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A Hybrid Type 2 Trial of Trauma-Focused Cognitive Behavioral Therapy and a Pragmatic Individual-Level Implementation Strategy

Award Number: R01MH119148
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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A Hybrid Type 2 Trial of Trauma-Focused Cognitive Behavioral Therapy and a Pragmatic Individual-Level Implementation Strategy - PROJECT ABSTRACT Most youth who experience significant trauma-related symptoms do not receive indicated services and, when they do, the services received are not evidence-based. The education sector is responsible for 70-80% of all mental health services delivered to youth, but there are (1) a limited menu of evidence-based treatments (EBTs) for trauma available for use in schools and (2) a need to enhance the uptake and use of EBT in schools and other community settings for youth exposed to trauma. Trauma-focused cognitive behavior therapy (TF-CBT) is an efficacious treatment for trauma-exposed youth, but there are no studies that have evaluated the effectiveness of TF-CBT when delivered in schools. Additionally, significant implementation barriers limit the successful adoption, delivery with fidelity, and sustainment of TF-CBT; especially individual clinician variables, such as beliefs and attitudes surrounding core components of the intervention (e.g., exposure to feared stimuli). These two gaps reveal the need for research that simultaneously examines effectiveness and implementation of TF-CBT when delivered in schools. Individual provider behavior change is a critical component of successful implementation of any EBT. Even when factors such as evidence-informed policy, supportive leadership, and effective training are in place, implementation ultimately rests with providers’ motivation and commitment to change. The Beliefs and Attitudes for Successful Implementation in Schools (BASIS) intervention is a facilitated, group-based blended implementation strategy. BASIS is brief, pragmatic, and is designed to augment standard EBP training and consultation procedures. It targets theoretically-derived individual-level determinants associated with behavior change using motivational and volitional behavior change strategies. BASIS has been rated as feasible and appropriate by SBMH clinicians, and found to increase clinicians’ attitudes, perceptions of social norms, and implementation intentions to use EBT in a small (n = 24) randomized trial (R21MH108714). Considering the need to examine the effectiveness of TF-CBT in the context of schools and the importance of individual-level strategies that augment EBT training and consultation, the current proposal is a hybrid type 2 effectiveness-implementation trial with 120 SBMH clinicians and 480 students using mixed methods. This project is designed to simultaneously test the effectiveness of TF-CBT in schools and the impact of BASIS on proximal mechanisms and TF-CBT implementation outcomes. Specifically, the proposal aims to experimentally evaluate TF-CBT in schools versus treatment as usual, including intervention mechanisms of change, mental health outcomes, and TF-CBT cost-effectiveness (Aim 1); and experimentally evaluate BASIS versus and attention control, including implementation mechanisms of change, TF-CBT implementation outcomes, and BASIS cost-effectiveness (Aim 2). TF-CBT and BASIS represent potentially robust and generalizable strategies for greatly enhancing the accessibility and quality of services for trauma-exposed youth.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $659,218 )
2024	2024	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	000	5	12/1/2023	NON-COMPETING CONTINUATION	$593,297
2024	2024	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	001	5	8/15/2024	NON-COMPETING CONTINUATION	$65,921
														Subtotal = $659,218

Issue Date FY: 2023 ( Subtotal = $681,585 )
2023	2023	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	001	4	3/3/2023	NON-COMPETING CONTINUATION	$681,585
2023	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	000	3	10/19/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $681,585

Issue Date FY: 2022 ( Subtotal = $700,135 )
2022	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	001	3	5/23/2022	NON-COMPETING CONTINUATION	$70,013
2022	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	000	3	11/24/2021	NON-COMPETING CONTINUATION	$630,122
														Subtotal = $700,135

Issue Date FY: 2021 ( Subtotal = $726,583 )
2021	2021	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	001	2	4/14/2021	NON-COMPETING CONTINUATION	$72,658
2021	2021	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	000	2	12/22/2020	NON-COMPETING CONTINUATION	$653,925
														Subtotal = $726,583

Issue Date FY: 2020 ( Subtotal = $790,591 )
2020	2020	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Mental Health Research Grants	000	1	1/22/2020	NEW	$790,591
														Subtotal = $790,591

Grand Total All Awards = $3,558,112

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A Hybrid Type 2 Trial of Trauma-Focused Cognitive Behavioral Therapy and a Pragmatic Individual-Level Implementation Strategy

Award Number: R01MH119148

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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