Implementation of evidence-based treatments for on-campus eating disorders

对校园饮食失调实施循证治疗

基本信息

批准号：
8217893
负责人：
WILLIAM Stewart AGRAS
金额：
$ 77.17万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-05 至 2017-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8217893
关键词：
Adoption Adult Affect Anorexia Nervosa Binge Eating Binge eating disorder Bulimia Client Cognitive Therapy Collaborations Communities Consultations Cost Analysis Counseling Data Coordinating Center Development Disease Eating Disorders Educational workshop Effectiveness Ensure Environment Evaluation Evidence based intervention Evidence based treatment Faculty Future Goals Health High Prevalence Individual Intervention Learning Life Manuals Mediator of activation protein Mental Depression Mental Health Mental Health Services Methods Modeling Monitor Mood Disorders Obesity Outcome Overweight Patients Population Procedures Process Provider Psychopathology Psychotherapy Quality Control Randomized Research Personnel Resources Services Site Students Symptoms Syndrome Testing Training Universities Washington aged college community setting cost design discounting dissemination research early adolescence evidence base falls follow-up implementation research improved member primary outcome purge response skills theories university student

项目摘要

DESCRIPTION (provided by applicant): This proposal is a response to PAR-10-038 "Dissemination and Implementation Research in Health." Despite major advances in developing evidence-based psychotherapies, the adoption of such treatments by community therapists has been slow. Hence, it is important to develop and test different methods to effectively train therapists to implement evidence-based psychotherapies in community settings. College campuses have a relatively high prevalence of eating disorders (EDs) and therefore present an efficient environment to test the implementation of strategies to treat these disorders. We propose to train therapists to implement interpersonal psychotherapy (IPT), evidence-based treatments for EDs. Therapists usually learn about new therapies via a workshop and treatment manual. However, it has been shown that this method does not effectively increase therapist skills, nor does it sustain utilization of these interventions. Hence, in this study we will compare two implementation strategies designed to improve upon this approach. The first is a low intensity strategy with the addition of external expert consultation following the workshop. The second is a theoretically-grounded high intensity approach focused on building internal expertise. In this strategy, a staff member from the counseling center will be trained in IPT and coached to train other staff members within the site to implement IPT. This strategy includes quality-control procedures designed to improve implementation and to ensure treatment fidelity. Twenty-six college counseling centers with approximately 230 therapists will be allocated at random to one of the two implementation strategies. Three centers: Washington University (Implementation and Cost Analysis Center), Rutgers University (Fidelity Monitoring Center), and Stanford University (Data Coordinating Center) will conduct the study. The primary aim is to compare therapist fidelity to IPT for the two training strategies and its consequent impact on client outcome. A secondary aim is to examine the generalization of use of IPT for depression. We hypothesize that the high intensity approach will prove significantly more effective than the low intensity strategy, particularly in sustainability. Exploratory moderator and mediator analyses will illuminate the institutional and therapist variables that affect implementation and client outcomes. Because the two approaches differ in resources, the implementation and service costs for each of the training methods will be determined. Implementation will proceed over a twenty month period with a 12-month follow-up to test sustainability, during which period consultation from Washington University will have ceased. This project continues a long-standing collaboration among the three PIs and centers that have focused in the past on understanding factors underlying eating disorders and on the development of evidence- based psychotherapies. To extend our expertise on implementation theory and procedures, we have established collaborations with faculty from the Dissemination and Implementation Core at Washington University, including Drs. Proctor and Raghavan who are co-investigators on this project. PUBLIC HEALTH RELEVANCE: Eating disorders occur most frequently in late adolescence and early adult life, and therefore constitute, along with mood disorders, a serious and prevalent mental health problem for college students. Although evidence-based treatments such as interpersonal psychotherapy (IPT) have been shown to be effective for both of these disorders, few community therapists use such treatments. Hence, the present study will involve partnering with college counseling centers to determine the most effective method to implement IPT for eating and mood disorders in these settings, and will establish a platform for future large-scale dissemination of evidence-based interventions to mental health service providers.

描述（由申请人提供）：本提案是对 PAR-10-038“健康领域的传播和实施研究”的回应。尽管在开发循证心理疗法方面取得了重大进展，但社区治疗师对此类疗法的采用进展缓慢。因此，开发和测试不同的方法来有效地培训治疗师在社区环境中实施循证心理治疗非常重要。大学校园的饮食失调（ED）患病率相对较高，因此提供了一个有效的环境来测试治疗这些疾病的策略的实施情况。我们建议培训治疗师实施人际心理治疗（IPT），即针对 ED 的循证治疗。治疗师通常通过研讨会和治疗手册了解新疗法。然而，事实证明，这种方法并不能有效提高治疗师的技能，也不能维持这些干预措施的利用。因此，在本研究中，我们将比较旨在改进这种方法的两种实施策略。第一个是低强度策略，在研讨会后增加外部专家咨询。第二种是基于理论的高强度方法，重点是建立内部专业知识。在该战略中，咨询中心的一名工作人员将接受 IPT 培训，并指导培训现场内的其他工作人员实施 IPT。该策略包括旨在改进实施并确保治疗保真度的质量控制程序。拥有约 230 名治疗师的 26 个大学咨询中心将被随机分配到两种实施策略之一。三个中心：华盛顿大学（实施和成本分析中心）、罗格斯大学（富达监控中心）和斯坦福大学（数据协调中心）将进行这项研究。主要目的是比较两种培训策略的治疗师对 IPT 的忠诚度及其对客户结果的影响。第二个目的是检验 IPT 治疗抑郁症的普遍性。我们假设高强度方法将比低强度策略更有效，特别是在可持续性方面。探索性调节者和中介者分析将阐明影响实施和客户结果的机构和治疗师变量。由于这两种方法的资源不同，因此将确定每种培训方法的实施和服务成本。实施将在 20 个月的时间内进行，并进行 12 个月的后续测试以测试可持续性，在此期间，华盛顿大学的咨询将停止。该项目延续了三个 PI 和中心之间的长期合作，过去这些合作的重点是了解饮食失调的潜在因素和开发循证心理疗法。为了扩展我们在实施理论和程序方面的专业知识，我们与华盛顿大学传播和实施核心的教师建立了合作，其中包括博士。 Proctor 和 Raghavan 是该项目的共同研究员。公共卫生相关性：饮食失调最常发生在青春期晚期和成年早期，因此与情绪障碍一起构成大学生严重且普遍的心理健康问题。尽管人际心理治疗 (IPT) 等循证治疗已被证明对这两种疾病有效，但很少有社区治疗师使用此类治疗。因此，本研究将涉及与大学咨询中心合作，以确定在这些环境中针对饮食和情绪障碍实施 IPT 的最有效方法，并将为未来大规模传播心理健康服务的循证干预措施建立一个平台。提供商。