Improving practice in community-based settings: a randomized trial of supervision – study protocol

نویسندگان

  • Shannon Dorsey
  • Michael D Pullmann
  • Esther Deblinger
  • Lucy Berliner
  • Suzanne E Kerns
  • Kelly Thompson
  • Jürgen Unützer
  • John R Weisz
  • Ann F Garland
چکیده

BACKGROUND Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. METHODS/DESIGN The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. DISCUSSION This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT01800266.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Soft Systems Methodology for Implementing Clinical Practice Guidelines in A General Hospital: A study protocol

Background: It is notoriously challenging to implement evidence-based care and to update and improve health care policy. Adhering to evidence-based Clinical Practice Guidelines (CPGs) serves as the driving force behind making decisions based on the best evidence and making efforts for improving the quality of patient care and outcomes. Despite requiring Iranian hospitals to implement CPGs in Ja...

متن کامل

Health education models application by peer group for improving breast cancer screening among Iranian women with a family history of breast cancer: A randomized control trial

    Background: Studies have shown that participation of Iranian women with family history of breast cancer in screening service is low. This investigation has evaluated the effectiveness of health models according to peer group in improving clinical breast exam (CBE) among Iranian women with a family history of breast cancer.    Methods: This was a randomized control ...

متن کامل

Effectiveness of a virtual intervention for primary healthcare professionals aimed at improving attitudes towards the empowerment of patients with chronic diseases: study protocol for a cluster randomized controlled trial (e-MPODERA project)

BACKGROUND Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases. METHODS This paper describes the protocol for a cluste...

متن کامل

Systems intervention to promote colon cancer screening in safety net settings: protocol for a community-based participatory randomized controlled trial

BACKGROUND Colorectal cancer is a leading cause of cancer mortality. Screening can be effective but is underutilized. System- or multi-level interventions could be effective at increasing screening, but most have been implemented and evaluated in higher-resource settings such as health maintenance organizations. Given the disparities evident for colorectal cancer and the potential for screening...

متن کامل

Supervising for Home Safety Program: A Randomized Controlled Trial (RCT) Testing Community-Based Group Delivery.

Objective The individually delivered Supervising for Home Safety (SHS) program improves caregivers' injury-related beliefs and supervision practices. The current randomized controlled trial used a group delivery in a community setting and assessed program impact, feasibility, and acceptance. Methods Caregivers of 2-5-year-olds were randomized to receive either the SHS or an attention-matched ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 8  شماره 

صفحات  -

تاریخ انتشار 2013