Fidelity, Assessment and Clinical Effectiveness Tracking (FACET) System: Making EBTs Feasible and Sustainable

Advances in treating adolescent substance abuse and related problems have resulted in an increased emphasis on redirecting resources to transport evidence based treatmentsEBTsintoreal worldsettingsyet the science practice gap remains a pressing problemDue to highly complex and multifaceted processes involved in translating EBTs to practice settings and to a host of diffusion barriersincluding lack of resourcesinfrastructureand technology based and quality assurance capacityonly a fraction of individuals in treatment for substance use disorderSUDreceive EBTsFurtherthe significant gains achieved in efficacy trials are difficult to replicate in actual practice without intensive monitoring of fidelityan essential component of successThe lack of feasible cost efficient fidelity monitoring tools and superstructures to ensure community based practitioners sustain competent and adherent service delivery represents a major impediment for disseminationinnovative methods and procedures are urgently neededThe proposed Phase II SBIR will complete the development of a commercially viable theory guidedempirically basedand user friendly online feedback and monitoring systemFidelityAssessmentand Clinical Effectiveness TrackingFACETto guide and sustain the implementation of EBTs and evaluate the system in a randomized trialFACET is designed to foster cliniciansself regulation of treatment adherence and provide community programs with more direct access to quality assurance information pertinent to maintaining fidelity and achieving positive youth and family treatment outcomesThe randomized trial will be conducted in staggered cohortswith a sequential roll out of training for clinicians within cohortsnper cohortto enhance study feasibilityClinicians will be trained to deliver Functional Family TherapyFFTan established treatment for adolescent substance abuse and co occurring problemsWithin each cohorttreatment sites will be randomized to either Implementation as UsualIAUor FACET assisted implementationFAIand clinicians will participate in the condition of their employing siteMeasurement will involve multi methodmulti source data collectionClinicians will complete five assessments over amonth periodThe impact of FAIcompared to IAU on implementation outcomes will be assessed using measures of clinician EBT knowledge and efficacybehavioral observations of clinician EBT skillsand work process improvements linked to staff time savings for potential customersThe adoption of FACET is expected to bridge the science practice gap and enhance the appealuser friendlinessand marketability of FFT dissemination services delivered to adolescent outpatient drug treatment programs by LIFFTCoThe proposed project will result in an evidence based monitoring system that can be marketed within a repeatable and scalable business modelThe primary long term goal of this project is to establish a data driven foundation for marketing the commercial FACET system in conjunction with EBT dissemination and establish the potential for FACET for other domains