Improving the Implementation and Sustainment of EBPs in Mental Health: Developing and Piloting the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS)

改善心理健康 EBP 的实施和维持：开发和试点选择和定制实施策略的协作组织方法 (COAST-IS)

• 批准号: 9371116
• 负责人: Byron James Powell
• 金额: $ 17.81万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9371116
• 关键词: Address; Adopted; Adoption; Anxiety; Behavioral; Child; Child Mental Health; Child Traumatic Stress; Climate; Clinical; Cognitive Therapy; Communities; Confidence Intervals; Data; Data Collection; Development; Effectiveness; Elements; Ensure; Evidence based practice; Failure; Feedback; Frequencies; Funding; Goals; Health; Intervention; Intervention Trial; Interview; Lead; Learning; Magic; Measures; Mental Health; Mental Health Services; Methods; National Institute of Mental Health; Outcome; Patient Self-Report; Penetration; Post-Traumatic Stress Disorders; Preparation; Problem behavior; Procedures; Process; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Methodology; Strategic Planning; Structure; Supervision; System; Techniques; Testing; Training; Trauma; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; Work; depressive symptoms; design; effective intervention; effectiveness trial; emotional experience; experience; implementation research; improved; innovation; learning network; pilot trial; programs; statistics; theories; therapy development

PROJECT SUMMARY Children and youth experience trauma at alarming rates, which can lead to serious mental health problems. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based practice (EBP) for those who experience emotional or behavioral difficulties related to trauma. However, much like other EBPs, TF-CBT is underutilized, and even when organizations and systems adopt it, implementation problems can limit its effectiveness. Implementing and sustaining TF-CBT and other EBPs with fidelity may require that multiple implementation strategies be selected and tailored to address multilevel, context-specific determinants (barriers and facilitators). Ideally, the selection and tailoring of implementation strategies would be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. The purpose of this K01 is to partner with the SAMHSA-funded National Child Traumatic Stress Network (NCTSN) to develop and pilot the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS). The COAST-IS intervention will involve coaching organizational leaders and therapists to use Intervention Mapping to select and tailor strategies. Intervention Mapping is a multistep process that is inherently ecological and incorporates theory, evidence, and stakeholder perspectives to ensure that intervention components effectively address key determinants of change. After collaboratively developing COAST-IS in Year 1, we will conduct a randomized pilot trial of the intervention within an NCTSN learning collaborative, randomly assigning eight organizations to the learning collaborative-only condition or the learning collaborative plus COAST-IS condition. We will then evaluate COAST-IS in the following aims: 1) to assess the acceptability, appropriateness, feasibility, and utility of COAST-IS; 2) to evaluate organizational stakeholders' fidelity to the core elements of Intervention Mapping; and 3) to demonstrate the feasibility of testing COAST-IS in a larger effectiveness trial. To accomplish these aims and prepare for a larger mixed methods effectiveness trial, the applicant will receive training in 1) intervention development, 2) partnered research, 3) pragmatic randomized controlled trials, and 4) mixed methods research under the direction of Drs. Morris Weinberger, Greg Aarons, Loretta Jones, and Ken Wells. This work is significant because it will yield a systematic method that integrates theory, evidence, and stakeholder perspectives to improve the effectiveness and precision of implementation strategies. Ultimately, COAST-IS may have the potential to improve implementation and sustainment of a wide-range of EBPs in mental health and other health sectors.

项目概要 儿童和青少年遭受创伤的速度惊人，这可能导致严重的心理健康问题。 以创伤为中心的认知行为疗法 (TF-CBT) 是一种循证实践 (EBP)，适用于以下患者 经历与创伤相关的情绪或行为困难。然而，与其他 EBP 一样，TF-CBT 未得到充分利用，即使组织和系统采用它，实施问题也会限制其 效力。忠实地实施和维持 TF-CBT 和其他 EBP 可能需要多个 选择并调整实施战略以解决多层次、具体情况的决定因素 （障碍和促进因素）。理想情况下，实施策略的选择和调整应遵循以下原则： 相关利益相关者的理论、证据和意见；然而，指导选择和剪裁的方法 的战略尚未制定完善。 K01 的目的是与 SAMHSA 资助的国家 儿童创伤应激网络 (NCTSN) 开发并试点协作组织方法 选择和定制实施策略 (COAST-IS)。 COAST-IS 干预将涉及 指导组织领导者和治疗师使用干预映射来选择和定制策略。 干预图是一个多步骤的过程，本质上是生态的，并结合了理论、证据和 利益相关者的观点，以确保干预措施有效解决关键决定因素 改变。在第一年合作开发 COAST-IS 后，我们将进行一项随机试点试验 在 NCTSN 学习协作中进行干预，随机分配八个组织进行学习 仅协作条件或学习协作加 COAST-IS 条件。然后我们将评估 COAST-IS 的目标如下： 1) 评估以下内容的可接受性、适当性、可行性和实用性： 海岸-IS； 2）评估组织利益相关者对干预图核心要素的忠诚度； 3) 证明在更大规模的有效性试验中测试 COAST-IS 的可行性。为了完成这些 旨在并准备进行更大规模的混合方法有效性试验，申请人将接受以下方面的培训：1) 干预措施开发，2) 合作研究，3) 实用随机对照试验，4) 混合 在博士的指导下进行方法研究。莫里斯·温伯格、格雷格·阿伦斯、洛雷塔·琼斯和肯·威尔斯。 这项工作意义重大，因为它将产生一种整合理论、证据和方法的系统方法。 利益相关者的观点，以提高实施战略的有效性和准确性。最终， COAST-IS 可能有潜力改善各种 EBP 的实施和维持 精神卫生和其他卫生部门。