Janey S. McMillen - US grants

[unreadable] DESCRIPTION (provided by applicant): Decades of research in developmental psychopathology support the significant and unique contribution of socio-emotional problems in the emergence of a myriad of negative outcomes, including heightened risk for psychiatric disorders and use of mental health services. This Phase II project continues research and development of an Emotional Intelligence (El) intervention, "Insight!", for children ages 5-7. "Insight!" offers multi-media resources and a skill-based curriculum specifically aimed at enhancing El competencies that is innovative in content and format. It provides a unique means of bridging the intervention setting with home efforts to promote emotional and social functioning of children. During Phase I, the prototype was developed and tested for feasibility with community- and school-based mental health professionals and elementary school teachers. Skill acquisition and product feasibility were tested with parents and children. Product feasibility was successfully established and substantial support for continued development was provided. Phase II will utilize Phase I findings to revise, modify, and extend intervention components to maximize quality and effectiveness. Once finalized, a scientific evaluation of intervention efficacy for mastery of El concepts and positive changes in emotional, social, and behavioral functioning will be conducted. Given "Insight!" is applicable within both community and school settings, two efficacy trials will be conducted. For the clinic-based trial, 100 children will be randomly assigned to treatment or control conditions. For the school-based trial, six K-2nd grade classrooms in each of two participating schools (one treatment, one control) will be randomly chosen to participate. For both trials, outcome data will be collected from child participants, parents, and teachers regarding participants' skill acquisition and emotional, social and behavioral functioning. Children, parents, and professionals will also evaluate quality and usability of "Insight!". Spanish translations of final versions will be created and a web-based distribution center developed with access to downloadable materials, shopping cart capability, and options for participation in interactive online training. Development of psychiatric disorders due to socio-emotional deficits is a public health concern with annual US economic, indirect cost of mental illnesses estimated at $79 billion. Development and implementation of efficacious El interventions such as "Insight!" can reduce these costs. [unreadable] [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): National survey data suggest the prevalence of problem behaviors in young children is between 10-25 percent (Webster-Stratton and Hammond, 1997). As children enter preschool and begin to navigate social situations outside the home, problem behaviors interfere with social development, placing children at risk for problematic peer relations and delayed social skills. Without intervention, social and behavioral problems tend to persist and even escalate over time and, in turn, have a tremendous impact on the development of child psychopathology. Decades of research indicate social and behavioral deficits negatively affect adjustment and place children at increased risk for a myriad of later negative outcomes including depression, substance abuse, and delinquency (see Parker, Rubin, Price and DeRosier, 1995, for review). In contrast, positive social relationships serve as a protective factor promoting more positive developmental outcomes. Prevention and treatment research supports the use of social skills training (SST) for improving children's peer relations, social behavior, and emotional adjustment (see Greenberg, Domitrovich, and Bumbarger, 2001, for review). In addition, intervening with problematic social behaviors before they become chronic and intractable has been repeatedly heralded as a key to preventing the development of more serious maladjustment (Greenberg, et al.; Parker et al.). Early intervention is critical in the prevention of severe social skill deficits and entrenched negative peer interaction patterns (Coie, 1990). The goal of this Phase II project is therefore to continue the research and development of a version of an existing evidence-based small group SST program in order to make it applicable for younger children. This project will adapt 3-C ISD's SST program for 6-12 year old children, SSGRIN (Social Skills Group Intervention), to create a new intervention for young children (ages 4-6 years) titled "SSGRIN-EC" (SSGRIN for Early Childhood). SSGRIN-EC will build on SSGRIN's foundation, as well as Phase I findings, to offer a unique early intervention resource that represents a significant advancement over what is currently available for SST with young children. SSGRIN-EC will provide mental health professionals with an innovative intervention program to enhance the emotional competencies and social relations of young children. SSGRIN-EC will offer multi-media resources, including video and interactive web resources, and a skill based curriculum specifically aimed at enhancing social skills competencies. It also provides a unique means of bridging intervention settings with home efforts to promote social and emotional functioning. The Phase I results provide substantial support for continued development, as well as essential constructive feedback to inform the direction of that development. The proposed Phase II project will utilize the Phase I findings to revise, modify, and extend the SSGRIN-EC components in order to maximize quality and effectiveness. Once finalized, a scientific evaluation of the efficacy of the