A growing number of research studies are attempting to increase access to naturalistic developmental behavioral interventions (NDBIs) for autistic toddlers and their families by translating these approaches into Part C Early Intervention systems. As efforts to increase the use of NDBIs across EI systems grow, it is important to expand the scope of research to evaluate the implementation impact of this work. In order to address this gap, the current study was grounded in the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (RE-AIM) to evaluate a broader range of implementation outcomes when a parent-mediated NDBI, Project ImPACT, was implemented within an Early Intervention system. Specific aims included examining: 1) the reach of Project ImPACT to children across the system; 2) the perceived effectiveness of Project ImPACT; 3) rates of provider participation in Project ImPACT training and consultation; 4) the delivery and adaptation of Project ImPACT by Early Intervention providers; and 5) providers’ intent to sustain their use of Project ImPACT. Forty-eight Early Intervention providers enrolled in Project ImPACT training, with a subsample participating in ongoing group consultation followed by an exit interview and a 6-month follow-up survey. Although there was a high level of interest in Project ImPACT training and good retention once enrolled, only half of EI providers who expressed interest in Project ImPACT training ultimately enrolled. Participating providers delivered Project ImPACT to families and children who were representative of state-level demographic information and perceived that Project ImPACT was effective for families and children on their caseload irrespective of whether children were autistic. Consistent with other research studies, providers’ fidelity to Project ImPACT was inconsistent, and providers reported a moderate level of adaptation to the program. At 6-month follow-up, providers reported high maintenance of Project ImPACT. The findings from this study have implications for how the RE-AIM framework could be used to more concisely characterize the impact of implementation efforts within public systems serving autistic toddlers and their families.

中文翻译：

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使用评估镜头来描述早期干预系统中 NDBI 的实施结果


越来越多的研究正在尝试将这些方法转化为 C 部分早期干预系统，从而增加自闭症幼儿及其家庭获得自然发展行为干预 (NDBI) 的机会。随着在 EI 系统中增加 NDBI 使用的努力不断增加，扩大研究范围以评估这项工作的实施影响非常重要。为了弥补这一差距，当前的研究以覆盖范围、有效性、采用、实施和维护框架 (RE-AIM) 为基础，以评估实施家长介导的 NDBI（ImPACT 项目）时更广泛的实施结果在早期干预系统内。具体目标包括审查：1）ImPACT 项目对整个系统儿童的影响； 2) ImPACT 项目的感知有效性； 3) 提供者参与 ImPACT 项目培训和咨询的比例； 4) 早期干预提供商实施和调整 ImPACT 项目； 5) 提供商维持使用 ImPACT 项目的意图。 48 名早期干预提供者参加了 ImPACT 项目培训，其中一部分样本参加了持续的小组咨询，随后进行了退出访谈和为期 6 个月的跟踪调查。尽管人们对 ImPACT 项目培训非常感兴趣，并且注册后的保留率也很高，但只有一半表示对 ImPACT 项目培训感兴趣的 EI 提供者最终注册了。参与的提供者向代表州级人口信息的家庭和儿童提供了 ImPACT 项目，并认为 ImPACT 项目对家庭和儿童的案例量是有效的，无论儿童是否患有自闭症。 与其他研究一致，提供者对 ImPACT 项目的忠诚度不一致，提供者报告对该计划的适应程度中等。在 6 个月的随访中，提供商报告 ImPACT 项目的维护成本很高。这项研究的结果对于如何使用 RE-AIM 框架来更简洁地描述为自闭症幼儿及其家庭服务的公共系统内实施工作的影响具有重要意义。