The proposed project builds upon Phase I """"""""proof of concept"""""""" efforts wherein the basic foundational components of an Internet-based Treatment Fidelity Monitoring System, the ITFMS, were created to assist MTFC consultants and implementing agencies to improve clinical outcomes by moving more efficiently towards and maintaining fidelity of program implementation. ITFMS feasibility for community agency, foster parent, and program consultant use was also examined (please see Phase I report). The Phase II aims involve the completion of the ITFMS system and a randomized controlled trial of the effectiveness of the final system. Within our effectiveness examination, we will focus on outcomes related to increasing MTFC agency and program consultant efficiency in moving towards criteria for implementation fidelity. Completion objectives for the ITFMS system will involve: 1) refinement and enhancement of the existing ITFMS foundational system components, in response to both reviewers and Phase I beta testers, such that the full set of site data necessary to fulfill MTFC fidelity criteria and certification requirements can be remotely and more efficiently entered and viewed by implementing agencies;2) addition of an integrated system component that will take the day-to-day data collected within each implementation site and automatically integrate and display it in a manner that will allow sites, program consultants, and developers to be more formatively aware of agency movement towards MTFC fidelity and more proactive in their feedback and discussions relative to supporting positive changes in site implementation;3) addition of a professional communication system that will allow for the free-flow of program ideas and implementation information not only between program consultants and sites, but also between implementation sites such that issues, problems and support can be garnered in an on- going, productive, and meaningful manner;and 4) a parent support component with resources and moderated peer-to-peer support. Once ITFMS system development is completed, it will first be offered to currently active MTFC sites for beta-testing and feedback on the entire system. Feedback from these sites will be integrated into the ITFMS system and then new and developing implementation sites will be solicited to participate in the randomized-controlled trial. The trial will involve randomly assigning sites to either a standard or internet-based MTFC consultant-supported implementation service. Because ITFMS is meant to facilitate movement towards MTFC fidelity implementation by community agencies, important fidelity domains derived from the fidelity management and effectiveness research will be assessed, including outcome indicants of implementation process, implementation efficiency, and implementation effectiveness. It is hypothesized that ITFMS agencies will report greater levels within each of these implementation fidelity domains when compared to the traditionally-implemented MTFC program. We will also assess commercialization indicants reflecting ITFMS usage and system satisfaction within implementing agencies.

Public Health Relevance

Mental health, child welfare, and juvenile justice agencies are jointly faced with the challenge of reducing the prevalence of adolescent antisocial behavior, but sadly, even though empirically-validated programs are available and widely disseminated, replication of research results in community settings remains slow and problematic. A critical contributor to unsuccessful dissemination efforts is the prohibitive need for intensive monitoring by intervention developers/consultants;a difficulty exacerbated as the distance increases between these individuals and community agencies attempting to achieve and maintain implementation fidelity. The current project proposes one possible solution to this problem by developing an Internet-based fidelity feedback mechanism for program consultants, clinical supervisors and interventionists as part of an empirically-validated program's data collection and reporting functions;mechanisms that would link local clinical programs and nationally-based dissemination teams through direct, immediate, high quality data and make it more likely that local service organizations can implement services at the highest possible level of fidelity and achieve stronger community-based intervention outcomes.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Small Business Technology Transfer (STTR) Grants - Phase II (R42)
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Special Emphasis Panel (ZRG1-BBBP-T (10))
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Haim, Adam
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Tfc Consultants, Inc.
United States
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Feil, Edward G; Sprengelmeyer, Peter G; Davis, Betsy et al. (2012) Development and testing of a multimedia internet-based system for fidelity and monitoring of multidimensional treatment foster care. J Med Internet Res 14:e139