intervention for mastery of social skills concepts and positive changes in social, emotional, and behavioral functioning will be conducted. PROJECT NARRATIVE: Problematic peer relations, particularly when chronic, can have a tremendous impact on children's mental health as well as their academic, behavioral, and emotional functioning. Without intervention, social and behavioral problems tend to persist and escalate over time which, in turn, has a tremendous impact on the development of psychopathology. Development of psychiatric disorders due to socio-emotional deficits is a public health concern with annual US economic, indirect cost of mental illnesses estimated at $79 billion. Cost-effectiveness analyses of social skills training programs with even modest effect sizes estimated a monetary savings of more than $95,000 per participant and more than $8 return on every dollar invested. The President's New Freedom Commission on Mental Health (2003) specifically calls for the identification and early treatment of children who experience mental health needs in order to prevent the potential onset of co-occurring disorders and break a cycle that otherwise can lead to school failure and other problems [unreadable] [unreadable] [unreadable]

DESCRIPTION (provided by applicant): While multiple psychological interventions for mental health(MH)problems in children and youth have established efficacy in research settings, empirically-based interventions (EBIs) are rarely used in everyday practice in community-based MH settings. This is of critical concern, particularly given the recent accountability movement and federal financial incentives for use of programs supported by empirical evidence. Even in those instances in whichinterventionsthathaveproveneffectiveunderstrictresearchconditionsaredeliveredinthe"realworld,"they often fail to achieve their intended outcomes. One explanation for this discrepancy is that the EBIs are not implemented with the same level of fidelity to the treatment model as in the research setting (Curtis, Ronan, and Borduin, 2004). A growing body of literature indicates the quality of implementation is directly related to the likelihood that an EBI will be adopted and sustained within the community MH setting as well as the strength of its treatment effects. Quality implementation in this instance refers to the degree to which an intervention is delivered as intended, i.e., with fidelity to the treatment model. Three key areas have been found to directly impact the quality of EBI implementation: (1) training support (including on-going implementation assistance);(2) structured, user-friendly resource materials;and (3) accountability tools for monitoring, tracking, and reporting fidelity to core intervention features. The goal of the proposed SBIR project is to develop and test a web-based dissemination toolbox (WDT) that supports quality implementation of community-based mental health EBIs for youth. The proposed WDT will build on recommendations from the research literature to create a suite of tools and services that can be applied in support of disseminating the majority of community-based EBIs on a broad scale. Currently, no comparable product exists for community-based interventions. The proposed WDT will leverage3-C ISD's technological expertise and experience to create a flexible, scalable web tool that will decrease costs (time, financial, personnel) to both community MH settings and intervention developers, enhance the integrity with which EBIs are implemented in community MH settings, and increase dissemination of EBIs into "real world" everyday practice. The final product will be highly innovative, providing the unique ability to apply the WDT to a wide array of EBIs, which will ensure broad-based marketability. Three specific aims will be accomplished through Phase I of this project: (1) the prototype of the WDT will be created with input from the project Advisory Board;(2) the prototype will be evaluated by stakeholder groups to test the feasibility, usability, and value of the proposed WDT;and (3) a full development plan for Phase II will be generated based on Phase I findings and recommendations. PUBLIC HEALTH RELEVANCE: As the mental health research-practice a phas become increasingly evident, numerous federal reports have called for action to better connect research findings to clinical practice [e.g., The President's New Freedom Commission Report(2003);Reports of the Surgeon General on Mental Health (U.S. Department of Health and Human Services, 1999), Youth Violence (HHS, 2001a), and Culture, Race, and Ethnicity (HHS, 2001b);and the National Children's Call to Action (HHS,2000)]. Building on the recommendations of clinical and research community members during the "Enhancing the Discipline of Clinical and Translational Sciences" meeting (May, 2005), the National Institutes of Health (NIH) identified research efforts to bridge science and practice as a primary objective of NIH's Roadmap. The proposed research directly addresses NIH's Roadmap priorities as well as these federal calls for action. Each year, about 6 percent of America's children and adolescents receive some form of MH care, at an annual cost of more than $11 billion. In addition, each year NIMH and other foundations fund more than $300 million for youth MH research, much of it devoted to treatment studies. The findings from the proposed research will advance our understanding of how to successfully integrate EBIs into everyday practice within community MH service settings for youth. Increasing the likelihood that EBIs will be adopted, used as intended, and sustained in everyday practice, in turn, increases the likelihood that youth and society at large will benefit from evidence-based practices.

