Investigating strategies to increase general education teachers' adherence to evidence-based social-emotional behavior practices: A meta-analysis of the single-case literature

Improving Delivery and Use of HIV Pre-Exposure Prophylaxis in the US: A Systematic Review of Implementation Strategies and Adjunctive Interventions

Implementation of pre-exposure prophylaxis (PrEP) to prevent HIV transmission is suboptimal in the United States. To date, the literature has focused on identifying determinants of PrEP use, with a lesser focus on developing and testing change methods to improve PrEP implementation. Moreover, the change methods available for improving the uptake and sustained use of PrEP have not been systematically categorized. To summarize the state of the literature, we conducted a systematic review of the implementation strategies used to improve PrEP implementation among delivery systems and providers, as well as the adjunctive interventions used to improve the uptake and persistent adherence to PrEP among patients. Between November 2020 and January 2021, we searched Ovid MEDLINE, PsycINFO, and Web of Science for peer reviewed articles. We identified 44 change methods (18 implementation strategies and 26 adjunctive interventions) across a variety of clinical and community-based service settings. We coded implementation strategies and adjunctive interventions in accordance with established taxonomies and reporting guidelines. Most studies focused on improving patient adherence to PrEP and most conducted pilot trials. Just over one-third of included studies demonstrated a positive effect on outcomes. In order to end the human immunodeficiency virus (HIV) epidemic in the U.S., future, large scale HIV prevention research is needed that develops and evaluates implementation strategies and adjunctive interventions for target populations disproportionately affected by HIV.

Co-design and Development of Implementation Strategies: Enhancing the PAX Good Behaviour Game in Australian Schools

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.

Students' 2018 PISA reading self-concept: Identifying predictors and examining model generalizability for emergent bilinguals

Decades of research have indicated that reading self-concept is an important predictor of reading achievement. During this period, the population of emergent bilinguals has continued to increase within United States' schools. However, the existing literature has tended to examine native English speakers' and emergent bilinguals' reading self-concept in the aggregate, thereby potentially obfuscating the unique pathways through which reading self-concept predicts reading achievement. Furthermore, due to the overreliance of native English speakers in samples relating to theory development, researchers attempting to examine predictors of reading achievement may a priori select variables that are more aligned with native English speakers' experiences. To address this issue, we adopted Elastic Net, which is a theoretically agnostic methodology and machine learning approach to variable selection to identify the proximal and distal predictors of reading self-concept for the entire population; in our study, participants from the United States who participated in PISA 2018 served as the baseline group to determine significant predictors of reading self-concept with the intent of identifying potential new directions for future researchers. Based on Elastic Net analysis, 20 variables at the student level, three variables at the teacher level, and 12 variables at the school level were identified as the most salient predictors of reading self-concept. We then utilized a multilevel modeling approach to test model generalizability of the identified predictors of reading self-concept for emergent bilinguals and native English speakers. We disaggregated and compared findings for both emergent bilinguals and native English speakers. Our results indicate that although some predictors were important for both groups (e.g., perceived information and communications technologies competence), other predictors were not (e.g., competitiveness). Suggestions for future directions and implications of the present study are examined.

Profiles of teachers' classroom management style: Differences in perceived school climate and professional characteristics

Teachers are tasked with not only delivering high-quality, evidence-based academic instruction, but they are also responsible for managing student behavior within the classroom and school. To manage these behaviors, teachers can use a variety of strategies that result in a range of outcomes on student and school-wide functioning. Although an overreliance on punitive strategies has been shown to worsen behavior problems, positive strategies and social-emotional learning (SEL) techniques are associated with more favorable outcomes for students' global functioning. In a sample of K-12 teachers (N = 111), we examined direct associations between teachers' use of behavior management techniques (i.e., punitive, positive, and SEL) and their self-reports of perceived school climate. Furthermore, latent profile analysis was used to identify teachers' behavior management styles and evaluate whether teachers' characteristics and perceived school climate predicted behavior management style. Findings not only replicate previous research examining direct associations between behavior management techniques and school climate, but also extend the theoretical understanding of teachers' behavior management approaches. Three profiles of teacher behavior management style emerged, including a (a) Moderate Proactive profile characterized by frequent use of positive strategies and SEL techniques and infrequent use of punitive strategies; (b) Moderate Reactive/Proactive profile characterized by moderate use of both punitive strategies and positive strategies, as well as slightly lower use of SEL techniques; and (c) High Proactive profile characterized by very frequent use of positive strategies and SEL techniques and very infrequent use of punitive strategies. Use of these profiles may enhance understanding of how school psychologists can support teachers' behavior management practices through consultation or professional development to promote effective school and classroom behavior management practices.

Acceptability, appropriateness, and feasibility of Rural School Support Strategies for behavioral interventions: a mixed methods evaluation over two years of a hybrid type 3 implementation-effectiveness trial

BACKGROUND

Positive Behavioral Interventions and Supports (PBIS) is a framework for implementing evidence-based interventions for preventing behavioral issues and improving climate in schools. The implementation of school-wide PBIS with fidelity is complex, requiring leadership commitment, teaming, and coordination of systems for tracking behaviors and consequences. Putting these components in place while ensuring alignment with the values and needs of the school community can be difficult for schools with fewer resources, such as rural schools. Implementation supports are needed, including strategies such as technical assistance, but it is unclear whether lower-cost modalities such as virtual support are acceptable, appropriate, and feasible and whether perceptions vary throughout the implementation process.

METHODS

A type 3 hybrid implementation-effectiveness trial is taking place in 40 Idaho schools, testing a bundle of implementation supports selected to meet the needs of schools in rural areas. Supports include technical assistance from an implementation support practitioner (ISP), didactic trainings, virtual learning sessions, and an online resource portal. Surveys and interviews in the first 2 years of implementation (fall 2019 to spring 2021) explored outcomes of acceptability, appropriateness, and feasibility regarding the implementation supports among more than 150 school stakeholders.

