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Baffsky R, Ivers R, Cullen P, McGillivray L, Werner-Seidler A, Calear AL, Batterham PJ, Toumbourou JW, Stokes R, Kotselas P, Prendergast T, Torok M. Co-design and Development of Implementation Strategies: Enhancing the PAX Good Behaviour Game in Australian Schools. JOURNAL OF PREVENTION (2022) 2023; 44:679-704. [PMID: 37741909 PMCID: PMC10638156 DOI: 10.1007/s10935-023-00749-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/25/2023]
Abstract
Effective implementation strategies are important for take-up of programs in schools. However, to date, few implementation strategies have been co-designed with teachers and support staff (including principals) in Australia. The aim of this study was to iteratively co-design multiple implementation strategies to enhance the delivery of mental health prevention program, PAX Good Behaviour Game, in New South Wales primary schools. The secondary aim was to evaluate the acceptability of the implementation strategies from the perspective of school staff. Twenty-nine educational staff (including principals) informed the co-design of the implementation strategies across three phases. Phase 1 involved a rapid review of the literature and stakeholder meetings to agree upon potential evidence-based strategies. Phase 2 involved focus group discussions with educational staff to co-design implementation strategies. Phase 3 involved semi-structured interviews with school staff to assess strategy acceptability after implementation at 6-months post-baseline. Data were analysed using deductive, framework analysis. The final co-designed intervention included nine implementation strategies accessible through a toolkit delivered to the school's leadership team. These strategies were deemed acceptable in school settings that experienced periods of both face-to-face and remote learning due to the changing COVID-19 situation in 2021. This paper contributes to the implementation literature by transparently reporting how educational staff-informed implementation strategies were iteratively co-designed. This will provide a roadmap for other researchers to co-design implementation strategies to further support the delivery of evidence-based prevention programs in schools.
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Affiliation(s)
- Rachel Baffsky
- School of Population Health, University of New South Wales, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia.
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | | | | | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
| | - John W Toumbourou
- School of Psychology and Centre for Social and Early Emotional Development (SEED), Deakin University, Geelong, VIC, Australia
| | - Rhoni Stokes
- Department of Education, New South Wales (NSW), Parramatta, NSW, Australia
| | - Pauline Kotselas
- Department of Education, New South Wales (NSW), Parramatta, NSW, Australia
| | - Traci Prendergast
- Department of Education, New South Wales (NSW), Parramatta, NSW, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
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Gustafsson J, Ray C, Lehto E, Roos E, Lehto R. Role of early childhood educators' demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention. Arch Public Health 2023; 81:127. [PMID: 37420242 DOI: 10.1186/s13690-023-01133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/14/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Research has indicated that the effectiveness of intervention programs is affected by how well these programs are implemented, but key gaps remain in our understanding of the factors that promote or inhibit implementation. This study examined how demographic characteristics and perceived work environment among early childhood educators were associated with implementation outcomes of the Increased Health and Wellbeing in Preschools (DAGIS) intervention, which was conducted as a cluster randomized trial. METHODS Participants included 101 educators from 32 intervention preschool classrooms. Data were analyzed at the classroom level, as the DAGIS intervention was delivered in preschool classrooms consisting of several educators instead of individual implementers. Linear regression was used to estimate the associations of educators' demographic characteristics and perceived work environment with different aspects of implementation (i.e., dose delivered; dose received - exposure; dose received - satisfaction; and perceived quality, as well as a total sum score based on these four dimensions). Municipality was controlled in the adjusted models. RESULTS Findings indicated that having a higher proportion of educators with a Bachelor's or Master's degree in education within the classroom was associated with higher dose received - exposure and higher total degree of implementation, and the significance of the models was unaffected by adjustment for municipality. Moreover, having a higher proportion of educators younger than 35 years within the classroom was associated with higher dose received - exposure. However, the association was non-significant when adjusted for municipality. No other educator factor (i.e., work experience in years and perceived support from coworkers, group work, and innovative climate) predicted implementation outcomes. CONCLUSIONS Higher educational attainment and younger age among educators at the classroom level were associated with higher scores for some of the implementation outcomes. Educators' work experience in years at the current preschool and in early childhood education, support from coworkers, group work, and innovative climate were not significantly associated with any implementation outcomes. Future research should explore ways to improve educators' implementation of interventions aimed at promoting children's health behaviors.
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Affiliation(s)
- Jasmine Gustafsson
- Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland.
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Carola Ray
- Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Elviira Lehto
- Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland
- Department of Teacher Education, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Reetta Lehto
- Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland
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Braun SS, Bradshaw CP, Beahm LA, Budavari AC, Downer J, Ialongo NS, Tolan PH. Predicting implementation of the PAX Good Behavior Game + MyTeachingPartner interventions. Front Psychol 2023; 14:1059138. [PMID: 36968753 PMCID: PMC10036766 DOI: 10.3389/fpsyg.2023.1059138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/10/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionEffective classroom management is critical to creating a classroom environment in which social, emotional, and academic learning can take place. The present study investigated the association between early career, early elementary teachers’ occupational health (job stress, burnout, and perceived teaching ability) and perceptions of program feasibility in relation to their implementation dosage and quality of two evidence-based classroom management programs implemented together: the PAX Good Behavior Game (GBG) and MyTeachingPartner (MTP) intervention.MethodsTeachers provided information on their occupational health at the start of the school year and were then randomized to the PAX GBG + MTP condition or control condition. Teachers’ perceptions of the feasibility of the program, implementation dosage, and implementation quality of the intervention were measured at the end of the school year for the 94 intervention teachers.ResultsTeachers participated in more MTP coaching cycles when they reported that the combined PAX GBG + MTP program was feasible. Although there were no main effects of occupational health on implementation, the associations between job stress and implementation quality were moderated by perceptions of feasibility.DiscussionFindings highlight the complexity of factors influencing the implementation of evidence-based programs in school settings.