DESCRIPTION (provided by applicant): The need to improve patient adherence to treatment protocol is immense, both for improved individual patient outcomes and advancement of scientific treatment knowledge. Past interventions to improve adherence have had mixed results, with the most success stemming from those that were very complex and costly. Convenient, cost effective tools to increase clinician/researcher awareness of adherence while creating minimal patient burden are needed. Self-monitoring (SM) is increasingly used across diverse medical fields as both a clinical tool and research method to gather critical adherence data from patients. SM presents myriad advantages over traditional data collection methods including lower recall bias, increased generalizability, and lower patient burden. However, traditional paper-and-pencil methods of SM are too complex and labor intensive for patients to complete easily, resulting in poor compliance and inaccurate, low quality data. In order to best sample patients'behaviors and experiences in real time and in natural environments, computerized SM technologies (C-SM) for mobile devices hold tremendous promise, with patients reporting them to be more convenient, less time consuming, easier to use, and more motivating to complete. Yet, despite the vast potential offered by C- SM, broad scale dissemination and use in medical treatment and research has not yet shown viability due to prohibitively high demands for time, finances, and trained technical staff to develop individualized software. Furthermore, currently available C-SM technologies are highly specialized for a specific purpose with little ability to adapt technology used for C-SM with one patient group to another. The goal of this Phase I project is to develop and test a technology infrastructure to support creation and broad scale deployment of C-SM for mobile devices. The proposed Mobile Application System for Health Monitoring (MAS-HM) would allow clinicians and medical researchers to: (a) create C-SM assessments, protocols, and prompts specifically for deployment to mobile devices (smartphone app, mobile web, or SMS text messaging), (b) monitor and track patients'SM progress, and (c) conduct synchronous data analysis to determine patient adherence level. Most importantly, the MAS-HM will utilize a ubiquitous technology platform that would remove key barriers to adopting C-SM methods and make mobile deployment of C-SM accessible for any medical intervention or research study. This Phase I proposal will accomplish three specific aims: 1) Design the MAS-HM prototype;2) Conduct feasibility groups with clinicians, medical researchers, and adolescents and young adults with chronic illness;and 3) Establish final prototype specifications using data compiled and analyzed from the feasibility groups. These specifications will be used to guide Phase II development prior to efficacy testing. The final MAS-HM product will leverage the ubiquity of mobile devices combined with their powerful networking and computational capabilities to significantly increase C-SM accuracy, timeliness, and ease of use. Greater access to and use of C-SM should translate into improved patient adherence and treatment effectiveness. PUBLIC HEALTH RELEVANCE: Medical non-adherence has been identified as a major public health problem that imposes a considerable financial burden upon modern health care systems [1-5]. Because of the complexities in measuring adherence, no estimate can be generalized, but poor adherence is to be expected in 30-50% of all patients, irrespective of disease, prognosis, or setting [2, 3, 6-8]. This burden has been estimated to cost $100 billion each year in the US [4], including 10% of hospital admissions [2, 3]. Adherence is also critical to the integrity of clinical research findings in order to preserve sufficient statistical power for analysis and to minimize the potential for obscured findings. Indeed, as clinician's increasingly rely on treatment protocols that are based on clinical trial evidence, it is critical to address adherence in the realm of research as well [9-14]. The proposed MAS-HM would remove barriers to adherence monitoring and provide significant advantages in convenience, cost effectiveness, and utility over existing clinical tools and research instruments.

