Trial Outcomes & Findings for Working to Implement and Sustain Digital Outcome Measures (NCT NCT04096274)

Last Updated: 2024-02-20

Results Overview

Fidelity to the OQ-A will be measured by using electronic meta-data from the OQ-A system combined with caregiver reported information on the number of sessions the youth attended. For each youth, a fidelity index will be generated that represents the product of two quantities: (a) the youth's completion rate (i.e., number of measures administered relative to the number of sessions attended within the 6-month observation period), and (b) the youth's viewing rate (i.e., the number of feedback reports viewed by the clinician relative to the number of measures administered). Note that this product is equivalent to the ratio of viewed feedback reports to total sessions; it represents an events/trials proportion. MBC fidelity index scores summarize the level of MBC fidelity experienced by each youth (range=0-1). Higher scores indicate the youth experienced greater fidelity to MBC.

Recruitment status

COMPLETED

Study phase

Target enrollment

686 participants

Primary outcome timeframe

0-6 months after youth's baseline/ entry into treatment

Results posted on

2024-02-20

Participant Flow

Data were only collected from caregivers of youth who received services at participating clinics. Caregivers reported on youth's mental health service experiences and outcomes. Consequently, started and completed numbers shown below only reflect caregivers of eligible youth who participated in services (i.e., number of caregivers enrolled). Youths were not enrolled.

Unit of analysis: Clinics

Participant milestones

Participant milestones
Measure	LOCI (Intervention) In clinics assigned to the LOCI condition, executives and first-level leaders will receive leadership training and coaching to support implementation of the OQ-A system. In addition, leaders and clinicians in this condition will receive training and technical assistance to implement the OQ-A measurement-based care system. Leadership for Organization Change and Implementation (LOCI) is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded. Training and Technical Assistance: All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization.	Training and Technical Assistance Only (Control) In clinics assigned to the control group, leaders and clinicians will receive training and technical assistance to implement the OQ-A measurement-based care system. In addition, to support enrollment in this condition, leaders in this condition will be offered access to general web-based leadership seminars. Training and Technical Assistance Only: All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.
Phase I STARTED	117 11	117 10
Phase I COMPLETED	112 10	112 8
Phase I NOT COMPLETED	5 1	5 2
Phase II STARTED	269 11	183 8
Phase II COMPLETED	258 10	172 8
Phase II NOT COMPLETED	11 1	11 0

Reasons for withdrawal

Reasons for withdrawal
Measure	LOCI (Intervention) In clinics assigned to the LOCI condition, executives and first-level leaders will receive leadership training and coaching to support implementation of the OQ-A system. In addition, leaders and clinicians in this condition will receive training and technical assistance to implement the OQ-A measurement-based care system. Leadership for Organization Change and Implementation (LOCI) is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded. Training and Technical Assistance: All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization.	Training and Technical Assistance Only (Control) In clinics assigned to the control group, leaders and clinicians will receive training and technical assistance to implement the OQ-A measurement-based care system. In addition, to support enrollment in this condition, leaders in this condition will be offered access to general web-based leadership seminars. Training and Technical Assistance Only: All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.
Phase I Lost to Follow-up	5	5
Phase II Lost to Follow-up	11	11

