The applicant is requesting five years of funding through the Mentored Research Scientist Development Award (K01) program to enhance her methodological and substantive skills for dissemination and implementation (DI) research concerning empirically-supported treatments (ESTs) in the community practice of psychotherapy, in particular treatments for Post-Traumatic Stress Disorder (PTSD). The ultimate goal is to have expertise to offer empirically-supported recommendations on how to overcome the barriers to achieving effective treatments in the community and to apply such protocols in large scale services effectiveness research. One focus is on understanding means of influencing clinician/patient treatment attitudes and preferences (marketing) with an equal concentration on re-designing the intervention and the strategies to implement them to fit the needs and preferences of clinicians/patients (cultural sensitivity). The applicant's strong background of research and clinical training in clinical psychopathology and its treatments provide an excellent foundation for this work. The University of Pennsylvania as well as a national Expert Advisory Panel offer an outstanding research environment to help the applicant accomplish the proposed training goals, including obtaining enhanced skills in qualitative research techniques and information technology such as product design and marketing. The research plan for this award is divided into three studies which complement the proposed sequences of educational activities and propose activities aimed at developing the applicant's ability to test and refine models of practitioner, client and system characteristics that affect the DI of ESTs. In the first study, an in-depth case study will be conducted concerning the apparent successful DI of an innovative and extremely popular psychotherapy in a Veteran's Administration (VA) setting, despite controversies about its empirical status. The second will involve a mixed-methods study on practitioners' attitudes and intentions to change practice, their perceived attributes of ESTs and their peer-network influences. The third is a small mixed-method study assessing trauma patients' treatment preferences. These studies will provide a preliminary test of two theoretical models of dissemination and guide the development of an R01 field experiment aimed at promoting implementation of ESTs for trauma survivors, sketched out in final section of this K01. ? ?
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