DESCRIPTION (provided by applicant): Over the past several decades, a large number of mental health (MH) practices and interventions have been rigorously tested through randomized control trials and shown efficacious. However, despite availability, evidence-based interventions (EBIs) are rarely adopted in everyday practice within community MH service settings. Further, even when adopted, MH EBIs are seldom implemented with strong adherence to the original design and often fail to be sustained over time. A growing body of literature demonstrates how implementation quality is directly related to the likelihood an EBI will be embedded into everyday clinical practice as well as the likelihood that EBI achieves its intended treatment outcomes. As outlined in NIMH's Strategic Plan, innovative methods to help close the gap between development of research-tested interventions and their widespread use are critically needed. This Phase II SBIR project will continue research and development of the Web- Based Dissemination Tool for Community Mental Health (WDT-C), a flexible technology infrastructure specifically designed to foster quality implementation of MH EBIs within community MH service settings on a broad scale. WDT-C will offer a suite of customizable online tools and services, including cost-efficient high quality training and supervision resources, ongoing implementation assistance for providers, adherence monitoring, and outcomes tracking. Prototype development and feasibility testing with key stakeholders were successfully completed in Phase I, providing substantial support for the product as well as specific recommendations for Phase II development. Three specific aims will be accomplished through this Phase II project. The first aim is to develop the full technology infrastructure utilizing Phase I feedback, and apply it to a third, independent MH EBI. To ensure maximal quality and make any needed adjustments prior to product testing, usability of this new WDT-C application will be assessed by community MH administrators and providers. The second aim is to conduct a scientific evaluation of WDT-C. Each of the three WDT-C supported EBIs will be implemented by community MH providers randomly assigned to either Implementation-As-Usual (no WDT-C support) or Enhanced Implementation (WDT-C supported implementation) conditions. Differences between conditions will be tested in five implementation outcome areas: (a) organizational readiness for intervention implementation, (b) adherence to intervention protocol, (c) satisfaction with intervention and implementation support, (d) sustainability of intervention, and (e) treatment benefits. The final aim is to finalize all product components based on Phase II findings and evaluations in preparation for Phase III commercialization. This SBIR project will yield a flexible, scalable technology infrastructure that can be applied to any community MH EBI to effectively decrease costs (time, financial, personnel) to both providers and intervention developers, enhance the quality with which EBIs are implemented in community settings, and increase dissemination of EBIs into real world everyday practice.

DESCRIPTION (provided by applicant): With one out of every four youth in the United States currently living with a chronic illness, it is critically important to empower youth to take ownersip of their own healthcare. Research suggests that a key component of a successful transition from pediatric care into adult-focused health care systems is proper management of treatment regimens [1]. Unfortunately, treatment adherence among adolescents with chronic illness is disappointingly low, with poor adherence found in 50-70% of all patients [2]. Reviews of adherence studies indicate the risk of treatment nonadherence declines with greater disease- and treatment-related knowledge and that providing a behavioral management component optimizes adherence [8-10]. The goal of this Phase II SBIR project is to continue the research and development of the Online Medical Monitoring System (OMMS), an integrated online and mobile technology infrastructure specifically designed to (a) enhance youths' disease- and treatment-related knowledge through interactive and game-based educational materials; (b) support adherence to the treatment regimen through customized task prompts via mobile and web-based delivery; and (c) promote patient-provider communication through real-world data collection and synchronized feedback loops. During Phase II, we will build on Phase I feedback to finalize the fully functioning product and conduct a field test examining the degree to which the OMMS enhances treatment adherence outcomes among adolescents with a variety of chronic illnesses. This Phase II project will accomplish three specific aims: 1) fully develop the OMMS product; 2) conduct a field test of the benefits of the OMMS with adolescents with chronic illness; and 3) finalize the OMMS and ready for broad scale commercialization. To our knowledge, the OMMS will be the first technology product that integrates educational, adherence tracking, and patient-provider communication tools into one comprehensive, streamlined package. We expect the OMMS to effectively provide essential information and much needed support to youth with chronic illness to help them successfully negotiate their treatment regimen and transition into self-managed healthcare.

