Melanie Livet, Ph.D. - US grants

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): With extensive government resources contributed each year to training and technical assistance for helping communities deliver public health programs, it is crucial for state and federal officials to identify cost-effective capacity-buildin solutions. Practitioners are under substantial pressure to quickly acquire the knowledge and tools to successfully plan, select, implement, and evaluate public health programs. With CDC's continued focus on accountability for program outcomes, it has become critically important to develop innovative, cost-effective, scalable strategies to strengthen community capacity to protect and promote health. The proposed project will directly address this need through the development and testing of a customizable interactive software product designed to empower communities to build the competencies needed to successfully deliver prevention programs. Scaling up this type of capacity building requires the integration of two components: (1) an evidence-based model used to train community practitioners to effectively deliver public health programs; and (2) an interactive technology platform that allows for customizable training. Getting to Outcomes (GTO) is a results-based approach to accountability that builds capacity to deliver effective programs using a 10-step process. We will adapt GTO for use with Positive Youth Development (PYD) programs. PYD is an approach that engages youth in their environments in a manner that is constructive, recognizes youths' strengths, and promotes positive outcomes. The goal of this project is to develop interactive web-based software for individualized training and practice that will build community practitioners' capacity to effectivey plan, implement, and evaluate PYD programs. The proposed software will be built on a state of the art dynamic e- learning platform. Community practitioners will learn through a tailored experience combining customized instruction with interactive exercises to encourage learners to reflect on, apply, and practice their skills. No other technology product offers a comparable system for building capacity of communities to effectively deliver PYD programs. This Phase I SBIR project will accomplish three specific aims: (1) Gather recommendations on how to adapt GTO to PYD through consultation with experts and literature searches; (2) Develop a working PYD GTO software prototype; and (3) Conduct a feasibility test with 60 stakeholders. By building local capacity to plan, implement, and evaluate PYD programs on a broad scale, the proposed product has the potential to significantly impact public health by maximizing positive outcomes for the nation's youth. In addition, this cost- effective training software can extend to areas beyond PYD to potentially transform the public health approach to capacity building.

? 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.