Teachers' Perceptions of School Organizational Climate as Predictors of Dosage and Quality of Implementation of a Social-Emotional and Character Development Program

Whole-school interventions promoting student commitment to school to prevent substance use and violence, and improve educational attainment: a systematic review

Background

Whole-school interventions modify the school environment to promote health. A subset of these interventions promotes student commitment to school to prevent substance (tobacco, alcohol, other drugs) use and/or violence. A previous review identified the theory of human functioning and school organisation as a comprehensive theory of such interventions, and found evidence that these interventions reduce substance use and/or violence.

Objectives

The objectives were to search for, appraise and synthesise evidence to address the following questions: (1) What whole-school interventions promoting student commitment to school to prevent substance use and/or violence have been evaluated, what intervention subtypes are apparent and how closely do these align with the theory of human functioning and school organisation? (2) What factors relating to setting, population and intervention affect implementation? (3) What are the effects on student substance use, violence and educational attainment? (4) What is the cost-effectiveness of such interventions? (5) Are intervention effects mediated by student commitment to school or moderated by setting or population?

Data sources

A total of 56 information sources were searched (in January 2020), then an updated search of 48 of these was carried out (in May 2021). Reference lists were also searched and experts were contacted.

Review methods

Eligible studies were process/outcome evaluations of whole-school interventions to reduce student violence or substance use among students aged 5-18 years attending schools, via actions aligning with the theory of human functioning and school organisation: modifying teaching to increase engagement, enhancing student-staff relationships, revising school policies, encouraging volunteering or increasing parental involvement. Data extraction and quality assessments used existing tools. Theory and process reports were synthesised qualitatively. Outcome and economic data were synthesised narratively; outcome data were meta-analysed.

Results

Searches retrieved 63 eligible reports on 27 studies of 22 interventions. We identified four intervention subtypes focused on student participation in school-wide decisions, improving staff-student relationships, increasing engagement in learning and involving parents. The theories of change of most intervention subtypes aligned closely with the theory of human functioning and school organisation, and informed refinement of an intervention theory of change. Theories of change for interventions increasing learning engagement did not align with this theory, aiming instead to increase school commitment primarily via social skills curricula. Factors influencing the implementation included whether or not interventions were tailorable, workable and well explained. Interventions with action groups comprising staff/students, etc. and providing local data were well implemented. Implementation was also affected by whether or not schools accepted the need for change and staff had the resources for delivery. Meta-analyses suggest small, but significant, intervention effects in preventing violence victimisation and perpetration, and substance use. There was sparse and inconsistent evidence of moderation and some evidence of mediation by student commitment to school. Two economic evaluations suggested that there is the potential for the interventions to be cost-effective.

Limitations

The quality of the studies was variable and the economic synthesis was limited to two studies.

Conclusions

Whole-school interventions aiming to promote student commitment to school share similar theories of change and factors affecting implementation. They have the potential to contribute to preventing violence and substance use among young people. Future trials should aim to optimise intervention effectiveness by better theorisation, and assess implementation and effect moderators and mediators.

Study registration

This study is registered as PROSPERO CRD42019154334.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/151/05) and is published in full in Public Health Research; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.

Role of early childhood educators' demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention

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.

What factors influence implementation of whole-school interventions aiming to promote student commitment to school to prevent substance use and violence? Systematic review and synthesis of process evaluations

BACKGROUND

Whole-school interventions go beyond classroom health education to modify the school environment to promote health. A sub-set aim to promote student commitment to school to reduce substance use and violence (outcomes associated with low commitment). It is unclear what factors influence implementation of such interventions.

METHODS

We conducted a systematic review including synthesis of evidence from process evaluations examining what factors affect implementation. Meta-ethnographic synthesis was informed by May's General Theory of Implementation.

RESULTS

Sixteen reports, covering 13 studies and 10 interventions were included in our synthesis. In terms of May's concept of 'sense-making', we found that school staff were more likely to understand what was required in implementing an intervention when provided with good-quality materials and support. Staff could sometimes wilfully or unintentionally misinterpret interventions. In terms of May's concept of 'cognitive participation', whereby staff commit to implementation, we found that lack of intervention adaptability could in particular undermine implementation of whole-school elements. Interventions providing local data were reported as helping build staff commitment. School leaders were more likely to commit to an intervention addressing an issue they already intended to tackle. Collaborative planning groups were reported as useful in ensuring staff 'collective action' (May's term for working together) to enact interventions. Collective action was also promoted by the presence of sufficient time, leadership and relationships. Implementation of whole-school interventions took time to build. Considering May's concept of 'reflexive monitoring' (formal or informal review of progress), this was important in assessing and enhancing implementation. 'Quick wins' could help maintain collective impetus to implement further intervention activities.

