A Hybrid Effectiveness-Implementation Trial of Group CBT in Urban Schools

城市学校团体 CBT 的混合有效性实施试验

• 批准号: 9883053
• 负责人: Ricardo B Eiraldi
• 金额: $ 70.52万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-15 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9883053
• 关键词: Address; Adoption; Aftercare; Anxiety; Anxiety Disorders; Behavioral; Characteristics; Child; Cities; Clinical; Cognitive Therapy; Communities; Competence; Consultations; Contracts; Cost Analysis; Counseling; Diagnostic; Effectiveness; Emotional; Evidence based practice; Exposure to; Friends; Funding; Health; Health Insurance Portability and Accountability Act; Impairment; Intervention; Learning; Life; Link; Low income; Measures; Mediating; Mediator of activation protein; Medicaid; Mental Health; Mental Health Services; National Institute of Mental Health; Nonprofit Organizations; Outcome; Philadelphia; Population; Procedures; Process; Program Development; Protocols documentation; Provider; Randomized; Research; Resources; Schools; Services; Severities; Social Problems; Strategic Planning; Stress; Supervision; Symptoms; System; Testing; Trainers Training; Training; Training Support; Treatment Effectiveness; Treatment Protocols; Work; anxiety treatment; arm; behavioral health; child services; cloud based; community setting; comparative cost effectiveness; contextual factors; cost; cost effective; cost effectiveness; design; dissemination research; effectiveness implementation study; effectiveness implementation trial; evidence base; implementation research; implementation strategy; improved; interdisciplinary collaboration; mental training; psychosocial; public health relevance; school district; treatment group; urban school

 DESCRIPTION (provided by applicant): Schools in low-income urban communities present a context with great potential for the implementation of psychosocial evidence-based practices (EBPs). Cognitive-behavioral therapy (CBT) is an EBP that has been found to be very effective in treating anxiety in various community settings, including schools. Friends for Life (FRIENDS) are an efficacious group CBT protocol for anxiety. Unfortunately, EBPs for anxiety are seldom employed in under-resourced urban schools, because treatment protocols are not tailored to the context or the population, existing behavioral health staff does not receive adequate training or support to allow them to implement the treatment with fidelity, and school districts do not have the resources to contract outside providers or consultants. In our prior work, we developed a more culturally sensitive, focused, and feasible CBT for anxiety protocol (adapted FRIENDS). The adapted protocol (aFRIENDS) addresses one of the major barriers to implementation (intervention context fit). Community mental health agency therapists who provide services in schools usually receive some training in EBPs but typically lack access to adequate support, such as clinical supervision, which is necessary for maintaining treatment fidelity. Two important questions regarding dissemination and implementation (D&I) of EBPs are: a) Can publicly funded mental health therapists in urban schools successfully implement EBPs when supported by their own agencies or does successful implementation require external, expert support? b) What is the comparative cost effectiveness of these two different implementation strategies? The aim of this five-year study is to conduct a 3-arm, parallel group, Type 2 hybrid effectiveness- implementation trial in 18 K-8 schools. Therapists and supervisors will be randomly assigned to one of three conditions: a) FRIENDS with Train-the-Trainer implementation strategy (i.e., Masters-level supervisors receive training from experts on conducting supervision); b) aFRIENDS with Train-the-Trainer strategy; c) aFRIENDS with Train-the-Trainer Plus strategy (i.e., supervisors receive training and consultation from experts on conducting supervision). We will also assess cost-effectiveness and mediators and moderators of implementation strategies on fidelity. Ninety therapists (30 per arm), 18 agency supervisors (6 per arm) and 360 children (120 per arm) will participate. Our guiding framework is the Interactive Systems Framework for Dissemination and Implementation. Therapists and supervisors will use GoToMeeting and SIMULATIONiQ Counseling TM, a cloud-based, HIPAA- compliant system for training mental health workers.

 描述（由申请人提供）：低收入城市社区的学校为实施心理社会循证实践 (EBP) 提供了巨大潜力。认知行为疗法 (CBT) 是一种已被发现非常有效的 EBP。生活之友 (FRIENDS) 是一种有效的团体 CBT 治疗方案，可有效治疗包括学校在内的各种社区环境中的焦虑症。学校，因为治疗方案不适合环境或人群，现有的行为健康工作人员没有得到足够的培训或支持，使他们能够忠实地实施治疗，学区没有资源与外部提供者或顾问签约在我们之前的工作中，我们制定了一种更具文化敏感性、针对性更强且可行的焦虑治疗方案（改编版朋友）。改编版方案（aFRIENDS）解决了实施的主要障碍之一（干预社区心理健康机构治疗师）。谁提供学校的服务机构通常会接受一些 EBP 培训，但通常缺乏足够的支持，例如临床监督，而这对于维持治疗保真度是必要的，关于 EBP 的传播和实施 (D&I) 的两个重要问题是： a) 能否获得公共资助的心理治疗。城市学校的健康治疗师在自己机构的支持下成功实施了 EBP，还是成功实施需要外部专家的支持 b) 这两种不同实施策略的比较成本效益是什么？ 3臂，平行组，在 18 所 K-8 学校进行 2 类混合有效性实施试验，治疗师和督导员将被随机分配到以下三种情况之一： a) 采用培训师培训实施策略的朋友（即硕士级督导员接受培训）。 b) aFRIENDS 采用培训师培训策略； c) aFRIENDS 采用培训师升级版策略（即主管接受培训并我们还将评估忠诚度实施策略的成本效益和调解员和调解员、18 名机构主管（每组 6 名）和 360 名儿童（每组 120 名）。我们的指导框架是用于传播和实施的交互式系统框架，治疗师和主管将使用 GoToMeeting 和 SIMULATIONiQ Counseling TM（基于云的 HIPAA）。合规的精神卫生工作者培训体系。

项目成果

A comparison of two group cognitive behavioral therapy protocols for anxiety in urban schools: appropriateness, child outcomes, and cost-effectiveness.

城市学校焦虑症两组认知行为治疗方案的比较：适当性、儿童结局和成本效益。

• 发表时间: 2023
• 作者: Lawson, Gwendolyn M;Jawad, Abbas F;Comly, Rachel;Khanna, Muniya;Glick, Henry A;Beidas, Rinad S;Goldstein, Jessica;Brizzolara;Wilson, Tara;Rabenau;Eiraldi, Ricardo
• 通讯作者: Eiraldi, Ricardo