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Affiliation(s)
- Summer S. Braun
- Department of Psychology and Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, United States
- *Correspondence: Summer S. Braun,
| | - Catherine P. Bradshaw
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Lydia A. Beahm
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Alexa C. Budavari
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Jason Downer
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Nicholas S. Ialongo
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Patrick H. Tolan
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
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Lyons MD, Taylor JV, Zeanah KL, Downey SK, Zabek FA. Supporting School Mental Health Providers: Evidence from a Short-Term Telementoring Model. CHILD & YOUTH CARE FORUM 2023; 52:65-84. [PMID: 35125853 PMCID: PMC8804076 DOI: 10.1007/s10566-022-09673-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 01/28/2023]
Abstract
Background To support student mental health, school staff must have knowledge of evidence-based practices and the capacity to implement them. One approach used to address this challenge is a group-based telementoring model called Extension for Community Healthcare Outcomes (ECHO). In other applications (e.g., healthcare settings), ECHO has been shown to increase healthcare professionals' self-efficacy and knowledge of evidence-based practices leading to improved patient outcomes. Objectives This study examined the potential for ECHO to be used as a method for increasing school staff engagement and knowledge of evidence-based school mental health practices. Methods Using a quasi-experimental design, this study compared outcomes across two professional development experiences aimed at promoting school staff ability to provide evidence-based mental health services. School staff from four school districts participated in a school mental health training initiative. All participants (N = 57) had access to asynchronous, online mental health modules. A sub-sample (n = 33) was also offered monthly ECHO sessions. Results Tests of group difference in outcomes revealed significant increases in engagement with online learning (d = 0.58) and satisfaction (d = 0.82) for those who participated in ECHO as compared to those who did not. Knowledge about evidence-based practices was not significantly different between groups. Conclusions Results suggest that group-based telementoring may be a promising approach for improving engagement and satisfaction with training initiatives aimed at promoting evidence-based school mental health practices. However, further study of ProjectECHO using experimental designs is needed to make causal inferences about its effect on provider outcomes.
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Affiliation(s)
- Michael D. Lyons
- School of Education and Human Development, University of Virginia, Charlottesville, VA USA
- Department of Health, and Human Sciences, University of Virginia, Charlottesville, VA USA
| | - Julia V. Taylor
- School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Kathryn L. Zeanah
- School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Sarah K. Downey
- School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Faith A. Zabek
- School of Education and Human Development, University of Virginia, Charlottesville, VA USA
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Splett JW, Perales K, Miller E, Hartley SN, Wandersman A, Halliday CA, Weist MD. Using readiness to understand implementation challenges in school mental health research. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3101-3121. [PMID: 35180319 DOI: 10.1002/jcop.22818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
Schools and research partners are increasingly implementing complex, multicomponent interventions and school-wide frameworks to better meet students' social, emotional, behavioral, and academic needs; however, in the research and real-world contexts, implementation is often fraught with many challenges and barriers to success. This study explores implementation barriers encountered during a randomized controlled trial testing effects of one complex intervention strategy-the Interconnected Systems Framework-from the lens of a practical model for conceptualizing organizational readiness-the Interactive Systems Framework for Dissemination and Implementation. Implementation of the Interconnected Systems Framework was explored via focus group and key informant interviews with school and mental health professionals, and research team members responsible for implementing the intervention in randomly assigned study schools. Results from inductive thematic analysis of verbatim transcripts identified three primary implementation challenges: staff turnover, inadequate leadership buy-in, and insufficient time for training/planning. Each challenge is explored from interview participants' perspectives and the extant literature, then connected to recommendations from implementation science to help others avoid similar challenges in their well-intentioned efforts to address the mounting concern for students' wellbeing.
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Affiliation(s)
- Joni W Splett
- School of Special Education, School Psychology & Early Childhood Studies, College of Education, University of Florida, Gainesville, Florida, USA
| | | | - Elaine Miller
- Division of K-16 Educational Initiatives, College of Education, University of South Florida, St. Petersburg, Florida, USA
| | - Samantha N Hartley
- University of Maryland School of Medicine, National Center for School Mental Health, Baltimore, Maryland, USA
| | - Abraham Wandersman
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
- Wandersman Center, Columbia, South Carolina, USA
| | - Colleen A Halliday
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Mark D Weist
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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Merle JL, Larson MF, Cook CR, Brewer SK, Hamlin C, Duong M, McGinnis JL, Thayer AJ, Gaias LM, Lyon AR. A Mixed-Method Study Examining Solutions to Common Barriers to Teachers' Adoption of Evidence-Based Classroom Practices. PSYCHOLOGY IN THE SCHOOLS 2022; 59:1825-1843. [PMID: 36060419 PMCID: PMC9439613 DOI: 10.1002/pits.22732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/25/2022] [Indexed: 01/05/2023]
Abstract
Objectives We conducted a mixed-method focus group study to (a) assess the appropriateness and likely effectiveness of strategies that target individual behavior change mechanisms associated with perceived barriers of lack of time and unsupportive leadership and (b) identify recommendations regarding strategies for overcoming the barriers. Method Sample included 39 school-based staff (80% female, 77% White) across two districts in the Midwest. Mixed methods included a simultaneous approach. Results Lack of time and supportive leadership continue to pervade school-based implementation efforts. Recommendations centered around the need for school leaders to give teachers the power to re-prioritize how they spend their time as well as providing protected, facilitated time for teachers to collaborate and learn practical skills targeting self-advocacy. Conclusion Our findings provide compelling evidence for the use of implementation methodology to strategically target mechanisms of individual behavior change during the process of incorporating new and innovative practices in schools.
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Meyer AE, Rodriguez-Quintana N, Miner K, Bilek EL, Vichich J, Smith SN, Koschmann E. Developing a statewide network of coaches to support youth access to evidence-based practices. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221101215. [PMID: 37091092 PMCID: PMC9924236 DOI: 10.1177/26334895221101215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: A national shortage of mental health providers for youth exists in the United States. Implementation support for mental health services in schools, where students are most likely to access care, can help to fill these gaps. Coaching consists of in vivo modeling and support during service delivery and is effective in supporting the implementation of evidence-based practices (EBPs). This implementation report describes the recruitment and training of community providers to become coaches as a part of a modified train-the-trainer model of implementation support. Method: An EBP implementation program, Transforming Research into Action to Improve the Lives of Students (TRAILS), trained community providers in Michigan to increase knowledge of cognitive behavioral therapy (CBT) and position them as coaches in schools. The development of the coach network involved five stages prior to the initiation of a randomized controlled trial: (1) recruitment, (2) a one-day clinical training, (3) 12 weeks of individualized consultation, (4) evaluation, and (5) training in the coaching protocol. Results: A total of 347 individuals attended an initial training, and 187 were paired with a consultant. Eighty-six clinicians from 47 of Michigan's 83 counties successfully became coaches by completing all required elements of training. Coaches showed significant improvements in the use and knowledge of CBT across consultation. Conclusion: Statewide networks of trained mental health professionals can address gaps in mental healthcare for youth. This article demonstrates one strategy for strengthening and leveraging community expertise to support the implementation of EPBs in schools. Plain Language Summary Although youth face many barriers in accessing effective mental health care, schools are one setting where they can more easily receive treatment. Research shows that training and supports are needed for school mental health professionals to provide effective care. Coaching, which involves in vivo support for school mental health professionals, is one helpful strategy. We describe the process of recruiting and training community clinicians to become coaches. The Transforming Research into Action to Improve the Lives of Students (TRAILS) program successfully recruited and trained a network of 86 community clinicians to become coaches. Clinicians attended two day-long trainings and participated in 12 weeks of personalized consultation. Clients to whom these clinicians provided CBT showed significant symptom improvement. Clinicians also reported that they increased their knowledge and use of core CBT strategies, including psychoeducation, exposure, and behavioral activation. Community mental health professionals who are trained as coaches can address gaps in access to care for youth. We demonstrate one strategy for strengthening and leveraging clinicians’ knowledge of CBT to support the school-based implementation of CBT.