CONCLUSION

We identified novel factors influencing implementation of whole-school elements such as: local adaptability of interventions; providing local data to build commitment; interventions addressing an issue already on school leaders' agenda; collaborative planning groups; and 'reflexive monitoring' as an explicit intervention component.

Addressing challenges at the intersection of early intervention and child welfare

BACKGROUND

The Keep Children and Families Safe Act amendment to the Child Abuse Prevention and Treatment Act (CAPTA) of 2003 mandated children under age three who are involved with Child Welfare (CW) to receive a referral to the system for early intervention (EI). While there is strong rationale for providing developmental services to young children and families impacted by maltreatment, the early implementation of this policy brought about many challenges related to interagency coordination and readiness of providers to provide cross-systems care. Currently, as the system and providers within the system recover from the effects of Covid-19, a predicted increase in need of services may exacerbate historical gaps in the provision of services to families involved with CW.

PARTICIPANTS AND SETTING

This policy-focused paper explores issues impacting CW and EI providers who coordinate care between CW and EI services.

METHODS

This paper provides a historical examination of these challenges and proposes an approach for improving developmental services for families referred from CW, specifically through the lens of addressing resources and supports available to providers.

RESULTS

The proposed approach includes an increase and reprioritization of resources to support provider readiness and well-being.

CONCLUSIONS

By focusing on support for providers, the authors propose a reduction of stress and improvement of services at each level of the "well-being" system.

Acceptability and feasibility of the school-engaged social and behavior change communication approach on malaria prevention in Ethiopia: implications for engagement, empowerment, and retention (EER) of education sectors in malaria elimination efforts

Background

Evidence on process outcomes such as acceptability, and feasibility of behavior change communication interventions are important in program evaluation to understand how, and why such a program works. However; documented evidence on the issue is not available as far as the social and behavior change communication (SBCC) on malaria is concerned. Enrolling the frontline providers this study measured the acceptability and feasibility of the school-engaged SBCC strategy on malaria prevention in malaria-endemic settings of Ethiopia.

Methods

A school-engaged SBCC strategy involving various communication and capacity-building interventions aimed to advance malaria preventive practices in primary schools in Jimma were implemented from 2017 to 2019. A cross-sectional study was conducted with 205 key stakeholders at the end of the intervention. Both acceptability and feasibility were measured using standardized tools. Data were collected using a structured questionnaire and filled by the study participants. The SPSS version 26 was used to analyze the data. Multivariate general linear modeling was performed to identify the predictors of acceptability and feasibility of the program. P-value < 5% was considered to decide statistical significance.

Results

The result showed the mean scores (M, range = R) of acceptability and feasibility of the program were (M = 25.63, R = 6 to 30) and (M = 19.35, R = 5 to 25) respectively. The multivariate linear modeling showed acceptability was affected by self-efficacy; (β = 0.438, P < 0.001), community support; (β = 0.417, P < 0.001), school climate; (β = − 0.16; P = 0.003), perceived malaria threat; (β = 0.40, P < 0.001) and knowledge; (β = 0.229, P = 0.013). Similarly, feasibility was influenced by self-efficacy; (β = 0.352, P < 0.001), community support; (β = 0.591, P < 0.001), school climate; (β = − 0.099, P-value < 0.030) and perceived malaria threat; (β = 0.172, P = 0.002).

Conclusion

With a considerably high level of acceptability, the school-engaged SBCC strategy to enhance malaria preventive practices seems feasible. The SBCC strategy targeting personal factors such as malaria threat perceptions, knowledge and skills on the program, and contextual factors that include school social climate and community support would be fruitful to facilitate the implementation of the program. The result implicates the benefit of intensifying such a strategy to engage, empower, and retain the education sectors in malaria elimination efforts and beyond.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11995-z.