DESCRIPTION (provided by applicant): Schools are the primary setting within which children receive mental health (MH) services. The effectiveness of MH programs has been repeatedly demonstrated for a wide array of MH problems, including behavioral and emotional disorders, substance abuse, ADHD, and suicidality. However, despite their availability, as well as recent education and federal financial incentives for use of programs supported by empirical evidence, MH evidence-based interventions (EBIs) are rarely used in everyday practice by schools. Further, school MH EBIs that have proven effective under strict research conditions often fail to achieve their intended outcomes when delivered in the real world. A wealth of research indicates the quality of EBI implementation is directly related to 1) the likelihood the intervention will be integrated and sustained within the school setting and 2) the strength of its treatment effects. The goal of this Phase II SBIR is to continue the research and development of CenterVention, a web-based technology infrastructure designed to promote broad-scale quality implementation of school MH EBIs. CenterVention will provide cost-effective high quality training, on-going implementation assistance, intervention resources, and adherence monitoring to support EBI implementation and sustainability within schools. Phase I prototype development and feasibility testing with key stakeholders were successfully completed, providing substantial support for the CenterVention product as well as specific recommendations for Phase II development. The first aim of Phase II is to revise each CenterVention component to enhance its usability and value. Once the full technology infrastructure is complete, we will integrate a third, independent school MH EBI and examine the usability of this new CenterVention application with school MH providers, teachers, administrators, and intervention developers. The second aim of Phase II is to conduct a rigorous, longitudinal test of the CenterVention product comparing two randomized conditions: Implementation-As-Usual (IAU; i.e., traditional EBI implementation with no CenterVention support) and Enhanced Implementation (EI; i.e., CenterVention-supported implementation). Five implementation outcomes will be examined: (1) readiness for EBI implementation, (2) adherence to EBI protocol, (3) satisfaction with the EBI and its implementation support, (4) sustainability of the EBI over time, and (5) treatment benefits for students. The third aim of Phase II is to finalize all product components based on Phase II findings and evaluations and prepare CenterVention for Phase III commercialization. This SBIR project will yield a flexible, scalable technology infrastructure that can be applied to any school MH EBI to effectively decrease costs (time, financial, personnel) to both schools and intervention developers, enhance the integrity with which EBIs are implemented in the school setting, and increase dissemination of EBIs into real world everyday practice. The proposed WDT not only offers the potential for significant societal benefits, but also addresses a large, currently untapped market.

DESCRIPTION (provided by applicant): Over the past several decades, a large number of evidence-based prevention initiatives for alcohol, tobacco, and other drug (ATOD) use have been rigorously tested and shown to be efficacious. However, despite availability, evidence-based interventions (EBIs) for prevention of ATOD use are rarely adopted in everyday practice within school and community service settings. Further, even when adopted, these EBIs are seldom implemented with strong adherence to the original design and often fail to be sustained over time. A growing body of literature demonstrates how implementation quality is directly related to the likelihood an EBI will be embedded into everyday practice, as well as the likelihood that the EBI achieves its intended treatment outcomes. The most effective EBI will not produce positive results if it is not implemented with quality and sustained within its real-world service setting. NIDA's Strategic Plan specifically identifies the need for effective methods to help close the gap between development of evidence-based prevention initiatives and their adoption and long-term sustainability in school and community service settings. The goal of this Phase I SBIR project is to test the feasibility, acceptability, and utility of incorporating ATOD EBIs into a web-based tool (Centervention) currently designed to support dissemination and quality implementation of mental health EBIs for youth within school settings. This flexible technology infrastructure offers a suite of customizable online tools and services, including cost-efficient, high quality training and supervision resources, ongoing implementation assistance for intervention providers, adherence monitoring, and outcomes tracking that might be applicable to ATOD EBIs within school and community service settings. Three specific aims will be accomplished through Phase I of this project: (1) an example ATOD EBI (Project CHOICE) will be incorporated into the Centervention framework to establish needed modifications for dissemination of ATOD EBIs; (2) a feasibility test of the Project CHOICE prototype will be conducted with stakeholder groups; and (3) based on Phase I findings and recommendations, a plan for incorporating and testing the dissemination of multiple ATOD EBIs during Phase II will be generated. The primary commercial application will be a technology infrastructure that provides tools and services specifically designed to support quality implementation of ATOD EBIs within school- or community-based service settings. If successful in increasing the likelihood that ATOD EBIs are adopted, used as intended, and sustained in everyday practice, the proposed product offers the potential for significant societal benefits.

