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使用 RE-AIM 框架评估基于社区的 PTSD 循证治疗培训计划。

Evaluating a community-based training program for evidence-based treatments for PTSD using the RE-AIM framework.

机构信息

Department of Psychiatry and Behavioral Sciences.

出版信息

Psychol Serv. 2022 Nov;19(4):740-750. doi: 10.1037/ser0000567. Epub 2021 Oct 25.

Abstract

Community mental health providers increasingly serve veterans with posttraumatic stress disorder (PTSD). However, recent surveys find that less than 20% of community providers are adequately trained to implement evidence-based treatments (EBTs) for PTSD. Since 2017, the STRONG STAR Training Initiative (SSTI) model has adapted traditional learning collaboratives aimed at increasing availability of EBTs for PTSD in community settings. This study reports on STRONG STAR program evaluation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to assess dissemination and implementation outcomes. Between January 2018 and January 2020, 280 mental health providers from 25 states participated. Providers initiating EBTs for PTSD with 930 patients, reaching 29% who had PTSD among their caseload. Overall, 238 of patients who initiated EBT completed treatment. Patients who completed treatment demonstrated a 32.51-point decrease, (237) = 25.27, < .001, in PTSD symptom severity and an 8.73-point decrease, (231) = 19.95, < .001, in depression symptom severity following treatment. High rates of SSTI providers continued implementing EBT for PTSD at 6 months (cognitive processing therapy [CPT]: 95%; prolonged exposure [PE]: 72%) and 1-year (CPT: 87%; PE: 77%) posttraining, similar to outcomes reported by community and Department of Veterans Affairs providers. In reporting on the first evaluation of a National Training Program for community-based mental health providers, we look ahead to continued work in refining scalable models for building provider competence in delivery of EBTs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

社区心理健康提供者越来越多地为患有创伤后应激障碍(PTSD)的退伍军人提供服务。然而,最近的调查发现,只有不到 20%的社区提供者接受过充分的培训,能够实施针对 PTSD 的循证治疗(EBT)。自 2017 年以来,STRONG STAR 培训计划(SSTI)模式已经调整了传统的学习合作,旨在增加 PTSD 在社区环境中 EBT 的可获得性。本研究使用 RE-AIM 框架(即传播和实施结果评估的可达性、有效性、采用、实施和维持)报告 STRONG STAR 计划评估结果,以评估传播和实施结果。在 2018 年 1 月至 2020 年 1 月期间,来自 25 个州的 280 名心理健康提供者参与了该研究。这些提供者共为 930 名 PTSD 患者启动了 EBT,其中 29%的患者 PTSD 患者是其患者群中的一部分。总体而言,238 名启动 EBT 的患者完成了治疗。完成治疗的患者 PTSD 症状严重程度下降了 32.51 分,(237)= 25.27, <.001,抑郁症状严重程度下降了 8.73 分,(231)= 19.95, <.001。SSTI 提供者在培训后 6 个月(认知加工疗法[CPT]:95%;延长暴露[PE]:72%)和 1 年(CPT:87%;PE:77%)持续实施 PTSD 的 EBT,与社区和退伍军人事务部提供者报告的结果相似。在报告首个针对社区为基础的心理健康提供者的国家培训计划的评估结果时,我们期待继续努力完善可扩展的模式,以提高提供者提供 EBT 的能力。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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