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Affiliation(s)
- Allison E Meyer
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | | | - Kristen Miner
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Emily L Bilek
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jennifer Vichich
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Shawna N Smith
- Department of Health Management & Policy, School of Public Health, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
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Olson JR, Berntson T, Zabel MD, Matarese M, Bruns EJ. Evaluation of a systems-level technical assistance program to support youth with complex behavioral health needs. EVALUATION AND PROGRAM PLANNING 2022; 92:102059. [PMID: 35218986 DOI: 10.1016/j.evalprogplan.2022.102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
The National Technical Assistance Network for Children's Behavioral Health (TA Network) supports the development and implementation of Systems of Care (SOC) for youth with serious emotional disorders and their families in states, tribes, territories, and communities throughout the United States. The purpose of the current research was to conduct an evaluation of the TA Network to assess: The degree to which it has deployed research-based elements of TA; levels of participant satisfaction; types and scope of TA services provided; and systems-level outcomes. Study participants were drawn from a stratified random sample of SOC grant recipients who received technical support from the TA Network between 2013 and 2017. Results suggest that the TA Network has encompassed research-based elements of effective TA. Participants rated their interactions with the network very highly, and they accessed a wide variety of resources from the network. Finally, participants reported a variety of systems-level outcomes associated with TA Network support. Together, these findings underscore the importance of structuring TA systems to tailor support to fit with recipients' needs, build positive, proactive relationships, and offer services of sufficient dosage. Given the lack of rigorous evaluations on provision of TA, future studies can confirm the degree to which such tailored approaches to TA result in increased satisfaction, more effective implementation of SOC principles, and ultimately improved outcomes for youth and families.
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Affiliation(s)
- Jonathan R Olson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Building 29, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA.
| | - Taylor Berntson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Building 29, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA.
| | - Michelle D Zabel
- The Institute for Innovation & Implementation, University of Maryland School of Social Work, 306 West Redwood Street, Baltimore, MD 21201, USA.
| | - Marlene Matarese
- The Institute for Innovation & Implementation, University of Maryland School of Social Work, 306 West Redwood Street, Baltimore, MD 21201, USA.
| | - Eric J Bruns
- Department of Psychiatry and Behavioral Sciences, University of Washington, Building 29, 6200 NE 74th Street, Suite 100, Seattle, WA 98115, USA.
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Knowledge and attitudes of Implementation Support Practitioners-Findings from a systematic integrative review. PLoS One 2022; 17:e0267533. [PMID: 35544529 PMCID: PMC9094539 DOI: 10.1371/journal.pone.0267533] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/10/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND It requires thoughtful planning and work to successfully apply and sustain research-supported interventions like healthcare treatments, social support, or preventive programs in practice. Implementation support practitioners (ISPs) such as facilitators, technical assistance providers, knowledge brokers, coaches or consultants may be involved to actively support the implementation process. This article presents knowledge and attitudes ISPs bring to their work. METHODS Building on a previously developed program logic, a systematic integrative review was conducted. Literature was sourced by searching nine electronic data bases, organizational websites, and by launching a call for publications among selected experts and social media. Article screening was performed independently by two researchers, and data from included studies were extracted by members of the research team and quality-assured by the lead researcher. The quality of included RCTs was assessed based on a framework by Hodder and colleagues. Thematic Analysis was used to capture information on knowledge and attitudes of ISPs across the included studies. Euler diagrams and heatmaps were used to present the results. RESULTS Results are based on 79 included studies. ISPs reportedly displayed knowledge about the clinical practice they work with, implementation / improvement practice, the local context, supporting change processes, and facilitating evidence-based practice in general. In particular, knowledge about the intervention to be implemented and its target population, specific improvement / implementation methods and approaches, organizational structures and sensitivities, training, and characteristics of (good) research was described in the literature. Seven themes describing ISPs' attitudes were identified: 1) professional, 2) motivated / motivating / encouraging / empowering, 3) empathetic / respectful / sensitive, 4) collaborative / inclusive, 5) authentic, 6) creative / flexible / innovative / adaptive, and 7) frank / direct / honest. Pertaining to a professional attitude, being responsive and focused were the most prevalent indicators across included publications. CONCLUSION The wide range and complexity of knowledge and attitudes found in the literature calls for a comprehensive and systematic approach to collaboratively develop a professional role for ISPs across disciplines. Embedding the ISP role in different health and social welfare settings will enhance implementation capacities considerably.
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Caron EB, Lind TA, Dozier M. Strategies that Promote Therapist Engagement in Active and Experiential Learning: Micro-Level Sequential Analysis. CLINICAL SUPERVISOR 2021; 40:112-133. [PMID: 34248258 DOI: 10.1080/07325223.2020.1870023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Therapists' active learning increases treatment fidelity, but research is needed on supervisory strategies to engage therapists in active learning. This study used sequential analysis to examine consultant behaviors associated with increased and decreased probability of eliciting therapists' active learning. The study included 162 consultation sessions from 27 community therapists implementing Attachment and Biobehavioral Catch-up. Consultants' client discussion, information provision, and modeling were associated with reduced likelihood of active learning. Consultants' questions, engagement in active learning strategies, use of video, and silence were associated with greater likelihood of therapist active learning. These findings inform supervisors' attempts to encourage active learning.
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Affiliation(s)
- E B Caron
- Department of Psychological Science, Fitchburg State University
| | - Teresa A Lind
- Department of Child and Family Development, San Diego State University.,Child and Adolescent Research Center (CASRC)
| | - Mary Dozier
- Department of Psychological and Brain Sciences, University of Delaware
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Johansson M, Biglan A, Embry D. The PAX Good Behavior Game: One Model for Evolving a More Nurturing Society. Clin Child Fam Psychol Rev 2020; 23:462-482. [PMID: 32839866 PMCID: PMC7585564 DOI: 10.1007/s10567-020-00323-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This paper describes the culture and components of the PAX Good Behavior Game and offers it as one model for how to enhance the well-being of populations through the diffusion of nurturing practices into several venues of society. The PAX components, also known as evidence-based kernels, are proposed to be useful in classrooms, families, organizations, criminal justice, and in improving public discussion and government. Kernels affect behavior in the short- and long-term through combinations of antecedents, reinforcers, relational networks, and physiological effects. Identifying common strategies, tools, and clear targets of change is suggested as a way to work towards evolving freely available evidence-based tools that can be combined to improve social conditions in multiple contexts.