Baseline Characteristics

Data not collected from caregivers for this baseline measure

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	LOCI (Intervention) n=386 Participants The Leadership for Organization Change and Implementation (LOCI) strategy is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded.	Training and Technical Assistance Only (Control) n=300 Participants All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.	Total n=686 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Age, Categorical Between 18 and 65 years	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Age, Categorical >=65 years	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Sex/Gender, Customized Male	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Sex/Gender, Customized Female	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Sex/Gender, Customized Prefer not to disclose	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized American Indian or Alaskan Native	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized Asian	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized Black or African American	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized Pacific Islander or Hawaiian Native	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized Prefer to self-describe	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized Prefer not to disclose	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized More than one race (Multiracial)	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized White	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Race/Ethnicity, Customized Unknown or not reported	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure	0 Participants Data not collected from caregivers for this baseline measure
Phase I: Youth Short-form Assessment for Children (SAC) Total Problem Score	37.1 units on a scale STANDARD_DEVIATION 13.6 • n=117 Participants • Data for Phase I only	34.1 units on a scale STANDARD_DEVIATION 12.8 • n=117 Participants • Data for Phase I only	35.6 units on a scale STANDARD_DEVIATION 13.2 • n=234 Participants • Data for Phase I only
Phase I: Youth received prior mental health treatment	66 Participants n=117 Participants • Data for Phase I only	58 Participants n=117 Participants • Data for Phase I only	124 Participants n=234 Participants • Data for Phase I only
Phase I: Family Income Less than $25,750	27 Participants n=117 Participants • Data for Phase I only	20 Participants n=117 Participants • Data for Phase I only	47 Participants n=234 Participants • Data for Phase I only
Phase I: Family Income $25,751 to $35,535	19 Participants n=117 Participants • Data for Phase I only	18 Participants n=117 Participants • Data for Phase I only	37 Participants n=234 Participants • Data for Phase I only
Phase I: Family Income $35,536 to $51,500	19 Participants n=117 Participants • Data for Phase I only	20 Participants n=117 Participants • Data for Phase I only	39 Participants n=234 Participants • Data for Phase I only
Phase I: Family Income More than $51,500	50 Participants n=117 Participants • Data for Phase I only	59 Participants n=117 Participants • Data for Phase I only	109 Participants n=234 Participants • Data for Phase I only
Phase I: Family Income Unknown or not reported	2 Participants n=117 Participants • Data for Phase I only	0 Participants n=117 Participants • Data for Phase I only	2 Participants n=234 Participants • Data for Phase I only
Phase I: Parent Highest Education Level High school graduate/GED or less	25 Participants n=117 Participants • Data for Phase I only	23 Participants n=117 Participants • Data for Phase I only	48 Participants n=234 Participants • Data for Phase I only
Phase I: Parent Highest Education Level Associate's degree or some college	48 Participants n=117 Participants • Data for Phase I only	42 Participants n=117 Participants • Data for Phase I only	90 Participants n=234 Participants • Data for Phase I only
Phase I: Parent Highest Education Level Bachelor's degree	26 Participants n=117 Participants • Data for Phase I only	28 Participants n=117 Participants • Data for Phase I only	54 Participants n=234 Participants • Data for Phase I only
Phase I: Parent Highest Education Level Graduate degree	18 Participants n=117 Participants • Data for Phase I only	24 Participants n=117 Participants • Data for Phase I only	42 Participants n=234 Participants • Data for Phase I only
Phase I: Parent Highest Education Level Unknown or not reported	0 Participants n=117 Participants • Data for Phase I only	0 Participants n=117 Participants • Data for Phase I only	0 Participants n=234 Participants • Data for Phase I only
Phase I: Youth age	11.3 years STANDARD_DEVIATION 3.7 • n=117 Participants • Data for Phase I only	12.1 years STANDARD_DEVIATION 4.0 • n=117 Participants • Data for Phase I only	11.7 years STANDARD_DEVIATION 3.8 • n=234 Participants • Data for Phase I only
Phase I: Youth sex Male	54 Participants n=117 Participants • Data for Phase I only	54 Participants n=117 Participants • Data for Phase I only	108 Participants n=234 Participants • Data for Phase I only
Phase I: Youth sex Female	62 Participants n=117 Participants • Data for Phase I only	63 Participants n=117 Participants • Data for Phase I only	125 Participants n=234 Participants • Data for Phase I only
Phase I: Youth sex Prefer not to disclose	1 Participants n=117 Participants • Data for Phase I only	0 Participants n=117 Participants • Data for Phase I only	1 Participants n=234 Participants • Data for Phase I only
Phase I: Youth Race American Indian or Alaskan Native	1 Participants n=117 Participants • Data for Phase I only	2 Participants n=117 Participants • Data for Phase I only	3 Participants n=234 Participants • Data for Phase I only
Phase I: Youth Race Asian	1 Participants n=386 Participants • Data for Phase I only	1 Participants n=300 Participants • Data for Phase I only	2 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Race Black or African American	1 Participants n=386 Participants • Data for Phase I only	2 Participants n=300 Participants • Data for Phase I only	3 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Race Multiracial	10 Participants n=386 Participants • Data for Phase I only	6 Participants n=300 Participants • Data for Phase I only	16 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Race Pacific Islander or Hawaiian Native	0 Participants n=386 Participants • Data for Phase I only	0 Participants n=300 Participants • Data for Phase I only	0 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Race Prefer to self-describe	3 Participants n=386 Participants • Data for Phase I only	2 Participants n=300 Participants • Data for Phase I only	5 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Race White	98 Participants n=386 Participants • Data for Phase I only	103 Participants n=300 Participants • Data for Phase I only	201 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Race Prefer not to disclose	3 Participants n=386 Participants • Data for Phase I only	1 Participants n=300 Participants • Data for Phase I only	4 Participants n=686 Participants • Data for Phase I only
