While multiple psychological interventions for mental health(MH)problems in children and youth have established efficacy in research settings, empirically-based interventions (EBIs) are rarely used in everyday practice in community-based MH settings. This is of critical concern, particularly given the recent accountability movement and federal financial incentives for use of programs supported by empirical evidence. Even in those instances in whichinterventionsthathaveproveneffectiveunderstrictresearchconditionsaredeliveredinthe""""""""realworld,""""""""they often fail to achieve their intended outcomes. One explanation for this discrepancy is that the EBIs are not implemented with the same level of fidelity to the treatment model as in the research setting (Curtis, Ronan, and Borduin, 2004). A growing body of literature indicates the quality of implementation is directly related to the likelihood that an EBI will be adopted and sustained within the community MH setting as well as the strength of its treatment effects. Quality implementation in this instance refers to the degree to which an intervention is delivered as intended, i.e., with fidelity to the treatment model. Three key areas have been found to directly impact the quality of EBI implementation: (1) training support (including on-going implementation assistance);(2) structured, user-friendly resource materials;and (3) accountability tools for monitoring, tracking, and reporting fidelity to core intervention features. The goal of the proposed SBIR project is to develop and test a web-based dissemination toolbox (WDT) that supports quality implementation of community-based mental health EBIs for youth. The proposed WDT will build on recommendations from the research literature to create a suite of tools and services that can be applied in support of disseminating the majority of community-based EBIs on a broad scale. Currently, no comparable product exists for community-based interventions. The proposed WDT will leverage3-C ISD's technological expertise and experience to create a flexible, scalable web tool that will decrease costs (time, financial, personnel) to both community MH settings and intervention developers, enhance the integrity with which EBIs are implemented in community MH settings, and increase dissemination of EBIs into """"""""real world"""""""" everyday practice. The final product will be highly innovative, providing the unique ability to apply the WDT to a wide array of EBIs, which will ensure broad-based marketability.
Three specific aims will be accomplished through Phase I of this project: (1) the prototype of the WDT will be created with input from the project Advisory Board;(2) the prototype will be evaluated by stakeholder groups to test the feasibility, usability, and value of the proposed WDT;and (3) a full development plan for Phase II will be generated based on Phase I findings and recommendations.
As the mental health research-practice a phas become increasingly evident, numerous federal reports have called for action to better connect research findings to clinical practice [e.g., The President's New Freedom Commission Report(2003);Reports of the Surgeon General on Mental Health (U.S. Department of Health and Human Services, 1999), Youth Violence (HHS, 2001a), and Culture, Race, and Ethnicity (HHS, 2001b);and the National Children's Call to Action (HHS,2000)]. Building on the recommendations of clinical and research community members during the """"""""Enhancing the Discipline of Clinical and Translational Sciences"""""""" meeting (May, 2005), the National Institutes of Health (NIH) identified research efforts to bridge science and practice as a primary objective of NIH's Roadmap. The proposed research directly addresses NIH's Roadmap priorities as well as these federal calls for action. Each year, about 6 percent of America's children and adolescents receive some form of MH care, at an annual cost of more than $11 billion. In addition, each year NIMH and other foundations fund more than $300 million for youth MH research, much of it devoted to treatment studies. The findings from the proposed research will advance our understanding of how to successfully integrate EBIs into everyday practice within community MH service settings for youth. Increasing the likelihood that EBIs will be adopted, used as intended, and sustained in everyday practice, in turn, increases the likelihood that youth and society at large will benefit from evidence-based practices.