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Affiliation(s)
- Magnus Johansson
- Department of Behavioural Science, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, NO-0130, Oslo, Norway.
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Developing an Evidence-Based Technical Assistance Model: a Process Evaluation of the National Training and Technical Assistance Center for Child, Youth, and Family Mental Health. J Behav Health Serv Res 2020; 47:312-330. [PMID: 31974705 PMCID: PMC7324420 DOI: 10.1007/s11414-020-09686-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The National Training and Technical Assistance Center for Child, Youth, and Family Mental Health (NTTAC) supports the development and implementation of systems of care (SOC) for youth with serious emotional disorders (SED) and their families. This article presents results from a process evaluation of NTTAC, conducted to support the Center’s quality improvement and contribute to the knowledge base around provision of technical assistance (TA). The evaluation used a mixed methods approach with data collection focused on a defined subset of NTTAC TA recipients—recipients of federal Comprehensive Community Mental Health Services for Children SOC grants. Data sources included coded administrative records from SOC grant sites, administrative data from NTTAC, standardized measures of SOC development, and stakeholder survey data. Results indicate that TA dosage matched needs and goals of TA recipients (SOC sites), overall levels of satisfaction with TA were high, and TA content was generally aligned with need. TA recipients reported significant progress on indicators of SOC development over time. Together, these findings suggest that it is possible to develop TA methods that reflect the level and type of TA recipients’ goals and needs, and, in turn, positively impact SOC development and behavioral health service delivery.
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Fagan AA, Bumbarger BK, Barth RP, Bradshaw CP, Cooper BR, Supplee LH, Walker DK. Scaling up Evidence-Based Interventions in US Public Systems to Prevent Behavioral Health Problems: Challenges and Opportunities. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 20:1147-1168. [PMID: 31444621 PMCID: PMC6881430 DOI: 10.1007/s11121-019-01048-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A number of programs, policies, and practices have been tested using rigorous scientific methods and shown to prevent behavioral health problems (Catalano et al., Lancet 379:1653-1664, 2012; National Research Council and Institute of Medicine, 2009). Yet these evidence-based interventions (EBIs) are not widely used in public systems, and they have limited reach (Glasgow et al., American Journal of Public Health 102:1274-1281, 2012; National Research Council and Institute of Medicine 2009; Prinz and Sanders, Clinical Psychology Review 27:739-749, 2007). To address this challenge and improve public health and well-being at a population level, the Society for Prevention Research (SPR) formed the Mapping Advances in Prevention Science (MAPS) IV Translation Research Task Force, which considered ways to scale up EBIs in five public systems: behavioral health, child welfare, education, juvenile justice, and public health. After reviewing other efforts to scale up EBIs in public systems, a common set of factors were identified as affecting scale-up in all five systems. The most important factor was the degree to which these systems enacted public policies (i.e., statutes, regulations, and guidance) requiring or recommending EBIs and provided public funds for EBIs. Across systems, other facilitators of scale-up were creating EBIs that are ready for scale-up, public awareness of and support for EBIs, community engagement and capacity to implement EBIs, leadership support for EBIs, a skilled workforce capable of delivering EBIs, and data monitoring and evaluation capacity. It was concluded that the following actions are needed to significantly increase EBI scale-up in public systems: (1) provide more public policies and funding to support the creation, testing, and scaling up of EBIs; (2) develop and evaluate specific frameworks that address systems level barriers impeding EBI scale-up; and (3) promote public support for EBIs, community capacity to implement EBIs at scale, and partnerships between community stakeholders, policy makers, practitioners, and scientists within and across systems.
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Affiliation(s)
- Abigail A Fagan
- Department of Sociology, Criminology & Law, University of Florida, 3362 Turlington Hall, P.O. Box 117330, Gainesville, FL, 32611-7330, USA.
| | | | - Richard P Barth
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD, USA
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Wu YQ, Chartier M, Ly G, Phanlouvong A, Thomas S, Weenusk J, Murdock N, Munro G, Sareen J. Qualitative case study investigating PAX-good behaviour game in first nations communities: insight into school personnel's perspectives in implementing a whole school approach to promote youth mental health. BMJ Open 2019; 9:e030728. [PMID: 31558456 PMCID: PMC6773306 DOI: 10.1136/bmjopen-2019-030728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES PAX-Good Behaviour Game (PAX-GBG) is associated with improved mental health among youth. First Nations community members decided on a whole school approach to facilitate PAX-GBG implementation, by offering intervention training to all staff members in their schools. Our objective is to gain a greater understanding of how this approach was viewed by school personnel, in order to improve implementation in remote and northern First Nations communities. DESIGN We conducted a qualitative case study using semi-structured interviews. SETTING Interviews were conducted in First Nations schools located in northern Manitoba, Canada, in February 2018. PARTICIPANTS We used purposive sampling in selecting the 23 school staff from First Nations communities. INTERVENTION PAX-GBG is a mental health promotion intervention that teachers deliver in the classroom alongside normal instructional activities. It was implemented school-wide over 4 months from October 2017 to February 2018. OUTCOME MEASURES We inquired about the participants' perception of PAX-GBG and the whole school approach. We applied an iterative coding system, identified recurring ideas and classified the ideas into major categories. RESULTS Implementing the PAX-GBG whole school approach improved students' behaviour and created a positive school environment. Students were learning self-regulation, had quieter voices and demonstrated awareness of the PAX-GBG strategies. All teachers interviewed had used the programme. Support from school administrators and having all school personnel use the programme consistently were facilitators to successful implementation. Challenges included the timing of training, lack of clarity in how to implement and implementing among students in older grades and those with special needs. CONCLUSIONS The whole school approach to implementing PAX-GBG was viewed as an acceptable and feasible way to extend the reach of PAX-GBG in order to promote the mental health of First Nations youth. Recommendations included ensuring school leadership support, changes to the training and cultural and literacy adaptations.
