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A Statewide Trial to Compare Three Training Models for Implementing an Evidence-based Treatment (EBT)

Primary Purpose

Training of Mental Health Professionals, Disruptive Behavior Disorders

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Training Models of PCIT
Training Models of PCIT
Parent-Child Interaction Therapy (PCIT) Treatment
Sponsored by
West Virginia University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Training of Mental Health Professionals focused on measuring Training, Implementation, Community-Based Mental Health Services, Parent-Child Interaction Therapy, Children

Eligibility Criteria

1 Year - undefined (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

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

Sites / Locations

  • University of Pittsburgh School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Clinicians and Supervisors

Administrators

Parent-Child Dyads

Arm Description

After randomization clinicians and supervisors from community behavioral health agencies receive training in one of three PCIT training models: Train the Trainer (TTT), Learning Collaborative (LC) or Web-Supported Self Study (SS).

After randomization administrators from participating community behavioral health agencies receive one of three treatments for PCIT (1/3 Learning Collaborative, 1/3 other treatment - none, and 1/3 other treatment - none).

Parent-child dyads receive Parent-Child Interaction Therapy (PCIT) treatment from trained clinicians/supervisors.

Outcomes

Primary Outcome Measures

Change in Clinician knowledge of treatment based on PCIT Coaches Quiz
The PCIT Coaches Quiz measures clinicians' knowledge of PCIT concepts; a scale to assess clinicians' knowledge of PCIT concepts and coaching scenarios, and is a mixed question format of multiple choice and short answer. It was created by PCIT Developers based on training content.
Change in Clinician PCIT skill competency based on Therapist Competency Checklist
Therapist Competency Checklist evaluates competency criteria based on established Training Guidelines. The criteria are divided into five categories representing the full PCIT protocol (e.g., assessment, treatment, coaching). These pre-determined, skill-based competency items are rated by the trainer after observing trainees behavior over 1 year.
Change in Clinician attitudes about training based on Feedback Surveys
The following areas are measured: satisfaction with implementation condition,treatment acceptability,understanding, feasibility, and systems support; and satisfaction with training content, format, and presenters.

Secondary Outcome Measures

Change in PCIT administrative interviews
Agency acceptability, adoption, appropriateness, cost feasibility, fidelity, penetration and sustainability of PCIT.
Change in PCIT patient functioning
Family Outcome - Client mental health functioning (symptom improvement and daily functioning), treatment satisfaction, barriers to treatment, and service use (additional services and PCIT treatment process).

Full Information

First Posted
August 27, 2015
Last Updated
April 30, 2018
Sponsor
West Virginia University
Collaborators
National Institute of Mental Health (NIMH)
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1. Study Identification

Unique Protocol Identification Number
NCT02543359
Brief Title
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

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
September 2012 (undefined)
Primary Completion Date
November 2, 2017 (Actual)
Study Completion Date
December 31, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
West Virginia University
Collaborators
National Institute of Mental Health (NIMH)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

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: to build knowledge about training outcomes, to build knowledge about implementation outcomes, and 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: Learning Collaborative (LC), Train-the-Trainer (TTT), or 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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Training of Mental Health Professionals, Disruptive Behavior Disorders
Keywords
Training, Implementation, Community-Based Mental Health Services, Parent-Child Interaction Therapy, Children

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
648 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Clinicians and Supervisors
Arm Type
Experimental
Arm Description
After randomization clinicians and supervisors from community behavioral health agencies receive training in one of three PCIT training models: Train the Trainer (TTT), Learning Collaborative (LC) or Web-Supported Self Study (SS).
Arm Title
Administrators
Arm Type
Experimental
Arm Description
After randomization administrators from participating community behavioral health agencies receive one of three treatments for PCIT (1/3 Learning Collaborative, 1/3 other treatment - none, and 1/3 other treatment - none).
Arm Title
Parent-Child Dyads
Arm Type
Experimental
Arm Description
Parent-child dyads receive Parent-Child Interaction Therapy (PCIT) treatment from trained clinicians/supervisors.
Intervention Type
Behavioral
Intervention Name(s)
Training Models of PCIT
Intervention Description
Agency participants are trained in one of three training model strategies: Train the Trainer Model (TTT), Learning Collaborative (LC), or Web-Supported Self Study (SS).One third of participating agencies will be randomized to the Train the Trainer training model.One third of participating agencies will be randomized to the Learning Collaborative training model.One third of participating agencies will be randomized to the Web-Supported Self Study.
Intervention Type
Behavioral
Intervention Name(s)
Training Models of PCIT
Intervention Description
One-third of administrators are trained in the Learning Collaborative training model. One-third of administrators will be trained to usual treatment (none). One-third of administrators will be trained to usual treatment (none).
Intervention Type
Behavioral
Intervention Name(s)
Parent-Child Interaction Therapy (PCIT) Treatment
Intervention Description
Parent-Child Interaction Therapy (PCIT), a parent coaching evidence-based protocol is given to each family from clinicians and supervisors in each training model.
Primary Outcome Measure Information:
Title
Change in Clinician knowledge of treatment based on PCIT Coaches Quiz
Description
The PCIT Coaches Quiz measures clinicians' knowledge of PCIT concepts; a scale to assess clinicians' knowledge of PCIT concepts and coaching scenarios, and is a mixed question format of multiple choice and short answer. It was created by PCIT Developers based on training content.
Time Frame
Measured at baseline, 6, 12, and 24 months
Title
Change in Clinician PCIT skill competency based on Therapist Competency Checklist
Description
Therapist Competency Checklist evaluates competency criteria based on established Training Guidelines. The criteria are divided into five categories representing the full PCIT protocol (e.g., assessment, treatment, coaching). These pre-determined, skill-based competency items are rated by the trainer after observing trainees behavior over 1 year.
Time Frame
Measured at baseline and 6, 12, and 24 months
Title
Change in Clinician attitudes about training based on Feedback Surveys
Description
The following areas are measured: satisfaction with implementation condition,treatment acceptability,understanding, feasibility, and systems support; and satisfaction with training content, format, and presenters.
Time Frame
Measured at baseline and 6, 12 months and 24 months
Secondary Outcome Measure Information:
Title
Change in PCIT administrative interviews
Description
Agency acceptability, adoption, appropriateness, cost feasibility, fidelity, penetration and sustainability of PCIT.
Time Frame
Measured at baseline and 6, 12 months and 24 months
Title
Change in PCIT patient functioning
Description
Family Outcome - Client mental health functioning (symptom improvement and daily functioning), treatment satisfaction, barriers to treatment, and service use (additional services and PCIT treatment process).
Time Frame
Measured at baseline, 3, 6 and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Accepts Healthy Volunteers
Accepts Healthy Volunteers
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Amy D Herschell, PhD
Organizational Affiliation
University of Pittsburgh
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Pittsburgh School of Medicine
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15203
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29056615
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.
Results Reference
background
PubMed Identifier
28503060
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.
Results Reference
background
PubMed Identifier
26416029
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.
Results Reference
background
PubMed Identifier
29216886
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.
Results Reference
background
PubMed Identifier
34928748
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. 2021 Dec 20:1-17. doi: 10.1080/15374416.2021.2001745. Online ahead of print.
Results Reference
derived

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A Statewide Trial to Compare Three Training Models for Implementing an Evidence-based Treatment (EBT)

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