Clinical trial NCT05041517: Brief Online Training (BOLT) for Routine Outcome Monitoring
Official title: Brief Online Training (BOLT) for Routine Outcome Monitoring
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mental Health Issue
Adoption of Measurement-Based Care (MBC)
Lead sponsor: University of Washington
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
First posted: 2021-09-13
Enrollment: 75
Sex: ALL
Minimum age (years): 22
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief 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.

Eligibility criteria: Inclusion Criteria:

* Between 22-80 years of age
* Employed as a School-Based Mental Health provider
* Must routinely provide individual-level interventions or therapy to students and spend \>50% of their time providing services in schools

Exclusion Criteria:

* Being younger than 22 or older than 80
* Not being employed as a School-Based Mental Health provider
* Don't provide individual-level interventions or therapy to students nor spend \>50% of their time providing services in schools.

Primary outcomes:
measure: Current Assessment Practice Evaluation - Revised (CAPER) - Change of use of MBC
timeFrame: Baseline, Weeks 2-32
measure: Monitoring & Feedback Attitudes Scale (MFAS) - Change of attitudes about MBC use
timeFrame: Baseline, Weeks: 2,4,6,8,10,16,20,24,28,32
measure: MBC Knowledge Questionnaire (MBCKQ) - Change of knowledge about MBC
timeFrame: Baseline, Weeks: 2,4,6,8,10,16,20,24,28,32
measure: Routine-Outcome Monitoring Skill - Change of skill of MBC use
timeFrame: Baseline, Weeks: 2,4,6,8,10,16,20,24,28,32
Secondary outcomes:
Other outcomes:
Locations:
city: Seattle
country: United States
facility: University of Washington
state: Washington
Study officials:
affiliation: University of Washington
name: Aaron Lyon, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lyon AR, Liu FF, Connors EH, King KM, Coifman JI, Cook H, McRee E, Ludwig K, Law A, Dorsey S, McCauley E. How low can you go? Examining the effects of brief online training and post-training consultation dose on implementation mechanisms and outcomes for measurement-based care. Implement Sci Commun. 2022 Jul 22;3(1):79. doi: 10.1186/s43058-022-00325-y.