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Affiliation(s)
- Yu Qi Wu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mariette Chartier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gia Ly
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ari Phanlouvong
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shelby Thomas
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Nora Murdock
- Department of Instructional Services, Manitoba First Nations Education Resource Centre, Winnipeg, Manitoba, Canada
| | - Garry Munro
- Cree Nation Tribal Health Centre Inc, The Pas, Manitoba, Canada
| | - Jitender Sareen
- Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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How do collective student behavior and other classroom contextual factors relate to teachers' implementation of an evidence-based intervention? A multilevel structural equation model. Dev Psychopathol 2019; 31:1827-1835. [PMID: 31439069 DOI: 10.1017/s095457941900097x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Building on prior work regarding the potential for peer contagion or deviance training in group delivered interventions (Dishion & Dodge, 2005, 2006; Dodge, Dishion, & Lansford, 2006), we leveraged data from a randomized trial, testing the integration of two preventive interventions (Promoting Alternative THinking Strategies and PAX Good Behavior Game), to explore the extent to which classroom contextual factors served as either a barrier to or a motivator for teachers to implement the evidence-based PAX Good Behavior Game with high frequency or dosage. We included students' baseline levels of behavior, measured with regard to both positive (i.e., engagement and social emotional skills) and negative (i.e., hyperactive and aggressive-disruptive) behaviors. Data were collected from 204 teachers in 18 urban elementary schools. A series of multilevel structural equation models were fit to the data. The analyses indicated that classrooms with higher classroom levels of aggressive behavior, on average, at baseline had teachers with lower implementation dosage (i.e., played fewer games) across the school year. In addition, teachers who reported higher baseline levels of emotional exhaustion, regardless of student behavior, also reported lower implementation dosage. Taken together, the results indicated that negative, but not positive, contextual factors at baseline were related to lower implementation dosage; this, in turn, suggests that negative contextual factors may serve as a barrier, rather than a motivator, of teachers' implementation dosage of classroom-based preventive interventions.
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McQuillin SD, Lyons MD, Becker KD, Hart MJ, Cohen K. Strengthening and Expanding Child Services in Low Resource Communities: The Role of Task-Shifting and Just-in-Time Training. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 63:355-365. [PMID: 30834554 DOI: 10.1002/ajcp.12314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the United States, the demand for child mental health services is increasing, while the supply is limited by workforce shortages. These shortages are unlikely to be corrected without significant structural changes in how mental health services are provided. One strategy for bridging this gap is task-shifting, defined as a process by which services that are typically delivered by professionals are moved to individuals with less extensive qualifications or training. Although task-shifting can increase the size of the workforce, there are challenges related to training new workers. In this paper, we propose Just-In-Time Training (JITT) as one strategy for improving task-shifting efforts. We define JITT as on-demand training experiences that only include what is necessary, when it is necessary, to promote competent service delivery. We offer a proof of concept from our own work shifting counseling and academic support tasks from school mental health professionals to pre-baccalaureate mentors, citing lessons learned during our iterative process of JITT development. We conclude with a series of key considerations for scaling up the pairing of task-shifting and JITT, including expanding the science of JITT and anticipating how task-shifting and JITT would work within the context of dynamic mental health service systems.
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Affiliation(s)
| | | | | | | | - Katie Cohen
- University of South Carolina, Columbia, SC, USA
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Promoting Teachers' Implementation of Classroom-Based Prevention Programming Through Coaching: The Mediating Role of the Coach-Teacher Relationship. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:404-416. [PMID: 29075934 DOI: 10.1007/s10488-017-0832-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is growing awareness of the importance of implementation fidelity and the supports, such as coaching, to optimize it. This study examined how coaching activities (i.e., check-ins, needs assessment, modeling, and technical assistance) related directly and indirectly to implementation dosage and quality of the PAX Good Behavior Game, via a mediating pathway through working relationship. Mediation analyses of 138 teachers revealed direct effects of modeling and working relationship on implementation dosage, whereas needs assessment was associated with greater dosage indirectly, by higher ratings of the working relationship. Understanding how coaching activities promote implementation fidelity elements has implications for improving program effectiveness.
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Promoting Afterschool Quality and Positive Youth Development: Cluster Randomized Trial of the Pax Good Behavior Game. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:159-173. [PMID: 28766191 DOI: 10.1007/s11121-017-0820-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This randomized trial tested a strategy originally developed for school settings, the Pax Good Behavior Game (PAX GBG), in the new context of afterschool programs. We examined this approach in afterschool since 70% of all juvenile crime occurs between the hours of 3-6 pm, making afterschool an important setting for prevention and promotion. Dual-career and working families need monitoring and supervision for their children in quality settings that are safe and appropriately structured. While substantial work has identified important features of afterschool programs, increasing attention is being given to how to foster quality. PAX GBG, with its focus on shared norms, cooperative teams, contingent activity rewards, and liberal praise, could potentially enhance not only appropriate structure and supportive relationships, but also youth self-regulation, co-regulation, and socio-emotional development. This study examined the PAX GBG among 76 afterschool programs, serving 811 youth ages 5-12, who were diverse in race-ethnicity, socio-economic status, and geographic locale. Demographically matched pairs of afterschool programs were randomized to PAX GBG or treatment-as-usual. Independent observers conducted ratings of implementation fidelity and program quality across time; along with surveys of children's problem and prosocial behavior. Interaction effects were found using hierarchical linear models such that experimental programs evidencing higher implementation fidelity demonstrated better program quality than controls, (i.e., less harshness, increased appropriate structure, support, and engagement), as well as reduced child-reported hyperactivity and intent-to-treat effects on prosocial behavior. This study demonstrates that best practices fostered by PAX GBG and implemented with fidelity in afterschool result in higher quality contexts for positive youth development.
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Chilenski SM, Welsh J, Olson J, Hoffman L, Perkins DF, Feinberg ME. Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:250-259. [PMID: 28677088 DOI: 10.1007/s11121-017-0812-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5 years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.
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Affiliation(s)
- Sarah M Chilenski
- Prevention Research Center, The Pennsylvania State University, University Park, PA, USA.
