Tschida Jessica, Peeran Izza, Drahota Amy
Michigan State University, East Lansing, Michigan, USA
Michigan State University, East Lansing, Michigan, USA.
BMJ Open. 2025 Jul 22;15(7):e095564. doi: 10.1136/bmjopen-2024-095564.
Anxiety disorders are among the most common co-occurring mental health conditions experienced by autistic youth. Without appropriate intervention, anxiety disorders and related difficulties experienced by autistic youth can remain well into adulthood, causing reduced quality of life. Behavioral Interventions for Anxiety in Children with Autism (BIACA) is a manualised, modular evidence-based cognitive behavioural therapy with demonstrated efficacy in reducing or fully remitting anxiety symptoms and improving overall adaptive functioning for autistic youth. However, BIACA has been developed and tested mostly in academic research laboratories and has involved a limited number of community clinicians. Thus, certain characteristics (eg, length, complexity) may require adaptation to facilitate adoption and use in community settings.
This mixed methods study will use and evaluate a community-engaged, intervention adaptation method (ie, Adapted version of the Method for Program Adaptation through Community Engagement (AM-PACE)) to develop an adapted version of BIACA for community use. In the current study, the AM-PACE method will involve: (1) a Community Advisory Board (CAB), (2) structured process to identify core components, (3) community feedback via surveys and semistructured interviews and (4) role play exercises with intended clients. Thereafter, community-based providers (=200) will be asked to evaluate the feasibility, acceptability, appropriateness, usability and intent to use for the original BIACA intervention and adapted BIACA intervention. Repeated measures Analysis of Variance (ANOVA) will be conducted to determine whether programme type predicts provider ratings. Higher provider ratings for the adapted BIACA intervention may indicate adaptations identified through AM-PACE-enhanced potential for BIACA to be equitably implemented in community settings.
Ethics approval was obtained from the Michigan State University Institutional Review Board. Research findings will be published in peer-reviewed journals, presented at international conferences and disseminated in alignment with CAB recommendations.
This study has been registered on Open Science Framework: https://doi.org/10.17605/OSF.IO/Z54MD.
焦虑症是自闭症青少年最常见的共病心理健康状况之一。如果没有适当的干预，自闭症青少年所经历的焦虑症及相关困难可能会持续到成年期，导致生活质量下降。自闭症儿童焦虑行为干预（BIACA）是一种基于手册的模块化循证认知行为疗法，已证明在减轻或完全缓解自闭症青少年的焦虑症状以及改善整体适应性功能方面具有疗效。然而，BIACA主要是在学术研究实验室中开发和测试的，参与的社区临床医生数量有限。因此，某些特征（例如，时长、复杂性）可能需要进行调整，以促进其在社区环境中的采用和使用。
这项混合方法研究将使用并评估一种社区参与的干预调整方法（即通过社区参与进行项目调整的方法（AM-PACE）的改编版），以开发适用于社区使用的BIACA改编版。在本研究中，AM-PACE方法将包括：（1）一个社区咨询委员会（CAB），（2）识别核心成分的结构化过程，（3）通过调查和半结构化访谈获得的社区反馈，以及（4）与目标客户进行角色扮演练习。此后，将要求200名社区服务提供者评估原始BIACA干预和改编后的BIACA干预的可行性、可接受性、适宜性、可用性和使用意愿。将进行重复测量方差分析（ANOVA），以确定项目类型是否能预测提供者的评分。改编后的BIACA干预获得更高的提供者评分，可能表明通过AM-PACE确定的调整增强了BIACA在社区环境中公平实施的潜力。
已获得密歇根州立大学机构审查委员会的伦理批准。研究结果将发表在同行评审期刊上，在国际会议上展示，并根据CAB的建议进行传播。
本研究已在开放科学框架上注册：https://doi.org/10.17605/OSF.IO/Z54MD。