? DESCRIPTION (provided by applicant): Background and Rationale: Asthma is the most common chronic illness affecting youth, with prevalence and morbidity being significant among adolescents. School-based and web-based asthma interventions have been shown to be effective with younger children. Yet, few interventions have been developed and tested with high school students, with only one currently deployed online. The efficacy of Asthma Self-Management for Adolescents (ASMA), an in-person evidence-based high school based intervention, has been established; we have also successfully commercialized technology products for youth that are built on 3C's dynamic e-learning platform (DELP). Objective: This Direct to Phase II SBIR project will fully develop and preliminarily validate ASMA 2.0, an empirically-based dynamic e-health intervention to assist adolescents with uncontrolled asthma to learn how to manage their illness and improve their asthma control. We will apply our demonstrated DELP platform to deploy this demonstrated asthma intervention. Building on ASMA's success, ASMA 2.0 will be grounded in social cognitive theory, motivational interviewing, and best practices for user interface design to create a product that can be disseminated to a broad audience of users. We will accomplish three specific aims: (1) to fully develop ASMA 2.0, including eight modules with core instructional topics, tailored sessions, and embedded interactive activities; (2) to conduct a two group randomized pilot trial with 70, 9th - 12th graders with uncontrolled asthma from two NYC public high schools in order to assess the preliminary intervention effects of ASMA 2.0, and to evaluate the feasibility and acceptability of ASMA 2.0; and (3) to finalize and prepare ASMA 2.0 for commercialization based on feedback from adolescents who participated in the pilot test of ASMA 2.0 and stakeholders who treat and/or educate adolescents with asthma or who are likely payers. We will also evaluate the reach, acceptability, feasibility, and sustainability of the ASMA 2.0 product. Hypotheses: Over two months post-intervention, relative to controls, ASMA 2.0 participants will show significantly greater improvement in asthma-related outcomes. We also hypothesize that ratings and software usage indices will demonstrate that ASMA 2.0 is a feasible, usable, and acceptable intervention for use with adolescents. We will also explore evidence of a dose-response in which participants who spend more time engaged with the e- training materials show greater positive change. Significance: ASMA 2.0 will be the first dynamically adaptive, personalized, interactive software product specifically designed for improving management of asthma and asthma control in adolescents with uncontrolled asthma. As detailed in the Commercialization Plan, ASMA 2.0 will be a unique commercial offering within a large potential market, with revenue being generated through sales to schools, clinics, emergency departments, health insurance companies, and professional health organizations (e.g., local ALA chapters, asthma coalitions).