- The Clearinghouse for Military Family Readiness, The Pennsylvania State University, University Park, PA, USA.
| | - Janet Welsh
- Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
- The Clearinghouse for Military Family Readiness, The Pennsylvania State University, University Park, PA, USA
| | | | - Lesa Hoffman
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS, USA
| | - Daniel F Perkins
- The Clearinghouse for Military Family Readiness, The Pennsylvania State University, University Park, PA, USA
- The Department of Agricultural Economics, Sociology, and Education, The Pennsylvania State University, University Park, PA, USA
| | - Mark E Feinberg
- Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
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Leveraging Technology to Facilitate Teachers’ Use of a Targeted Classroom Intervention: Evaluation of the Daily Report Card.Online (DRC.O) System. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09320-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Ashworth E, Demkowicz O, Lendrum A, Frearson K. Coaching Models of School-Based Prevention and Promotion Programmes: A Qualitative Exploration of UK Teachers' Perceptions. SCHOOL MENTAL HEALTH 2018; 10:287-300. [PMID: 30147801 PMCID: PMC6096953 DOI: 10.1007/s12310-018-9282-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
There has been increased interest in recent years regarding the utility of imported universal prevention and promotion (P&P) programmes in UK schools, many of which have a coaching model attached. However, there have been relatively few studies exploring the cultural transferability and social validity of these models, even though evidence suggests that these factors are important to the successful implementation of the programmes, and thus the achievement of the intended outcomes. The aim of the current study was to explore the coaching practices that teachers report experiencing, and to further understanding of the perceived benefits of these coaching practices to teachers. The sample consisted of 33 teachers implementing one of two universal, school-based P&P programmes, Good Behavior Game and Promoting Alternative Thinking Strategies as part of large-scale, randomised controlled trials. Qualitative, semi-structured interviews were conducted, and data were analysed thematically utilising a hybrid approach. Teachers typically reported engaging in six distinct practices with their coaches. While the majority of these practices were in line with coaching literature, there were some discrepancies between intended coaching practices and teachers’ reports. The coaching practices were generally perceived to be acceptable to teachers. Two unanticipated practices, validation and motivation, appeared to be of particular value to teachers, although these are not currently a prominent feature in existing coaching models. The findings provide implications for improving the development of socially valid coaching models for UK schools.
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Affiliation(s)
- Emma Ashworth
- Institute of Education, University of Manchester, Oxford Road, Manchester, UK
| | - Ola Demkowicz
- Institute of Education, University of Manchester, Oxford Road, Manchester, UK
| | - Ann Lendrum
- Institute of Education, University of Manchester, Oxford Road, Manchester, UK
| | - Kirsty Frearson
- Institute of Education, University of Manchester, Oxford Road, Manchester, UK
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Olson JR, McCarthy KJ, Perkins DF, Borden LM. A formative evaluation of a coach-based technical assistance model for youth- and family-focused programming. EVALUATION AND PROGRAM PLANNING 2018; 67:29-37. [PMID: 29174950 DOI: 10.1016/j.evalprogplan.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/06/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The Children, Youth, and Families At-Risk (CYFAR) initiative provides funding and technical support for local community-based programs designed to promote positive outcomes among vulnerable populations. In 2013, CYFAR implemented significant changes in the way it provides technical assistance (TA) to grantees. These changes included introducing a new TA model in which trained coaches provide proactive support that is tailored to individual CYFAR projects. The purpose of this paper is to describe the evolution of this TA model and present preliminary findings from a formative evaluation. METHODS CYFAR Principal Investigators (PIs) were invited to respond to online surveys in 2015 and 2016. The surveys were designed to assess PI attitudes towards the nature and quality of support that they receive from their coaches. RESULTS CYFAR PIs reported that their coaches have incorporated a range of coaching skills and techniques into their work. PIs have generally positive attitudes towards their coaches, and these attitudes have become more positive over time. CONCLUSIONS Results suggest that CYFAR PIs have been generally supportive of the new TA system. Factors that may have facilitated support include a strong emphasis on team-building and the provision of specific resources that support program design, implementation, and evaluation.
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Affiliation(s)
- Jonathan R Olson
- Public Health Program, Bastyr University,14500 Juanita Drive, Kenmore, WA 98028, United States.
| | - Kimberly J McCarthy
- Penn State Clearinghouse for Military Family Readiness, The Pennsylvania State University,311 South Allen Street, Suite 002, State College, PA 16801, United States.
| | - Daniel F Perkins
- Penn State Clearinghouse for Military Family Readiness, The Pennsylvania State University,311 South Allen Street, Suite 002, State College, PA 16801, United States.
| | - Lynne M Borden
- College of Education and Human Development, University of Minnesota, Room 290D McNH, 1985 Buford Avenue, St Paul, MN 55108, United States.
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Larson M, Cook CR, Fiat A, Lyon AR. Stressed Teachers Don’t Make Good Implementers: Examining the Interplay Between Stress Reduction and Intervention Fidelity. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9250-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Owens JS, Schwartz ME, Erchul WP, Himawan LK, Evans SW, Coles EK, Schulte AC. Teacher Perceptions of School Consultant Social Influence Strategies: Replication and Expansion. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2017. [DOI: 10.1080/10474412.2016.1275649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Roze M, Vandentorren S, Vuillermoz C, Chauvin P, Melchior M. Emotional and behavioral difficulties in children growing up homeless in Paris. Results of the ENFAMS survey. Eur Psychiatry 2016; 38:51-60. [PMID: 27664530 DOI: 10.1016/j.eurpsy.2016.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 05/05/2016] [Accepted: 05/07/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Children growing up in homeless families are disproportionately more likely to experience health and psychological problems. Our objective was to describe social, environmental, individual and family characteristics associated with emotional and behavioral difficulties among homeless children living in the Paris region. METHODS Face-to-face interviews with a representative sample of homeless families were conducted by bilingual psychologists and interviewers between January and May 2013 (n=343 children ages 4-13 years). Mothers reported children's emotional and behavioral difficulties (Strength and Difficulties Questionnaire [SDQ]), family socio-demographic characteristics, residential mobility, and parents' and children's physical and mental health. Children were interviewed regarding their perception of their living arrangements, friendships and school experiences. We studied children's SDQ total score in a linear regression framework. RESULTS Homeless children had higher SDQ total scores than children in the general population of France, (mean total score=11.3 vs 8.9, P<0,001). In multivariate analyses, children's difficulties were associated with parents' region of birth (beta=1.74 for Sub-Saharan Africa, beta=0.60 for Eastern Europe, beta=3.22 for other countries, P=0.020), residential mobility (beta=0.22, P=0.012), children's health (beta=3.49, P<0.001) and overweight (beta=2.14, P=0.007), the child's sleeping habits (beta=2.82, P=0.002), the mother's suicide risk (beta=4.13, P<0.001), the child's dislike of the family's accommodation (beta=3.59, P<0.001) and the child's experience of bullying (beta=3.21, P=0.002). CONCLUSIONS Children growing up homeless experience high levels of psychological difficulties which can put them at risk for poor mental health and educational outcomes long-term. Access to appropriate screening and medical care for this vulnerable yet underserved group are greatly needed.
