for moderators, including social determinants of health, that impact effectiveness among underrepresented groups]. Further, the strong training and research plans embedded within this K23 proposal will effectively position the applicant for an independent research career evaluating strategies that enhance the service outcomes of ASD interventions when implemented within diverse service systems.

项目摘要/摘要 这个K23职业发展奖的目的是支持申请人获取知识和 作为实施科学家，独立研究职业所需的技能，他们评估了策略 交付后，增强早期干预对自闭症谱系障碍（ASD）的影响 潜水员服务系统。它将通过完成候选人的社区背景来实现这一目标 从事干预忠诚和适​​应，临床决策，以专家心态的研究， 临床试验设计和评估，以及代表性不足的儿童的自闭症服务不平等]。 持续的分布进行早期干预措施损害了加速儿童及其的生活质量 家庭，可以通过翻译基于循证的治疗，这种父母介导的干预措施来解决 （PMI）进入服务系统，是照顾幼儿的访问点。虽然翻译工作 正在进行中，大量损耗损害了PMI的影响。 社区。这个差距可能反映出以保持忠诚的方式实施PMI 有时还与不可避免地在PMI出现的代表性不足的家庭的复杂需求相抵触。这 K23提案将通过评估共同生产或忠诚度与家庭之间的平衡来解决这一差距 集中的护理，在基于证据的ASD循证PMI中，项目影响，以国家资助的早期资助 干预系统。主要利益相关者将使用第一个研究目标的混合方法调查结果 开发和评估针对理想共同生产以增强照顾者的实施策略 参与项目影响。在劳伦斯·斯卡希尔（Lawrence Scahill）博士的主要心态下，专家 ASD的临床试验和来自Aubyn Stahmer博士的Chris Sheldrick博士的临床试验[和Jennifer 辛格（Singh），博士]，申请人将在以下方面接受培训：1）早期干预保真度和适应； 2）临床和 共同的决策； 3）临床试验的设计和执行； [4）文化多样性和系统性 不平等]。在这些领域的培训将增强申请人对以下研究的追求：1） 评估项目影响中的共同制作； 2）制定针对理想共同的实施策略 通过教授忠诚度和以家庭为中心的护理的平衡来产生项目影响； 3）行为 一项试验随机试验，以评估评估项目影响培训的可行性 与往常 （Project Impact-Tau）。该提案与NIMH的战略目标[4.3a调整基于证据的战略目标一致 干预以说明主持人，包括健康的社会决定者，影响有效性 在代表性不足的群体中]。此外，嵌入在此K23中的强大培训和研究计划 提案将有效地定位申请人的独立研究职业，评估策略 在潜水员服务系统中实施时，可以增强ASD干预措施的服务结果。