Brief Online Training (BOLT) for Routine Outcome Monitoring
Condition: Mental Health Issue; Adoption of Measurement-Based Care (MBC)
Study type: Interventional

Summary: 
      The goal of this project is to improve school-based services by developing and testing an
      online training and consultation system to facilitate the use of measurement-based care (also
      known and referenced in original grant as routine outcome monitoring). Measurement-based care
      (MBC) is the target intervention because it is an EBP with extensive empirical support for
      its ability to improve mental health service outcomes and is a feasible and cost-effective
      option. Following the iterative development of the BOLT training and consultation package
      (phases 1-4), the investigators will conduct a randomized control pilot trial (phase 5) to
      test the (1) impact of the package on MBC knowledge, attitudes and use, (2) impact of varying
      degrees of consultation dosage on weekly assessments of MBC use, and (3) moderators and
      mechanisms of impact.
    

Detailed description: 
      In the US, although roughly one in five children experiences a mental health problem severe
      enough to warrant diagnosis and intervention, most lack access to needed services. Schools
      offer opportunities to improve service access, but school mental health clinicians are
      unlikely to deliver high-quality evidence-based practices (EBP). Multiple barriers interfere
      with clinicians receiving adequate training and support for EBP, including limited time and
      scarce training resources. The goal of this project is to improve school-based services by
      developing and testing an online training and consultation system to facilitate the use of
      measurement-based care (MBC). MBC is the target intervention because it is an EBP with
      extensive empirical support for its ability to improve mental health service outcomes and is
      a feasible and cost-effective option.

      The larger study was conducted in phases to address study aims (this clinical trial record
      reflects Aim 3/Phase 5):

        -  AIM 1: Phases 1 and 2. Develop the Brief On-Line Training (BOLT) for Measurement-Based
           Care training through prototyping and continuous user testing. The goal is to optimize
           BOLT's impact on system usability and clinician gains in MBC knowledge and attitudes.

        -  AIM 2: Phases 3 and 4. Develop the BOLT post-training consultation procedures to
           optimize effective consultation.

        -  AIM 3: Phase 5. Test BOLT by conducting a randomized controlled pilot trial of the full
           BOLT training/consultation package to test (1) its impact on MBC knowledge, attitudes,
           and use; (2) the impact of varying degrees of consultation dosage on weekly assessments
           of MBC use; and (3) moderators and mechanisms of impact: (a) system usability, (b)
           clinician knowledge and attitudes gain, (c) experience of collaboration, and (d)
           responsiveness of consultation.

      During the final year (i.e., phase 5), participants include a sample of 75 clinicians,
      recruited from national email listservs in order to most closely approximate how clinicians
      tend to discover and engage in online training opportunities. Participants complete an
      initial online survey about their use of MBC in practice and are randomly assigned to
      participate in one of two study conditions: the BOLT condition (training and consultation) or
      a Control condition (no training and no consultation). Participants in the BOLT condition
      complete a self-paced Brief Online Training (BOLT) for Measurement-Based Care (MBC), are
      asked to begin to use MBC with their caseloads, and are then randomly assigned to one of
      three different consultation groups receiving 2 weeks, 4 weeks or 8 weeks of consultation.
      Participation in a consultation group includes participating in biweekly group phone
      consultations and posting weekly assignments on an online consultation discussion board about
      their use of MBC in practice. Participants in all BOLT groups and the Control condition
      complete weekly online surveys for the full 32 weeks of data collection.
    

Intervention name(s): BOLT + PTC
Intervention type(s): Behavioral
Intervention description(s): BOLT is a Brief Online Training (BOLT) for Measurement-Based Care (MBC). Participants in the BOLT condition were subsequently randomized into varying amounts of post-training consultation (PTC).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research