title: Implementing highly specialized and evidence-based pediatric eating disorder treatment: protocol for a mixed methods evaluation.
abstract: BACKGROUND
  Eating disorders, which include anorexia nervosa and bulimia nervosa, are common in adolescent females and can have serious emotional and physical consequences, including death. Despite our knowledge about the severity of these illnesses, previous research indicates that adolescent patients are not receiving the best available treatment with fidelity. The main goal of this project is to reduce the knowledge gap between what research indicates is the best known treatment and what is actually delivered in clinical practice. Informed by the National Implementation Research Network model and the Consolidated Framework for Implementation Research meta-theory, our primary study aim is to increase the capacity of Ontario-based therapists to provide family-based treatment, by providing training and ongoing supervision.
  
  
  METHODS
  We will use a multi-site case study with a mixed method pre/post design to examine several implementation outcomes across four eating disorder treatment programs. We will provide a training workshop on family-based treatment as well as ongoing monthly supervision. In addition, we will assemble implementation teams at each site and coach them by phone on a monthly basis regarding any process issues. Our main outcomes include fidelity to the treatment model using quantitative evaluation of audio-recorded therapy sessions, as well as qualitative analysis of the perceptions of the implementation process using audio-recorded focus groups with all clinicians and administrators involved in the study.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to evaluate an implementation strategy for an evidence-based treatment for eating disorders. Challenges to date include obtaining ethics approval at all sites, and recruitment. This research will help to inform future studies on how to best implement evidence-based treatments in this field.
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. coutur@mcmaster.ca.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Couturier
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. kimberms@mcmaster.ca.
authors.forename: Melissa
authors.initials: M
authors.lastname: Kimber
authors.affiliation: Stanford University, 401 Quarry Road, Stanford, California, USA. jimlock@stanford.edu.
authors.forename: James
authors.initials: J
authors.lastname: Lock
authors.affiliation: Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada. melanie.barwick@sickkids.ca.
authors.forename: Melanie
authors.initials: M
authors.lastname: Barwick
authors.affiliation: Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada. gail.mcvey@sickkids.ca.
authors.forename: Gail
authors.initials: G
authors.lastname: McVey
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. findls@mcmaster.ca.
authors.forename: Sheri
authors.initials: S
authors.lastname: Findlay
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. webbc@hhsc.ca.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Webb
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. mboettcher@hsnsudbury.ca.
authors.forename: Marlene
authors.initials: M
authors.lastname: Boettcher
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. niccols@hhsc.ca.
authors.forename: Alison
authors.initials: A
authors.lastname: Niccols
authors.affiliation: McMaster University, 1200 Main St. W, Hamilton, Ontario, Canada. woodfor@mcmaster.ca.
authors.forename: Tracy
authors.initials: T
authors.lastname: Woodford
mesh_terms: D000293:Adolescent; D002648:Child; D002985:Clinical Protocols; D019317:Evidence-Based Medicine / Q000379:methods; D001068:Feeding and Eating Disorders / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009864:Ontario; D016730:Program Development; D015397:Program Evaluation