Clinical trial NCT02543359: A Statewide Trial to Compare Three Training Models for Implementing an Evidence-based Treatment (EBT)
Official title: A Statewide Trial to Compare Three Training Models for Implementing an EBT
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Training of Mental Health Professionals
Disruptive Behavior Disorders
Keywords: Training
Implementation
Community-Based Mental Health Services
Parent-Child Interaction Therapy
Children
Lead sponsor: West Virginia University
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
First posted: 2015-09-07
Enrollment: 648
Sex: ALL
Minimum age (years): 1
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Evidence-based treatments (EBTs) are available for treating Disruptive Behavior Disorders ( DBDs) including Parent-Child Interaction Therapy (PCIT). Despite EBTs' potential to help children and families, they have primarily remained in university settings. Recognized field leaders have expressed concern over the discrepancy between treatment research and clinical practice, and have indicated that EBT implementation is a priority. Little empirical evidence exists regarding how effective commonly used training models are in changing clinician behavior, achieving full implementation (e.g., increasing treatment fidelity, integrating into service settings), and supporting positive client outcomes. This novel application will evaluate the effectiveness of three training models (Learning Collaborative, Train-the-Trainer, and Web-Supported Self-Study) to implement a well-established EBT in real-world, community settings.

To accomplish this goal, the project will be guided by three specific aims:

1. to build knowledge about training outcomes,
2. to build knowledge about implementation outcomes, and
3. to understand the impact of training clinicians using LC, TTT, and SS models on key client outcomes.

Seventy-two of 243 possible (30%) licensed psychiatric clinics across Pennsylvania will be randomized to one of three training conditions:

1. Learning Collaborative (LC),
2. Train-the-Trainer (TTT), or
3. Web-Supported Self-Study (SS).

Data also will be collected on staff trained by clinicians in the TTT group given that the intention of a TTT model is for participants of that group to return to their organization and train others within the organization. The impact of training (clinician level) will be evaluated at 4 time-points coinciding with the training schedule: baseline, 6, 12, and 24-months. Immediately after training begins, parent-child dyads (client level) will be recruited from the caseloads of participating clinicians (N = 288). Client outcomes will be assessed at four timepoints (pre-treatment, 3, 6, and 12-months). Implementation outcomes (clinic level) will be assessed at baseline, 6, 12, and 24-months after training. This proposal builds on an ongoing state-led initiative to implement, and ultimately sustain, PCIT statewide. Lessons learned from this project will directly impact future EBT implementation efforts in Pennsylvania and other states, helping to increase the use of EBTs in community settings nationwide.


Eligibility criteria: Inclusion Criteria:

Administrators group

* must be employed at an agency selected to participate in training as an Executive Director, Chief Financial Officer, or other person responsible for daily operations.

Clinicians/Supervisors group

* a masters or doctoral level professional in the human services field (e.g., social work, psychology, education),
* licensed in his/her field or receiving supervision from a licensed individual,
* actively seeing children and families who are appropriate for PCIT,
* receptive to training in PCIT but not previously trained in PCIT,
* amenable to study tasks (e.g., video-taping, completing assessments).

Parent-Child Dyads group

* Any parent-child dyad who a trained clinician enrolls in PCIT services

Exclusion Criteria:

Administrators group

* not employed at an agency selected to participate in training as an Executive Director, Chief Financial Officer, or other person responsible for daily operations.

Clinicians group

* a bachelors or lower level professional in the human services field,
* unlicensed in his/her field or not receiving supervision from a licensed individual,
* not actively seeing children and families who are appropriate for PCIT,
* not receptive to training in PCIT but not previously trained in PCIT, and/or
* not amenable to study tasks. Interns also will be excluded.

Parent-Child Dyads group

- if he/she is a ward of the state or living in state custody

Primary outcomes:
measure: Change in Clinician knowledge of treatment based on PCIT Coaches Quiz
timeFrame: Measured at baseline, 6, 12, and 24 months
measure: Change in Clinician PCIT skill competency based on Therapist Competency Checklist
timeFrame: Measured at baseline and 6, 12, and 24 months
measure: Change in Clinician attitudes about training based on Feedback Surveys
timeFrame: Measured at baseline and 6, 12 months and 24 months
Secondary outcomes:
measure: Change in PCIT administrative interviews
timeFrame: Measured at baseline and 6, 12 months and 24 months
measure: Change in PCIT patient functioning
timeFrame: Measured at baseline, 3, 6 and 12 months
Other outcomes:
Locations:
city: Pittsburgh
country: United States
facility: University of Pittsburgh School of Medicine
state: Pennsylvania
Study officials:
affiliation: University of Pittsburgh
name: Amy D Herschell, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jackson CB, Macphee FL, Hunter LJ, Herschell AD, Carter MJ. Enrolling Family Participants in a Statewide Implementation Trial of an Evidence-Based Treatment. Prog Community Health Partnersh. 2017;11(3):233-241. doi: 10.1353/cpr.2017.0028.
citation: Herschell AD, Scudder AB, Schaffner KF, Slagel LA. Feasibility and Effectiveness of Parent-Child Interaction Therapy with Victims of Domestic Violence: A Pilot Study. J Child Fam Stud. 2017 Jan;26(1):271-283. doi: 10.1007/s10826-016-0546-y. Epub 2016 Sep 19.
citation: Herschell AD, Kolko DJ, Scudder AT, Taber-Thomas S, Schaffner KF, Hiegel SA, Iyengar S, Chaffin M, Mrozowski S. Protocol for a statewide randomized controlled trial to compare three training models for implementing an evidence-based treatment. Implement Sci. 2015 Sep 28;10:133. doi: 10.1186/s13012-015-0324-z.
citation: Scudder AT, Taber-Thomas SM, Schaffner K, Pemberton JR, Hunter L, Herschell AD. A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives. Health Res Policy Syst. 2017 Dec 7;15(1):102. doi: 10.1186/s12961-017-0230-8.
citation: Herschell AD, Kolko DJ, Scudder AT, Taber-Thomas SM, Schaffner KF, Hart JA, Mrozowski SJ, Hiegel SA, Iyengar S, Metzger A, Jackson CB. A Statewide Randomized Controlled Trial to Compare Three Models for Implementing Parent Child Interaction Therapy. J Clin Child Adolesc Psychol. 2023 Nov-Dec;52(6):780-796. doi: 10.1080/15374416.2021.2001745. Epub 2021 Dec 20.