Phase I: Youth Hispanic/ Latinx Ethnicity	21 Participants n=117 Participants • Date for Phase I only	14 Participants n=117 Participants • Date for Phase I only	35 Participants n=234 Participants • Date for Phase I only
Phase II: Youth Short-form Assessment for Children (SAC) Total Problem Score	35.1 units on a scale STANDARD_DEVIATION 13.3 • n=269 Participants • Data for Phase II only	34.7 units on a scale STANDARD_DEVIATION 13.6 • n=183 Participants • Data for Phase II only	34.9 units on a scale STANDARD_DEVIATION 13.4 • n=452 Participants • Data for Phase II only
Phase II: Youth received prior mental health treatment	153 Participants n=269 Participants • Data for Phase II only	110 Participants n=183 Participants • Data for Phase II only	263 Participants n=452 Participants • Data for Phase II only
Phase II: Family income Less than $25,750	57 Participants n=269 Participants • Data for Phase II only	34 Participants n=183 Participants • Data for Phase II only	91 Participants n=452 Participants • Data for Phase II only
Phase II: Family income $25,751 to $35,535	45 Participants n=269 Participants • Data for Phase II only	25 Participants n=183 Participants • Data for Phase II only	70 Participants n=452 Participants • Data for Phase II only
Phase II: Family income $35,536 to $51,500	55 Participants n=269 Participants • Data for Phase II only	29 Participants n=183 Participants • Data for Phase II only	84 Participants n=452 Participants • Data for Phase II only
Phase II: Family income More than $51,500	107 Participants n=269 Participants • Data for Phase II only	91 Participants n=183 Participants • Data for Phase II only	198 Participants n=452 Participants • Data for Phase II only
Phase II: Family income Unknown	5 Participants n=269 Participants • Data for Phase II only	4 Participants n=183 Participants • Data for Phase II only	9 Participants n=452 Participants • Data for Phase II only
Phase II: Parent Highest Education Level High school graduate/ GED or less	37 Participants n=269 Participants • Data for Phase II only	29 Participants n=183 Participants • Data for Phase II only	66 Participants n=452 Participants • Data for Phase II only
Phase II: Parent Highest Education Level Associate's degree or some college	129 Participants n=269 Participants • Data for Phase II only	76 Participants n=183 Participants • Data for Phase II only	205 Participants n=452 Participants • Data for Phase II only
Phase II: Parent Highest Education Level Bachelor's degree	64 Participants n=269 Participants • Data for Phase II only	53 Participants n=183 Participants • Data for Phase II only	117 Participants n=452 Participants • Data for Phase II only
Phase II: Parent Highest Education Level Graduate degree	34 Participants n=269 Participants • Data for Phase II only	25 Participants n=183 Participants • Data for Phase II only	59 Participants n=452 Participants • Data for Phase II only
Phase II: Parent Highest Education Level Unknown	5 Participants n=269 Participants • Data for Phase II only	0 Participants n=183 Participants • Data for Phase II only	5 Participants n=452 Participants • Data for Phase II only
Phase II: Youth age	10.5 years STANDARD_DEVIATION 3.6 • n=269 Participants • Data for Phase II only	11.6 years STANDARD_DEVIATION 3.8 • n=183 Participants • Data for Phase II only	10.9 years STANDARD_DEVIATION 3.7 • n=452 Participants • Data for Phase II only
Phase II: Youth sex Male	118 Participants n=269 Participants • Data for Phase II only	67 Participants n=183 Participants • Data for Phase II only	185 Participants n=452 Participants • Data for Phase II only
Phase II: Youth sex Female	149 Participants n=269 Participants • Data for Phase II only	114 Participants n=183 Participants • Data for Phase II only	263 Participants n=452 Participants • Data for Phase II only
Phase II: Youth sex Prefer not to disclose	2 Participants n=269 Participants • Data for Phase II only	2 Participants n=183 Participants • Data for Phase II only	4 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race American Indian or Alaskan Native	5 Participants n=269 Participants • Data for Phase II only	0 Participants n=183 Participants • Data for Phase II only	5 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race Asian	3 Participants n=269 Participants • Data for Phase II only	2 Participants n=183 Participants • Data for Phase II only	5 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race Black or African American	2 Participants n=269 Participants • Data for Phase II only	3 Participants n=183 Participants • Data for Phase II only	5 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race Pacific Islander or Hawaiian Native	1 Participants n=269 Participants • Data for Phase II only	0 Participants n=183 Participants • Data for Phase II only	1 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race Prefer not to disclose	3 Participants n=269 Participants • Data for Phase II only	0 Participants n=183 Participants • Data for Phase II only	3 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race Prefer to self-describe	12 Participants n=269 Participants • Data for Phase II only	5 Participants n=183 Participants • Data for Phase II only	17 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race Multiracial	20 Participants n=269 Participants • Data for Phase II only	13 Participants n=183 Participants • Data for Phase II only	33 Participants n=452 Participants • Data for Phase II only
Phase II: Youth race White	223 Participants n=269 Participants • Data for Phase II only	160 Participants n=183 Participants • Data for Phase II only	383 Participants n=452 Participants • Data for Phase II only
Phase II: Youth Hispanic/ Latinx Ethnicity	40 Participants n=269 Participants • Data for Phase II only	21 Participants n=183 Participants • Data for Phase II only	61 Participants n=452 Participants • Data for Phase II only

