title: Protocol for a statewide randomized controlled trial to compare three training models for implementing an evidence-based treatment.
abstract: BACKGROUND
  Evidence-based treatments (EBTs) are available for treating childhood behavioral health challenges. Despite EBTs' potential to help children and families, they have primarily remained in university settings. Little empirical evidence exists regarding how specific, commonly used training and quality control models are effective in changing practice, achieving full implementation, and supporting positive client outcomes.
  
  
  METHODS
  This study (NIMH RO1 MH095750; ClinicalTrials.gov Identifier: NCT02543359), which is currently in progress, will evaluate the effectiveness of three training models (Learning Collaborative (LC), Cascading Model (CM), and Distance Education (DE)) to implement a well-established EBT , Parent-Child Interaction Therapy, in real-world, community settings. The three models differ in their costs, skill training, quality control methods, and capacity to address broader implementation challenges. The project is guided by three specific aims: (1) to build knowledge about training outcomes, (2) to build knowledge about implementation outcomes, and (3) to test the differential impact of training clinicians using LC, CM, and DE models on key client outcomes. Fifty (50) licensed psychiatric clinics across Pennsylvania were randomized to one of the three training conditions: (1) LC, (2) CM, or (3) DE. The impact of training on practice skills (clinician level) and implementation/sustainment outcomes (clinic level) are being evaluated at four timepoints coinciding with the training schedule: baseline, 6 (mid), 12 (post), and 24 months (1 year follow-up). Immediately after training begins, parent-child dyads (client level) are recruited from the caseloads of participating clinicians. Client outcomes are being assessed at four timepoints (pre-treatment, 1, 6, and 12 months after the pre-treatment).
  
  
  CONCLUSIONS
  This proposal builds on an ongoing initiative to implement an EBT statewide. A team of diverse stakeholders including state policy makers, payers, consumers, service providers, and academics from different, but complementary areas (e.g., public health, social work, psychiatry), has been assembled to guide the research plan by incorporating input from multidimensional perspective.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT02543359.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. herschellad@upmc.edu.|Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. herschellad@upmc.edu.
authors.forename: Amy D
authors.initials: AD
authors.lastname: Herschell
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kolko
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Ashley T
authors.initials: AT
authors.lastname: Scudder
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Taber-Thomas
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Kristen F
authors.initials: KF
authors.lastname: Schaffner
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Hiegel
authors.affiliation: University of Pittsburgh Department of Statistics, Pittsburgh, PA, USA.
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.affiliation: Georgia State University School of Public Health, Atlanta, GA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Chaffin
authors.affiliation: Pennsylvania Office of Mental Health and Substance Abuse Services, Harrisburg, PA, USA.
authors.forename: Stanley
authors.initials: S
authors.lastname: Mrozowski
mesh_terms: D019958:Attention Deficit and Disruptive Behavior Disorders / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003299:Cooperative Behavior; D003365:Costs and Cost Analysis; D020375:Education, Distance; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005196:Family Therapy / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D010287:Parent-Child Relations; D010414:Pennsylvania; D015397:Program Evaluation; D012107:Research Design