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了解自闭症干预措施的多层次实施策略的机制,在跨服务系统的随机试验中
Aubyn C Stahmer1, Anna S Lau2, Scott Roesch3
1Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA, 95819, USA. astahmer@health.ucdavis.edu.
Implementation science : IS
|December 15, 2025
概括
领导力培训战略 (TLI) 通过增加领导者支持,有效地促进了基于证据的自闭症干预 (EBI),但并没有激活所有拟议的机制. 公共服务系统需要进一步关注领导层战略.
科学领域:
- 实施科学 实施科学
- 公共卫生 公共卫生
- 儿童心理学 儿童心理学
背景情况:
- 了解实施战略的有效性需要检查机制的激活.
- TEAMS试验调查了自闭症干预的领导者和提供者策略.
- 这项研究侧重于通过支持AIM HI和CPRT的战略激活的机制.
研究的目的:
- 检查领导层 (TLI) 和提供者层面的战略是否激活了拟议的实施机制.
- 评估是否激活的机制调解了领导层战略对结果的影响.
- 评估自闭症干预措施在心理健康和教育环境中的战略有效性.
主要方法:
- 组织被随机分配到TLI,提供者策略,两者,或没有 (仅培训).
- 多级建模分析了来自65个项目/地区,95个领导者和385个提供商的数据.
- 假设的机制包括实施领导力,气候,支持,EBI态度和动机.
主要成果:
- 该TLI战略激活了实施支持策略,这是最接近的机制.
- 提供者级战略没有激活任何假设的机制.
- 互动有利于实施气候和提供者动机的联合策略;没有机制调解了TLI效应.
结论:
- 在TLI培训增加了领导者行动促进自闭症EBI在心理健康和教育.
- TLI对忠实度和临床结果的影响并未完全通过激活机制来解释.
- 调查结果强调了领导层在公共服务系统中实施战略的重要性.
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