School Coordinators' Perceptions of Organizational Readiness Is Associated with Implementation Fidelity in a Smoking Prevention Program: Findings from the X:IT II Study

School organizational readiness to implement interventions may play an important role for the actual obtained implementation level, and knowledge about organizational readiness prior to intervention start can help pinpoint how to optimize support to the schools. In this study, we applied a novel heuristic, R = MC2 to assess school organizational readiness prior to implementation of a multicomponent smoking prevention program. Furthermore, we examined the association to actual implementation after the first year of study. We used questionnaire data from school coordinators at 40 schools in Denmark who had accepted to implement the multi-component smoking prevention intervention-X:IT II-in the school year 2017-2018 including three main components: (1) Rules on smoke-free school time, (2) A smoke-free curriculum, and (3) Parental involvement. On behalf of the school, a school coordinator answered a baseline questionnaire about the organizational readiness and a follow-up questionnaire about implementation of the three components after first year of study. Readiness was measured by summing aspects of motivation (relative advantage, compatibility, complexity, and priority), general capacity (culture, climate, and staff capacity), and innovation-specific capacity (knowledge, skills, and abilities). Based on school coordinators' perceptions, almost all schools had good general capacity while the other two areas of readiness varied across schools; overall, 56.8% of schools (N = 25) had good motivation for implementing the X:IT II intervention and 61.3% (N = 27) had high innovation-specific capacity. Half of the schools had high overall readiness defined as high motivation and high innovation-specific capacity. Schools with high overall readiness implemented the rules on smoke-free school time, smoke-free curriculum, and parental involvement to a higher degree than schools with low overall readiness. All participating schools possessed sufficient levels of general capacity, e.g., a well-functioning organizational culture and sufficient staff capacity. High levels of motivation and innovation-specific capacity were positively associated with the schools' actual implementation of the main intervention components. This way of conceptualizing and measuring organizational readiness may be useful in future studies, i.e., in studies where enhancing readiness is a main objective.

Childhood Protective Factors and a Prevention Program Reduce Later Problem Behaviors

Prior research has yet to elucidate how constellations of protective factors in childhood and prevention efforts simultaneously may influence youth involvement in problem behaviors across different points in development. The current study examines how latent classes of social and emotional learning (SEL) skills, parent-child relationships, and peer influences in third grade and receipt of an ongoing SEL intervention predict substance use and violence in fifth and eighth grade. The urban, predominantly low-income, sample (N = 1,169) was nested in 14 schools that were randomly assigned to the Positive Action program or business-as-usual. Membership in a latent class reflecting protective childhood factors predicted less substance use and violence in fifth grade; however, the SEL program predicted less substance use and violence in eighth grade. Findings generally support that SEL interventions can successfully target and boost developmentally appropriate positive behaviors and can prevail over initial risk factors with enough time and exposure.

Minimizing Health-Compromising Behaviors via School-Based Programs: An Optimization Approach

School health programs are united by their desire to promote health and health-related outcomes among youth. They are also united by the fact that their expected effects are contingent on successful program implementation, which is often impeded by a multitude of real-world barriers. Techniques used in management science may help optimize school-based programs by accounting for implementation barriers. In this exploratory study, we present a detailed example of the first known application of linear programming (LP), which is an optimization technique, to Positive Action (PA). PA is a social emotional and character development program that includes a six-unit, teacher-delivered, classroom curriculum. We specify how we used LP to calculate the optimal levels of program implementation needed to minimize substance use, subject to known levels of implementation barriers (e.g., disruptive behavior, teacher education, teacher attitudes towards character development, school resources, and school safety). We found that LP is a technique that can be applied to data from a school health program. Specifically, we were able to develop a model that calculated the number of lessons that should be taught to minimize a specific health-compromising behavior, given expected levels of predetermined implementation barriers. Our findings from this exploratory study support the utility of applying LP during the program planning and implementation processes of school health programs.

Individual and organizational factors associated with teacher self-reported implementation of the PATHS curriculum

The current study examined a comprehensive set of individual and organizational factors as potential predictors of how the Promoting Alternative THinking (PATHS) Curriculum was implemented by teachers in an urban Midwestern school district. The study used data from a randomized trial of an implementation support model conducted in 28 urban elementary schools. All schools implemented PATHS in grades K-3. Program fidelity was assessed with teacher self-reported ratings of lesson dosage, frequency of supplemental material use, and quality of delivery over repeated time points. The initial levels of implementation and change over time were examined in a series of three level longitudinal hierarchical liner models (HLM). Over time, teachers reported somewhat lower levels of program use but maintained their quality of delivery. Teachers with more positive attitudes towards PATHS reported more frequent lesson delivery at the intercept (winter Year 1). Teachers from schools with a more positive culture for social-emotional learning (SEL) rated the quality of their PATHS delivery more positively than teachers from schools lacking SEL culture and reported more frequent supplemental materials use. Early career teachers initially described themselves as delivering PATHS with lower quality but improved similarly over time compared to more experienced teachers. Implications of the findings and recommendations for future research are discussed.

