Effectiveness of a multi-level implementation strategy for ASD interventions: Study protocol for two linked cluster randomized trials

Lauren Brookman-Frazee, Aubyn Stahmer

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the T ranslating E vidence-based Interventions (EBI) for A SD: M ulti-Level Implementation S trategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. Methods: A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. Implementation outcomes including provider training completion, fidelity (coded by observers blind to group assignment) and child behavior change will be examined for 295 mental health providers, 295 teachers, and 590 children. Discussion: This implementation intervention has the potential to increase quality of care for ASD in publicly funded settings by improving effectiveness of intervention implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services.

Original languageEnglish (US)
Article number66
JournalImplementation Science
Volume13
Issue number1
DOIs
StatePublished - May 9 2018

Fingerprint

Mental Health
Motivational Interviewing
Organizational Innovation
Social Welfare
Quality of Health Care
Mental Health Services
Child Behavior
Centers for Disease Control and Prevention (U.S.)
Motivation
Teaching
Public Health
Education
Costs and Cost Analysis
Research
Autism Spectrum Disorder

Keywords

  • Autism
  • Education services
  • Fidelity
  • Implementation strategy
  • Leadership
  • Mental health services
  • Provider training

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics
  • Public Health, Environmental and Occupational Health

Cite this

Effectiveness of a multi-level implementation strategy for ASD interventions : Study protocol for two linked cluster randomized trials. / Brookman-Frazee, Lauren; Stahmer, Aubyn.

In: Implementation Science, Vol. 13, No. 1, 66, 09.05.2018.

Research output: Contribution to journalArticle

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