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Fidelity Training and Feedback System for Adolescent Externalizing Problems

Award Number: R34MH117212
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2018
PERIOD OF PERFORMANCE END DATE: 06/30/2022

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Fidelity Training and Feedback System for Adolescent Externalizing Problems - This R34 study will advance the science of mental health services for adolescent externalizing problems (AEPs) by developing therapist training procedures to increase fidelity to evidence-based interventions (EBIs) in usual care. Two widely endorsed approaches are consistently effective for treating AEPs: family therapy and CBT. Importantly, stronger fidelity to core EBIs of these approaches predicts better outcomes in research and community settings. Yet these EBIs are not widely implemented with fidelity. To help close this quality gap in adolescent services, we will develop an online intervention to strengthen fidelity to these EBIs in routine care: Fidelity Training and Feedback System (FTFS). FTFS will target two essential aspects of EBI fidelity: Training components will seek to improve EBI self-monitoring, and a Feedback component will seek to increase EBI utilization. In keeping with NIMH’s Experimental Therapeutics paradigm, this study will examine whether an Intervention (FTFS) has direct impact on its immediate Targets (EBI self-monitoring and utilization); If promising, future R01 studies will examine links among Intervention, Targets, and ultimate Outcomes (AEPs). The FTFS package will be an online quality assurance system completed by therapists and supervisors that can be readily sustained in usual care. Two weekly Training components will adapt gold-standard observational fidelity coding procedures to promote improved self-monitoring of the targeted EBIs, and a monthly Feedback component will adapt a measurement feedback system to promote increased utilization of these EBIs in everyday practice. To maximize provider investment, sites will delineate their own fidelity standards for family therapy and CBT and help design their own feedback report templates. The proposed study will be among the first to (1) test whether training therapists in observational assessment of EBI fidelity increases the accuracy with which they self-monitor use of those EBIs and (2) adapt measurement feedback procedures to track and improve therapist utilization of EBIs. To achieve study aims we will first partner with two community clinics to develop sustainable FTFS procedures using a three-phase Pilot process. We will then initiate an experimental Trial during which therapists (n = 32, treating 192 clients) at four different clinics will be randomized to FTFS versus no-intervention Control. In both conditions we will collect three kinds of data: therapist-report checklists on use of core family therapy and CBT techniques with adolescent cases, treatment session audiorecordings, and recordings of supervision meetings. FTFS uptake will be tracked electronically for online components and via observer ratings of supervision meetings (Aim 1: FTFS feasibility). Session recordings will be coded by observers for three facets of EBI fidelity: adherence (extent of EBI utilization), working alliance, and therapist competence. Observer ratings will measure the strength of EBI self-monitoring (Aim 2: therapist reliability and accuracy) and fidelity (Aim 3 [EBI utilization] & Aim 4 [alliance, competence]). If effective, FTFS could be adapted to promote EBI fidelity for a variety of clinical populations and approaches.


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: 2023 ( Subtotal = -$2,142 )
2023	2020	PARTNERSHIP TO END ADDICTION	711 3RD AVE RM 500	NEW YORK	NY	10017	NEW YORK	USA	Mental Health Research Grants	000	3	9/8/2023	NON-COMPETING CONTINUATION	-$2,142
														Subtotal = -$2,142

Issue Date FY: 2020 ( Subtotal = $256,526 )
2020	2020	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	485 LEXINGTON AVE RM 300	NEW YORK	NY	10017	NEW YORK	USA	Mental Health Research Grants	000	3	7/23/2020	NON-COMPETING CONTINUATION	$256,526
														Subtotal = $256,526

Issue Date FY: 2019 ( Subtotal = $256,203 )
2019	2019	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	633 3RD AVE FL 19	NEW YORK	NY	10017	NEW YORK	USA	Mental Health Research Grants	001	2	8/2/2019	NON-COMPETING CONTINUATION	$256,203
2019	2018	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	633 3RD AVE FL 19	NEW YORK	NY	10017	NEW YORK	USA	Mental Health Research Grants	000	1	8/1/2019	NEW	$0
														Subtotal = $256,203

Issue Date FY: 2018 ( Subtotal = $259,999 )
2018	2018	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	633 3RD AVE FL 19	NEW YORK	NY	10017	NEW YORK	USA	Mental Health Research Grants	000	1	8/30/2018	NEW	$259,999
														Subtotal = $259,999

Grand Total All Awards = $770,586

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Fidelity Training and Feedback System for Adolescent Externalizing Problems

Award Number: R34MH117212

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/01/2018

PERIOD OF PERFORMANCE END DATE: 06/30/2022

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