Improving adherence to evidence-based practice using an innovative and easy-to-use health IT solution

使用创新且易于使用的健康 IT 解决方案提高对循证实践的遵守

• 批准号: 10253990
• 负责人: Brian E. Bunnell
• 金额: $ 44.27万
• 依托单位: ADHERE.LY, LLC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10253990
• 关键词: Adherence; Administrator; Adult; Affect; Anxiety; Area; Caregivers; Child; Clinical; Cognitive Therapy; Communities; Community Practice; Consolidated Framework for Implementation Research; Dissemination and Implementation; Educational workshop; Effectiveness; Electronic Mail; Environment; Evidence based practice; Exercise; Florida; Fostering; Goals; Health; Health Personnel; Healthcare; Individual; Intervention; Interview; Learning; Link; Marketing; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methodology; Methods; Modeling; National Institute of Mental Health; Observational Study; Online Systems; Outcome; Patient Care; Patients; Phase; Positioning Attribute; Post-Traumatic Stress Disorders; Preparation; Problem Sets; Process; Provider; Randomized; Reporting; Research; Small Business Technology Transfer Research; South Carolina; Structure; Surveys; Therapeutic; Time; Universities; Youth; base; clinical practice; commercialization; compliance behavior; design; effectiveness implementation study; effectiveness implementation trial; evidence base; experience; grasp; implementation outcomes; improved; innovation; interest; iterative design; novel strategies; patient engagement; practice setting; skills; success; systematic review; theories; tool; user-friendly

PROJECT SUMMARY/ABSTRACT Homework, or between-session practice of skills learned during therapy, is one of the most integral, yet underutilized components of high-quality, evidence-based mental health treatments (EBTs) such as Cognitive Behavioral Therapy (CBT). Many providers struggle to consistently develop, assign, and assess homework exercises with their patients, and many patients have difficulty remembering to practice skills in a correct and timely way that fosters adequate learning. Innovative health IT solutions are needed to overcome these barriers to implementing this crucial component of high quality EBTs. To meet this need, our experienced team at Adhere.ly, LLC, in partnership with the University of South Florida, the Medical University of South Carolina, and Doxy.me, LLC developed Adhere.ly, an innovative, state-of-the art, and user-friendly web-based solution to improve provider implementation and patient engagement in homework during EBTs. Adhere.ly includes engaging therapeutic exercises for providers to introduce, practice, and assign as homework to patients, who receive SMS/email reminders with links to practice those exercises during the week. Adhere.ly was initially developed for providers treating children with PTSD and their caregivers. Broadening Adhere.ly’s features and exercises will increase its clinical utility and ability to support NIMH priorities and PA-18-579 Specific Areas of Research Interest in “Tools and Platforms to Improve the Dissemination and Implementation of EBTs.” The objectives of this Phase I STTR proposal–guided by the Accelerated Creation to Sustainment model and Modified Consolidated Framework for Implementation Research–are threefold. First, we will seek to understand and prioritize key stakeholder goals, challenges, affordances, and constraints by conducting individual, semi-structured qualitative interviews with adult mental health patients, providers, and administrators (n≤20 each) and a quantitative survey of 100 providers. We will conduct a mixed methods analysis to inform the design of new Adhere.ly features and exercises and an implementation/sustainment (I/S) blueprint (Aim 1). Second, we will use participatory design methodologies (e.g., co-design workshops) with adult mental health patients and providers to iteratively design, refine, and develop new Adhere.ly features and therapeutic exercises that support a range of adult EBTs, and an I/S blueprint (Aim 2). Third, we will conduct a feasibility Optimization, Effectiveness, and Implementation (OEI) Hybrid trial with 20 community mental health providers randomized to CBT+Adhere.ly (n=10) vs. CBT alone (n=10), and 40 treatment seeking, provider-referred adult patients with clinically elevated anxiety and/or depression (outcomes), which we will assess at baseline and 3-months post-baseline. We will assess homework use by providers and adherence of patients (targets) weekly via session audio recordings and patient-report. We will optimize new features, exercises, and our I/S plan during the trial and assess implementation outcomes post-implementation (Aim 3).

项目概要/摘要 家庭作业，或者在治疗过程中所学技能的课间练习，是迄今为止最不可或缺的任务之一 高质量、循证心理健康治疗 (EBT) 中未得到充分利用的部分，例如认知疗法 行为治疗 (CBT) 许多提供者都在努力持续地制定、分配和评估作业。 与患者一起练习，许多患者很难记住以正确和正确的方式练习技能 需要及时地促进充分学习的创新健康 IT 解决方案来克服这些问题。 实施高质量 EBT 的这一关键组成部分的障碍 为了满足这一需求，我们经验丰富的团队。 Adhere.ly, LLC 与南佛罗里达大学、南卡罗来纳医科大学合作， 和 Doxy.me, LLC 开发了 Adhere.ly，这是一种创新、最先进且用户友好的基于网络的解决方案 Adhere.ly 包括改善提供者实施和患者在 EBT 期间作业的参与度。 让提供者参与治疗练习，向患者介绍、练习和布置家庭作业，患者 接收短信/电子邮件提醒，其中包含本周练习这些练习的链接。 Adhere.ly 最初是这样的。 为治疗 PTSD 儿童及其护理人员而开发，扩大 Adhere.ly 的功能和范围。 演习将提高其临床实用性和支持 NIMH 优先事项和 PA-18-579 特定领域的能力 研究兴趣为“改善 EBT 传播和实施的工具和平台”。 第一阶段 STTR 提案的目标——以加速创造到维持模型为指导 修改后的实施研究综合框架有三个方面：首先，我们将寻求： 通过开展 对成年心理健康患者、提供者和服务提供者进行个人、半结构化的定性访谈 我们将采用混合方法对 100 家提供商进行定量调查。 分析为新 Adhere.ly 功能和练习以及实施/维持 (I/S) 的设计提供信息 其次，我们将使用参与式设计方法（例如协同设计研讨会）。 成人心理健康患者和提供者迭代设计、完善和开发新的 Adhere.ly 功能和 支持一系列成人 EBT 的治疗练习和 I/S 蓝图（目标 2）。 可行性 优化、有效性和实施 (OEI) 与 20 个社区心理健康社区进行的混合试验 随机接受 CBT+Adhere.ly (n=10) 与单独 CBT (n=10) 的提供者，以及 40 名寻求治疗的提供者， 医疗服务提供者转介的临床上焦虑和/或抑郁（结果）升高的成年患者，我们将 在基线和基线后 3 个月进行评估 我们将评估提供者的作业使用情况和遵守情况。 每周通过会话录音和患者报告对患者（目标）进行优化， 练习，以及我们在试验期间的 I/S 计划，并评估实施后的实施结果（目标 3）。