? DESCRIPTION (provided by applicant): Over the past several decades, a large number of evidence-based treatment programs for alcohol, tobacco, and other drug (ATOD) use in youth have been rigorously tested and shown to be efficacious. Nevertheless, evidence-based ATOD programs (EBPs) are rarely adopted in everyday practice, are seldom implemented with strong fidelity, and often fail to be sustained over time in their intended service settings. A growing body of literature demonstrates implementation quality is directly related to the likelihood an EBP will be embedded into everyday practice and achieve its intended treatment outcomes. NIDA's Strategic Plan specifically identifies the need for effective methods to help close the gap between development of ATOD-EBPs and their adoption and long-term sustainability in service settings. This Phase II SBIR project will complete research and development of Centervention-ATOD, a customizable suite of online tools specifically designed to support quality implementation and sustainability of any ATOD-EBP within real-world service settings. During Phase I, we developed the Centervention-ATOD prototype with iterative input from key stakeholders; applied this technology infrastructure to an evidence-based ATOD prevention program; and evaluated the feasibility, usability, and value of the prototype and proposed scalable product. Stakeholders voiced strong support for continued research and development and suggested broadening the product's scope to include intervention- focused programs as well as examining cost-effectiveness outcomes. This Phase II SBIR project will accomplish three specific aims: (1) develop and expand Centervention-ATOD prototype components to enhance usability and utility for service settings, and integrate a second evidence-based ATOD program into the technology infrastructure. The utility and usability of Centervention-ATOD for this new EBP will be assessed and recommended modifications incorporated prior to pilot testing; (2) evaluate through pilot testing whether Centervention-ATOD confers additive benefits in provider implementation proficiency and efficacy, quality of implementation delivery, and EBP outcomes compared to traditional implementation methods; and (3) in collaboration with our expert consultant, conduct a formal cost-effectiveness analysis in order to evaluate monetary and non-monetary costs and benefits of implementing EBPs using Centervention-ATOD. No other comparable product exists that is specifically designed to help ATOD treatment facilities implement and sustain EBPs. Centervention-ATOD will leverage 3C Institute's technological expertise and experience to create a flexible, scalable technology infrastructure applicable to ATOD-EBPs on a broad scale, decreasing costs to service providers, enhancing implementation quality, and increasing program sustainability, thereby offering the potential for significant societal benefits and addressing a large, commercial market.

There has been substantial progress in developing evidence-based prevention programs (EBPPs) for preventing risky behaviors and promoting positive outcomes for youth. Unfortunately, their adoption, quality implementation, long-term sustainability, and scalability in real world service settings continues to lag far behind, resulting in an inability to achieve the intended broad scale public impact. This SBIR Fast Track project will address a key implementation barrier to broad scale adoption and sustained use of EBPPs?the need for ongoing tracking and documentation of how (process data) and to what extent (outcomes data) an EBPP results in intended youth outcomes under real-world conditions. Building on the existing collaboration between 3C Institute and Penn State University Prevention Research Center's EPISCenter, we will develop Impact, an easy to use, cost- and time-efficient technology platform to gather relevant process and outcome data and produce meaningful real-time reports at provider, service setting, and state-wide levels. The proposed project will accomplish five specific aims: Phase I: (1) Create a fully-functional prototype based on feedback gathered from providers and administrators during prior research by 3C and EPISCenter. Previously developed wireframes will be made fully functional and a complete system blueprint will be developed for five of EPISCenter's supported EBPPs. (2) Conduct a feasibility test with providers and agency/state administrators currently implementing one or more EBPPs supported by EPISCenter. Phase II: (3) Develop the full product with stakeholders, including all proposed Impact functionality for five EPISCenter-supported EBPPs, through an iterative development-testing-revision process to ensure the software achieves optimal usability for intended end users. (4) Conduct a field study with EBPP providers to assess the feasibility, usability, and value of process and outcomes tracking. Providers will be assigned to one of two conditions: (a) using EPISCenter's current methods (Excel spreadsheet & asynchronous reporting) and then (b) using Impact. We expect Impact will result in significant improvements in all areas. (5) Prepare Impact for commercialization by conducting focus groups with EBPP providers and administrators to review pilot test results and gather stakeholder feedback to finalize the complete product. Preparation for Phase III commercial launch will also include development of all needed demos, training materials, and resources for end users and integration of e-commerce functions into the website. Impact's technology infrastructure will be able to accommodate a wide array of EBPPs, providing a much needed cost-effective mechanism to support broad-scale dissemination and use in service settings. In addition, administrators will be able to track implementation, thus enhancing accountability and providing on-going quality assurance, while also providing data analytics to quickly and effectively monitor impact and cost-effectiveness, thereby increasing the likelihood a program's core features are adhered to over time and maximizing treatment benefits for youth.