Fidelity, Assessment and Clinical Effectiveness Tracking: Making FFT Sustainable

保真度、评估和临床效果跟踪：使 FFT 可持续发展

• 批准号: 9198092
• 负责人: Holly Barrett Waldron
• 金额: $ 4万
• 依托单位: LIFFT COMPANY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9198092
• 关键词: Address; Adherence; Administrator; Adolescent; Adoption; Attitude; Behavior; Clinical; Clinical Data; Clinical Services; Clinical effectiveness; Collection; Communities; Complex; Data; Data Collection; Development; Diffusion; Effectiveness; Electronics; Elements; Ensure; Evidence based treatment; Family; Family psychotherapy; Feedback; Fostering; Frequencies; Generic Drugs; Goals; Health; Healthcare; Individual; Informal Social Control; Internet; Link; Measures; Methods; Modeling; Monitor; Online Systems; Outcome; Outpatients; Participant; Patient Self-Report; Performance; Pharmacotherapy; Phase; Procedures; Process; Proxy; Randomized Controlled Trials; Reporting; Research Infrastructure; Resources; Retrieval; Sampling; Science; Secure; Services; Site; Small Business Innovation Research Grant; Substance Use Disorder; Supervision; System; Systems Integration; Technology; Testing; Text; Thinking; Training; Translating; Treatment outcome; Youth; addiction; adolescent substance abuse; adolescent substance use; base; cost efficient; dashboard; design; efficacy trial; experience; innovation; programs; prototype; quality assurance; reduced substance use; success; theories; tool; treatment adherence; treatment program; usability; user-friendly; web site

Advances in treating adolescent substance abuse and related problems have resulted in an increased emphasis on redirecting resources to transport evidence-based treatments (EBTs) into “real-world” settings, yet the science-practice gap remains a pressing problem. Due to highly complex and multifaceted processes involved in translating EBTs to practice settings and to a host of diffusion barriers, including lack of resources, infrastructure, and technology-based and quality assurance capacity, only a fraction of individuals in treatment for substance use disorder (SUD) receive EBTs. Further, the significant gains achieved in efficacy trials are difficult to replicate in actual practice without intensive monitoring of fidelity, an essential component of success. The lack of feasible cost efficient fidelity monitoring tools and superstructures to ensure community- based practitioners sustain competent and adherent service delivery represents a major impediment for dissemination; innovative methods and procedures are urgently needed. The proposed Phase I SBIR will involve the development of a prototype theory-guided, empirically based, and user-friendly online feedback and monitoring system to guide and sustain the implementation of Functional Family Therapy (FFT) for adolescent substance abuse, a well-established treatment shown to reduce substance use and related problems and enhance youth and family adaptive functioning. The tracking system “Adherence and Clinical Effectiveness” (ACE) will be designed to foster clinicians' self-regulation of treatment adherence and provide community programs with more direct access to quality assurance information pertinent to maintaining fidelity and achieving positive youth and family treatment outcomes. The adoption of the system is expected to bridge the science-practice gap, enhancing the appeal, user-friendliness, and marketability of FFT dissemination services delivered to adolescent outpatient drug treatment programs by LIFFT, Co. Phase I will focus on creating content, and developing and testing the functionality and feasibility of a prototype of the web-based ACE system. Phase II will complete the development of a fully functional, full-featured, commercially viable program and evaluate, in a randomized controlled trial, the acceptability and effectiveness of ACE for enhancing sustainability in treatment settings. The specific aims are: Aim 1: Develop content for ACE, based on FFT theory, empirical evidence, and our prior extensive FFT training, supervision, and dissemination experiences. Aim 2: Program an Alpha prototype of the ACE online framework that contains the basic essential elements of text, graphics, and interactive features. The prototype will include a secure website and fillable electronic forms and other mechanisms for data collection, storage, and retrieval for dashboard data summary and clinical reports. Aim 3: Test the functionality and feasibility of the ACE prototype with an independent pilot sample of 15 FFT clinicians and supervisors. Functionality testing will include login procedures, navigation, uploading of audio files (i.e., “proxy” therapy recordings), and online form submission.

治疗青少年药物滥用和相关问题的进步导致了增加 强调将资源重定向以将基于证据的治疗（EBT）运输到“现实世界”环境中， 然而，科学实践差距仍然是一个紧迫的问题。由于高度复杂且多方面的过程 参与将EBT转换为练习设置和许多扩散障碍，包括缺乏资源， 基础设施以及基于技术和质量保证的能力，只有一小部分接受治疗 用于药物使用障碍（SUD）会接受EBT。此外，在效率试验中取得的巨大收益是 在没有密集监控保真度的情况下，很难在实际实践中复制，这是 成功。缺乏可行的成本高效的忠诚监控工具和上层建筑，以确保社区 - 基于的从业人员维持胜任和坚定的服务提供代表的主要障碍 传播；迫切需要创新的方法和程序。拟议的I期Sbir将 涉及开发原型理论引导，基于经验和用户友好的在线反馈和 监测系统以指导和维持青少年功能家庭疗法（FFT）的实施 药物滥用，一种公认的治疗方法，可减少药物使用和相关问题， 增强青年和家庭适应性功能。跟踪系统“依从性和临床有效性” （ACE）将旨在促进临床医生对治疗依从性的自我调节，并提供社区 具有更直接访问质量保证信息的计划，与维持忠诚有关 取得积极的青年和家庭治疗成果。该系统的采用有望桥接 科学实践差距，增强FFT传播服务的外观，用户友好性和可销售性 通过LIFFT，Co。送给青少年门诊药物治疗计划 内容，并开发和测试基于Web的ACE原型的功能和可行性 系统。第二阶段将完成功能齐全，功能齐全，可行的计划的开发 并在随机对照试验中评估ACE增强的可接受性和有效性 在治疗环境中的可持续性。具体目的是：目标1：基于FFT开发ACE的内容 理论，经验证据以及我们先前广泛的FFT培训，监督和传播经验。 AIM 2：编程ACE在线框架的Alpha原型，其中包含的基本基本要素 文本，图形和交互功能。该原型将包括一个安全的网站和可填充的电子表格 以及用于数据收集，存储和检索仪表板数据摘要和临床检索的其他机制 报告。目标3：测试ACE原型的功能和可行性，并具有独立的试点样本 15名FFT临床医生和主管。功能测试将包括登录过程，导航，上传 音频文件（即“代理”治疗记录）和在线表单提交。