PRIMARY outcome

Timeframe: 0-6 months after youth's baseline/ entry into treatment

Population: Youths from the Phase I Cohort were included in this analysis.

Outcome measures

Outcome measures
Measure	LOCI (Intervention) n=117 Participants The Leadership for Organization Change and Implementation (LOCI) strategy is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded.	Training and Technical Assistance Only (Control) n=117 Participants All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.
Percentage Fidelity to the OQ-A System Experienced by the Youth (0-100%)	23.1 percentage fidelity achieved Standard Error 9.0	3.4 percentage fidelity achieved Standard Error 2.5

PRIMARY outcome

Timeframe: 0-6 months after youth's baseline/ entry into treatment

Population: Analysis includes youths from Phase I cohort.

The SAC Total Problem Score is a 48-item measure of youth internalizing (e.g., anxious, depressed) and externalizing (e.g., aggressive, noncompliant, overactive) behaviors (range=0-96) completed by caregivers of youth. Total Problem Score was assessed at baseline (youth's entry into treatment) and monthly for 6 months, change from baseline to month 6 is reported.

Outcome measures

Outcome measures
Measure	LOCI (Intervention) n=117 Participants The Leadership for Organization Change and Implementation (LOCI) strategy is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded.	Training and Technical Assistance Only (Control) n=117 Participants All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.
Change From Baseline to 6-months in Youth Total Problems Score on the Short Form Assessment for Children (SAC) - Phase I Cohort	-8.17 units on a scale Standard Error 1.19	-4.04 units on a scale Standard Error 1.15

PRIMARY outcome

Timeframe: 0-6 months after youth's baseline/ entry into treatment

Population: Analyses based on an intent-to-treat approach. Note that one clinic was identified as an extreme outlier and consequently was excluded from analyses.

Outcome measures

Outcome measures
Measure	LOCI (Intervention) n=269 Participants The Leadership for Organization Change and Implementation (LOCI) strategy is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded.	Training and Technical Assistance Only (Control) n=146 Participants All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.
Percentage Fidelity to the OQ-A System Experienced by the Youth (0-100%)	5.65 percentage fidelity achieved Standard Error 4.79	0.97 percentage fidelity achieved Standard Error 1.27

PRIMARY outcome

Timeframe: 0-6 months after youth's baseline/ entry into treatment

Population: One clinic was excluded from analyses because it was an extreme outlier.

Outcome measures

Outcome measures
Measure	LOCI (Intervention) n=269 Participants The Leadership for Organization Change and Implementation (LOCI) strategy is a multicomponent implementation strategy that engages organizational executives and first-level leaders (i.e., those who administratively supervise clinicians) to build an organizational climate to support the implementation of a focal evidence-based practice (EBP) with fidelity. In this study, the focal EBP is the OQ-A system. LOCI includes two overarching components: (1) monthly organizational strategy meetings between executives and LOCI consultants/trainers to develop and embed policies, procedures, and practices that support implementation of a focal EBP, and (2) training and coaching for first-level leaders, to develop their skills in leading implementation. The aim of these components is to develop an organizational implementation climate in which clinicians' perceive that use of the OQ-A with high fidelity is expected, supported, and rewarded.	Training and Technical Assistance Only (Control) n=146 Participants All leaders and clinicians in participating clinics will receive standardized OQ-A training and technical assistance provided by the OQ-A purveyor organization. This includes an initial, 6-hr, in-person OQ-A training; two, live, virtual, 1-hr booster trainings, offered 3 and 5 months after the initial training; and, year-round technical assistance from the OQ-A purveyor organization. Technical assistance includes virtual training sessions, online library of training videos, and customer care representative for technical support. In addition, to encourage participation in the study, a set of four 1-hr, web-based general leadership seminars will be offered to leaders in the control condition. These will cover topics ranging from effective leadership, to giving effective feedback.
Change From Baseline to 6-months in Youth Total Problems Score on the Short-form Assessment for Children (SAC) - Phase II Cohort	-4.82 units on a scale Standard Error .70	-5.19 units on a scale Standard Error 1.02

Adverse Events

LOCI (Intervention)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Training and Technical Assistance Only (Control)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Nathaniel Williams

Boise State University

Phone: 2084263145

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place