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Affiliation(s)
- M Roze
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136, Équipe de Recherche en Épidémiologie Sociale), 75012 Paris, France.
| | - S Vandentorren
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136, Équipe de Recherche en Épidémiologie Sociale), 75012 Paris, France; Institut de Veille Sanitaire, Saint-Maurice, France
| | - C Vuillermoz
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136, Équipe de Recherche en Épidémiologie Sociale), 75012 Paris, France
| | - P Chauvin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136, Équipe de Recherche en Épidémiologie Sociale), 75012 Paris, France
| | - M Melchior
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136, Équipe de Recherche en Épidémiologie Sociale), 75012 Paris, France
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Schneider DR, Pereira APD, Cruz JI, Strelow M, Chan G, Kurki A, Sanchez ZM. Evaluation of the Implementation of a Preventive Program for Children in Brazilian Schools. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2016. [DOI: 10.1590/1982-3703000592016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The article discusses the pilot implementation of the evidence-based preventive program Good Behavior Game (GBG) in public schools in four Brazilian cities. GBG is a method for classroom behavior management by teachers, which aims at developing sociability among elementary school students between 6 and 10 years old. The objective of this study was to evaluate the program implementation process, focusing on the acceptability and perceived results by the professionals involved. Mixed methods were used, and data analysis was conducted using triangulation, including questionnaires and semi-structured interviews with 28 teachers, 9 school administrators, and 6 coaches. Data analysis was performed through descriptive and inferential statistics and content analysis, according to the nature of data. GBG had a high acceptance among teachers and school administrators. Professionals highlighted the importance of stimulating teamwork, the systematic use of rewards, and the objectivity of classroom rules. Acceptability was attributed, in large part, to the effectiveness of the strategy for classroom management. Nevertheless, this study highlighted the need of adaptations to better reflect the Brazilian societal and economic context.
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Affiliation(s)
| | | | | | | | - Gail Chan
- American Institutes for Research, Estados Unidos da América
| | - Anja Kurki
- American Institutes for Research, Estados Unidos da América
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Cappella E, Jackson DR, Kim HY, Bilal C, Holland S, Atkins MS. Implementation of Teacher Consultation and Coaching in Urban Schools: A Mixed Method Study. SCHOOL MENTAL HEALTH 2016; 8:222-237. [PMID: 27293490 DOI: 10.1007/s12310-015-9165-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Guided by implementation science scholarship and school mental health research, the current study uses qualitative and quantitative data to illuminate the barriers, opportunities, and processes underlying the implementation of a teacher consultation and coaching model (BRIDGE) in urban elementary schools. Data come from five public elementary schools, 12 school mental health staff (BRIDGE consultants), and 18 teachers participating in a classroom-randomized trial of BRIDGE. Findings from directed content analysis of teacher focus group and interview data suggest that aspects of the BRIDGE intervention model, school organization and classroom contexts, and teachers/consultants and their relationship were relevant as implementation facilitators or barriers. In addition, case study analysis of intervention materials and fidelity tools from classrooms with moderate-to-high dosage and adherence suggest variation in consultation and coaching by initial level of observed classroom need. Results illuminate the need for implementation research to extend beyond simple indicators of fidelity to the multiple systems and variation in processes at play across levels of the implementation context.
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Nadeem E, Cappella E, Holland S, Coccaro C, Crisonino G. Development and Piloting of a Classroom-Focused Measurement Feedback System. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 43:379-93. [PMID: 25894312 PMCID: PMC4609583 DOI: 10.1007/s10488-015-0651-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The present study used a community partnered research method to develop and pilot a classroom-focused measurement feedback system (MFS) for school mental health providers to support teachers' use of effective universal and target classroom practices related to student emotional and behavioral issues. School personnel from seven urban elementary and middle school classrooms participated. Phase I involved development and refinement of the system through a baseline needs assessment and rapid-cycle feedback. Phase II involved detailed case study analysis of pre-to-post quantitative and implementation process data. Results suggest that teachers who used the dashboard along with consultation showed improvement in observed classroom organization and emotional support. Results also suggest that MFS use was tied closely to consultation dose, and that broader support at the school level was critical. Classroom-focused MFSs are a promising tool to support classroom improvement, and warrant future research focused on their effectiveness and broad applicability.
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Affiliation(s)
- Erum Nadeem
- Department of Child and Adolescent Psychiatry, New York University, One Park Ave, 7th Floor, NYU Child Study Center, New York, NY, 10016, USA.
| | - Elise Cappella
- Department of Applied Psychology, Steinhardt School of New York University, New York, NY, USA
| | - Sibyl Holland
- Graduate School of Education, Harvard University, Cambridge, MA, USA
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Chilenski SM, Perkins DF, Olson J, Hoffman L, Feinberg ME, Greenberg M, Welsh J, Crowley DM, Spoth R. The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study. EVALUATION AND PROGRAM PLANNING 2016; 54:19-29. [PMID: 26476860 PMCID: PMC4666771 DOI: 10.1016/j.evalprogplan.2015.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 06/03/2023]
Abstract
BACKGROUND Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. METHODS Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. RESULTS Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. CONCLUSIONS Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider - prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation.
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Affiliation(s)
- Sarah M Chilenski
- Prevention Research Center, The Pennsylvania State University, United States; The Clearinghouse for Military Family Readiness, The Pennsylvania State University, United States.
| | - Daniel F Perkins
- The Clearinghouse for Military Family Readiness, and the Department of Agricultural Economics, Sociology, and Education, The Pennsylvania State University, United States
| | - Jonathan Olson
- The Clearinghouse for Military Family Readiness, The Pennsylvania State University, United States
| | - Lesa Hoffman
- Schiefelbusch Institute for Life Span Studies, University of Kansas, United States
| | - Mark E Feinberg
- Prevention Research Center, The Pennsylvania State University, United States
| | - Mark Greenberg
- Prevention Research Center, The Pennsylvania State University, United States
| | - Janet Welsh
- Prevention Research Center, The Pennsylvania State University, United States
| | - D Max Crowley
- Prevention Research Center, The Pennsylvania State University, United States; Human Development and Family Studies, The Pennsylvania State University, United States
| | - Richard Spoth
- Partnerships in Prevention Science Institute, Iowa State University, United States
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Nadeem E, Ringle V. De-adoption of an evidence-based trauma intervention in schools: A retrospective report from an urban school district. SCHOOL MENTAL HEALTH 2016; 8:132-143. [PMID: 28775793 DOI: 10.1007/s12310-016-9179-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The de-adoption of evidence-based practices (EBPs) is a largely understudied topic. The present study examined factors related to the de-adoption of an EBP for students exposed to traumatic events in a large urban school district. Qualitative interviews conducted with school clinicians and district administrators two years after the district embarked on a large-scale roll-out of the EBP distinguished between factors that impacted partial de-adoption after one year (phase 1) and complete de-adoption by the district after two years (phase 2). Phase 1 factors included organizational consistency, workforce stability, prior success, positive student outcomes, school- and district- level supports, innovation-setting fit, and innovation-related issues. Phase 2 factors included district-level leadership changes, financial and workforce instability, and shifting priorities. Study results suggest that sustainment-enhancing strategies should be included in the early stages of program implementation to most effectively adapt to school- and system- level changes.