Understanding the Organizational Implementation Context of Schools: A Qualitative Study of School District Administrators, Principals, and Teachers

Key features of the school environment can have a significant impact on teachers' effective use of evidence-based practices (EBP), yet implementation-specific organizational constructs have rarely been studied in the education sector. This study examined three aspects of the organizational implementation context (implementation leadership, climate, and citizenship behavior), which have been conceptualized and validated in other service settings. Focus groups with central office administrators, principals, and teachers were conducted to understand the applicability and conceptual boundaries of these organizational constructs in schools. Focus group transcripts were coded, and the results indicated both similarities and differences in their conceptualizations of implementation leadership, climate, and citizenship behavior in school. The data indicated that: (1) implementation leadership was largely present in schools with the addition of Distributed Leadership; (2) two implementation climate constructs were most clearly present (i.e., Focus on EBP and Educational Support for EBP) and two additional constructs (i.e., Existing Support to Deliver EBP and Prioritization of EBP) emerged as part of this construct; and (3) implementation citizenship behavior (Helping Others and Keeping Informed) was consistently acknowledged across schools and two new components emerged (i.e., Information Sharing and Observation/Feedback). Recommendations to researchers and community stakeholders are discussed.

How do collective student behavior and other classroom contextual factors relate to teachers' implementation of an evidence-based intervention? A multilevel structural equation model

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.

Predictors of Healthy Youth Relationships Program Implementation in a Sample of Canadian Middle School Teachers

Implementation of evidence-based, Tier 1 social-emotional learning (SEL) programming that supports healthy relationships skills is recognized as a key mental health promotion and violence prevention strategy for youth. However, work specifically exploring how to support the high-quality implementation of such programming with Canadian teachers and schools is just beginning to emerge. Drawing on implementation frameworks that emphasize the importance of setting, provider, and implementation process characteristics for understanding program implementation outcomes, this prospective, longitudinal study explores implementation of the Fourth R, a SEL-based healthy relationships program, in a Western Canadian province using a sample of middle school teachers. The aim of this mixed-methods study was to illuminate relationships among teachers’ attitudes toward evidence-based programming, perceptions of organizational climate, and training experience with program implementation outcomes (dosage, quality, fidelity). Findings of this exploratory study identified that these characteristics influenced implementation dosage, quality, and fidelity in differential ways. Qualitative data drawn from teacher interviews supported quantitative findings and highlighted the importance of organizational support for high-quality implementation. We discuss areas for further study, given that there are significant gaps in knowledge about teachers’ attitudes toward evidence-based programming, school climate, and other systemic factors in the Canadian context, as well as relevance of study findings to the field of school psychology.

Interventions integrating health and academic interventions to prevent substance use and violence: a systematic review and synthesis of process evaluations

BACKGROUND

Within increasingly constrained school timetables, interventions that integrate academic and health education to reduce substance use and violence may hold promise as a category of intervention that can positively affect both academic and health outcomes. There are no current systematic reviews exploring the effectiveness of such interventions or factors that affect their implementation.

METHODS

A total of 19 bibliographic databases and 32 websites were searched. References were also extracted from the reference lists of included studies, and experts and authors were contacted to identify relevant studies. We included reports with no restrictions on language or date. References were screened on title/abstract and those not thus excluded were screened on full report. Data extraction and appraisal followed the Critical Appraisal Skills Programme, Evidence for Policy and Practice Information and Co-ordinating Centre and Cochrane tools. Extracted process data were qualitatively meta-synthesised for common themes.

RESULTS

Seventy-eight thousand four hundred fifty-one unique references were identified, and 62 reports were included. A total of 16 reports (reporting on 15 studies of 12 interventions) evaluated process. Key facilitators of integrated academic and health curricula were supportive senior management and alignment of the intervention with school ethos; a positive teaching environment, including positive perceptions around the ability to be flexible in the adaptation and delivery of integrated academic and health curricula; positive pre-existing student and teacher attitudes towards intervention content; and parental support of interventions, largely through reinforcement of messaging at home. Important barriers were over-burdened teachers, with little time to learn and implement integrated curricula.

CONCLUSION

Several useful facilitating and inhibiting factors linked to the implementation of interventions that integrate academic and health education for reduced substance use and/or violence were identified, providing tentative but insightful evidence of context-specific issues that may impact intervention success. However, overall, there is still a considerable gap in our understanding of how to achieve the successful implementation of these interventions.

A systematic review and synthesis of theories of change of school-based interventions integrating health and academic education as a novel means of preventing violence and substance use among students

BACKGROUND

Schools can play an important role in promoting health. However, many education policies and institutions are increasingly emphasising academic attainment targets, which appear to be diminishing the time available for health education lessons. Interventions that integrate both health and academic learning may present an ideal solution, simultaneously addressing health education and academic development. The theories of change underlying these interventions are therefore of interest, but are poorly studied.