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Affiliation(s)
- Erum Nadeem
- Ferkauf Graduate School of Psychology, Yeshiva University.,Department of Child and Adolescent Psychiatry, New York University School of Medicine
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Domitrovich CE, Bradshaw CP, Berg JK, Pas ET, Becker KD, Musci R, Embry DD, Ialongo N. How Do School-Based Prevention Programs Impact Teachers? Findings from a Randomized Trial of an Integrated Classroom Management and Social-Emotional Program. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:325-37. [DOI: 10.1007/s11121-015-0618-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weis R, Osborne KJ, Dean EL. Effectiveness of a Universal, Interdependent Group Contingency Program on Children's Academic Achievement: A Countywide Evaluation. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2015. [DOI: 10.1080/15377903.2015.1025322] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Eiraldi R, Wolk CB, Locke J, Beidas R. Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools. ACTA ACUST UNITED AC 2015; 8:124-145. [PMID: 26336512 DOI: 10.1080/1754730x.2015.1037848] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts.
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Affiliation(s)
- Ricardo Eiraldi
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, 3440 Market St, Philadelphia, PA 19104-3306, USA ; Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA 19104-4319, USA
| | - Courtney Benjamin Wolk
- Center for Mental Health Policy and Services Research, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3 Floor, Philadelphia, PA 19104, USA
| | - Jill Locke
- Center for Mental Health Policy and Services Research, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3 Floor, Philadelphia, PA 19104, USA
| | - Rinad Beidas
- Center for Mental Health Policy and Services Research, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3 Floor, Philadelphia, PA 19104, USA
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Consultation and Coaching to Increase the Uptake of Evidence-Based Practices: Introduction to the Special Issue. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9142-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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From Consultation to Student Outcomes: The Role of Teacher Knowledge, Skills, and Beliefs in Increasing Integrity in Classroom Management Strategies. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9143-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fazel M, Hoagwood K, Stephan S, Ford T. Mental health interventions in schools 1: Mental health interventions in schools in high-income countries. Lancet Psychiatry 2014; 1:377-387. [PMID: 26114092 PMCID: PMC4477835 DOI: 10.1016/s2215-0366(14)70312-8] [Citation(s) in RCA: 254] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Mental health services embedded within school systems can create a continuum of integrative care that improves both mental health and educational attainment for children. To strengthen this continuum, and for optimum child development, a reconfiguration of education and mental health systems to aid implementation of evidence-based practice might be needed. Integrative strategies that combine classroom-level and student-level interventions have much potential. A robust research agenda is needed that focuses on system-level implementation and maintenance of interventions over time. Both ethical and scientific justifications exist for integration of mental health and education: integration democratises access to services and, if coupled with use of evidence-based practices, can promote the healthy development of children.
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Affiliation(s)
- Mina Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Kimberly Hoagwood
- Department of Child Psychiatry, New York University Langone Medical Center and School of Medicine, New York, NY, USA
| | - Sharon Stephan
- Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tamsin Ford
- Child and Adolescent Psychiatry, University of Exeter Medical School, Veysey Building, Exeter, Devon, UK
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Nadeem E, Gleacher A, Beidas RS. Consultation as an implementation strategy for evidence-based practices across multiple contexts: unpacking the black box. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2014; 40:439-50. [PMID: 23716145 DOI: 10.1007/s10488-013-0502-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
There is great interest in the dissemination and implementation of evidence-based treatments and practices for children across schools and community mental health settings. A growing body of literature suggests that the use of one-time workshops as a training tool is ineffective in influencing therapist behavior and patient outcomes and that ongoing expert consultation and coaching is critical to actual uptake and quality implementation. Yet, we have very limited understanding of how expert consultation fits into the larger implementation support system, or the most effective consultation strategies. This commentary reviews the literature on consultation in child mental health, and proposes a set of core consultation functions, processes, and outcomes that should be further studied in the implementation of evidence-based practices for children.
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Affiliation(s)
- Erum Nadeem
- Department of Child and Adolescent Psychiatry, New York University, One Park Avenue, 7th Floor, New York, NY, 10016, USA,
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Becker KD, Darney D, Domitrovich C, Keperling JP, Ialongo NS. Supporting universal prevention programs: a two-phased coaching model. Clin Child Fam Psychol Rev 2014; 16:213-28. [PMID: 23660973 DOI: 10.1007/s10567-013-0134-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Schools are adopting evidence-based programs designed to enhance students' emotional and behavioral competencies at increasing rates (Hemmeter et al. in Early Child Res Q 26:96-109, 2011). At the same time, teachers express the need for increased support surrounding implementation of these evidence-based programs (Carter and Van Norman in Early Child Educ 38:279-288, 2010). Ongoing professional development in the form of coaching may enhance teacher skills and implementation (Noell et al. in School Psychol Rev 34:87-106, 2005; Stormont et al. 2012). There exists a need for a coaching model that can be applied to a variety of teacher skill levels and one that guides coach decision-making about how best to support teachers. This article provides a detailed account of a two-phased coaching model with empirical support developed and tested with coaches and teachers in urban schools (Becker et al. 2013). In the initial universal coaching phase, all teachers receive the same coaching elements regardless of their skill level. Then, in the tailored coaching phase, coaching varies according to the strengths and needs of each teacher. Specifically, more intensive coaching strategies are used only with teachers who need additional coaching supports, whereas other teachers receive just enough support to consolidate and maintain their strong implementation. Examples of how coaches used the two-phased coaching model when working with teachers who were implementing two universal prevention programs (i.e., the PATHS curriculum and PAX Good Behavior Game [PAX GBG]) provide illustrations of the application of this model. The potential reach of this coaching model extends to other school-based programs as well as other settings in which coaches partner with interventionists to implement evidence-based programs.
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Affiliation(s)
- Kimberly D Becker
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Hoagwood K, Atkins M, Ialongo N. Unpacking the black box of implementation: the next generation for policy, research and practice. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2013; 40:451-5. [PMID: 23942647 PMCID: PMC3824224 DOI: 10.1007/s10488-013-0512-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Kimberly Hoagwood
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, One Park Avenue at East 33rd, 8th Floor, New York, NY, 10016, USA,
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