METHODS

A systematic review of evaluations of interventions that integrate academic and health education for reduced substance use and/or violence was carried out. As part of this, reports describing theory were assessed for quality and data extracted. Theoretical data were synthesised within and across individual interventions using reciprocal translation and meta-ethnographic line of argument synthesis to produce an overall theory of change for interventions that integrate health and academic education to prevent substance use and violence.

RESULTS

Forty-eight reports provided theoretical descriptions of 18 interventions. An overarching theory that emerged was that eroding 'boundaries' at multiple and mutually reinforcing levels-by integrating academic and health education, by transforming relationships between teachers and students, by generalising learning from classrooms to the wider school environment and by ensuring consistent messages from schools and families-is intended to lead to the development of a community of engaged students oriented towards pro-social behaviour and away from substance use, violence and other risk behaviours.

CONCLUSIONS

Eroding 'boundaries' between health and academic education, teachers and students, classrooms and the wider school and schools and families were seen to be the most critical to establishing new frameworks of family, classroom or school organisation that are conducive to promoting both academic and social-emotional outcomes. Whether such interventions are feasible to implement and effective in reducing risk behaviours will be examined in other reports arising from the review.

Percepções da comunidade escolar sobre a implantação do programa unplugged em escolas

Resumo O objetivo do presente estudo foi investigar as percepções da comunidade escolar sobre o programa Unplugged, implantado pelo Ministério da Saúde em escolas públicas brasileiras de ensino fundamental II. A metodologia utilizada foi a qualitativa e envolveu coleta de dados através de 11 grupos focais de professores (n=13), alunos (n=54) e administradores escolares (n=11) em 8 escolas de 3 cidades brasileiras. Análise de conteúdo permitiu a identificação de 3 eixos temáticos. As facilidades identificadas estiveram relacionadas com o suporte técnico para implantação da metodologia, como a formação e supervisão recebida, além do suporte dos administradores das escolas. As dificuldades apontadas estiveram relacionadas ao tempo das aulas, a obtenção de materiais de suporte para as aulas e ao cumprimento adequado do currículo regular. Como potencialidade, identificou-se a melhoria das relações de convivência. Os resultados aqui alcançados permitem o aprimoramento da implantação do programa Unplugged nas escolas brasileiras.

Challenges, Opportunities, and Methods for Large-Scale Evaluations

The logic, theory, and practice of large-scale evaluation were once limited to large federal initiatives. However, with the advent of regularly collected performance measures and the often multisite implementation of quality improvement efforts, there is an opportunity to adopt large-scale evaluation methods in local and regional evaluation efforts. While ineffective programs show little variation in their ineffectiveness, effective programs generally show a range of effects. A central task of large-scale evaluation is to describe and ascribe why the same program, implemented in multiple settings, produces different effects. By its attention to variation attributable to setting, activities, outputs, and by participants and documenting the conditions in which programs achieve greater and lesser success, large-scale evaluation supports the needs of decision-makers when choosing to implement an evidence-based program. In addition to knowing a program is effective, decision-makers want to know whether it is appropriate for their situation and what facilitates or impedes effective implementation and bears on the program's ultimate effectiveness. This article presents the different methods and approaches appropriate for effectively and efficiently constructing and executing a large-scale evaluation that will provide decision-makers the evidence they need for evidence-informed adoption of effective programs.

Meeting the Challenges of Longitudinal Cluster-Based Trials in Schools: Lessons From the Chicago Trial of Positive Action

We describe challenges in the 6-year longitudinal cluster randomized controlled trial (CRCT) of Positive Action (PA), a social-emotional and character development (SECD) program, conducted in 14 low-income, urban Chicago Public Schools. Challenges pertained to logistics of study planning (school recruitment, retention of schools during the trial, consent rates, assessment of student outcomes, and confidentiality), study design (randomization of a small number of schools), fidelity (implementation of PA and control condition activities), and evaluation (restricted range of outcomes, measurement invariance, statistical power, student mobility, and moderators of program effects). Strategies used to address the challenges within each of these areas are discussed. Incorporation of lessons learned from this study may help to improve future evaluations of longitudinal CRCTs, especially those that involve evaluation of school-based interventions for minority populations and urban areas.

Studying Program Implementation Is Not Easy but It Is Essential

This study offers a commentary on the articles contained in the special issue of Prevention Science, "Readiness to implement Social- Emotional Learning interventions." The commentary also puts these articles into current context by summarizing important findings in implementation research and listing some priorities for future work.