RESULTS

Evaluations showed high acceptability and appropriateness of the PBIS concepts and training. The 20 schools receiving additional implementation support rated the technical assistance and support from the project's ISPs as the most acceptable and appropriate resource. Reasons for acceptability were the relationship built with the ISP, the ISP's expertise, and being a "neutral party." Although in-person support from the ISP was preferred, remote support was acceptable and increased feasibility of attendance. Virtual learning sessions were acceptable for learning and collaboration, particularly in the second year of implementation, once ISPs had developed closer relationships with school teams.

CONCLUSIONS

School staff found training, technical assistance, and virtual learning sessions to be acceptable and appropriate. Virtual formats of training and technical assistance decreased in acceptability but increased feasibility of attendance. In-person support was preferred during initial implementation, and virtual support was more acceptable thereafter.

TRIAL REGISTRATION

This trial was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.

Assessing the effectiveness and the mechanisms of the Social-Emotional Prevention Program for Preschoolers: Findings from a universal school-based intervention

The Social-Emotional Prevention Program (SEP) encompasses a multifaceted approach (classroom curriculum, with teacher and parent training) intended to increase preschool children's social adjustment, as well as to reduce risk of emotional and behavioral problems. The present study's focus was on implementing the technology-assisted SEP version and was aimed at (a) investigating the program's effectiveness on children's social-emotional competencies and parental practices, as well as (b) testing the program's conceptual framework, with an emphasis on children's emotion regulation (ER) skills and parental emotion socialization practices as explanatory intervention mechanisms. A randomized-controlled trial (RCT) was conducted with five schools assigned to either the intervention or to a comparison condition (wait-list control). Structural equation models (SEM) and complier average causal effects (CACE) were conducted to evaluate SEP effectiveness on teacher- and parent-rated child outcomes (primary outcomes) and parenting behaviors (secondary outcomes). Findings from the present study indicated that (a) SEP fosters increased social-emotional competencies and increased use of adaptive ER strategies, with teacher and parent ratings converging to support these outcomes; (b) parental participation in the program increased the use of reappraisal and emotion coaching strategies; and (c) children's ER mediated the intervention's effect on social competence, whereas parental coaching and parental ER mediated SEP effects on children's ER. This study's findings suggest that the SEP may be an effective universal intervention for promoting preschoolers' social-emotional competence and may provide emerging evidence to support the program's hypothesized mechanisms of change.

School experiences following traumatic brain injury: A longitudinal qualitative study

BACKGROUND

This longitudinal qualitative study tracked students with traumatic brain injury (TBI) from hospital discharge through their return to school and then for an average of four years of school.

OBJECTIVE

To better understand the experiences of students and parents in the education system following TBI.

METHODS

Participants were parents and educators of 21 students with TBI. Interviews were conducted using open-ended questions and students were observed in the classroom.

RESULTS

From these data, three themes were identified: lack of student tracking year to year, lack of educator training, and conflicting views between educators and parents about students' needs. These factors ultimately led to parent frustration and eventually conflict and deteriorating relationships between parents and educators.

CONCLUSION

The results suggest that improving educator training could positively affect the factors identified and possibly mitigate parent frustration.

Strategies for Enhancing the Implementation of Universal Mental Health Prevention Programs in Schools: A Systematic Review

A number of school-based mental health prevention programs have been found to be effective in research trials, but little is known about how to support implementation in real-life settings. To address this translational problem, this systematic review aims to identify effective strategies for enhancing the implementation of mental health prevention programs for children in schools. Four electronic databases were searched for empirical, peer-reviewed articles in English from January 2000 to October 2021 reporting the effects of implementation strategies for school-based universal mental health programs. Twenty-one articles were included in the narrative synthesis and assessed for quality using the Mixed Methods Appraisal Tool. Twenty-two strategies were found to be effective at improving program fidelity or adoption. The strategies with the strongest positive evidence base were those that involved monitoring and provision of feedback, engaging principals as program leaders, improving teachers' buy-in and organising school personnel implementation meetings. We recommend school-based practitioners trial strategies with positive findings from this review as part of their continuous quality improvement. This review highlights the pressing need for large-scale, randomised controlled trials to develop and trial more robust strategies to enhance adoption, as the five implementation studies found to measure adoption used qualitative methods limited by small samples sizes and case study designs.

Social-Emotional Learning for Whom? Implications of a Universal SEL Program and Teacher Well-being for Teachers' Interactions with Students

Social-emotional learning interventions are intended to improve classroom dynamics and have the potential to enhance the well-being of students and their teachers. Using data drawn from an effectiveness trial of the Social Skills Improvement System SEL Edition Classwide Intervention Program (SSIS SEL CIP; Elliott and Gresham in SSIS SEL Edition Classwide Intervention Program manual, Pearson, Inc., 2017), the present quantitative study explored associations between classroom implementation of a universal SEL program, teachers' emotional well-being, and teacher-student interactions. The results from a sample of 80 first- and second-grade teachers located in three socioeconomically and geographically diverse regions of the USA indicated that implementation of the SSIS SEL CIP curriculum was positively associated with teachers' classroom organization skills at the end of the year. Findings also revealed an interaction between treatment condition and teacher emotional well-being such that control teachers with lower well-being also had lower quality classroom organization but this association did not exist for teachers in the intervention condition. Findings suggest that implementation of the SSIS SEL CIP may help to preserve positive teacher-student interactions even when teachers are reporting lower levels of emotional well-being.

Longitudinal Effects of a Motivationally Focused Strategy to Increase the Yield of Training and Consultation on Teachers' Adoption and Fidelity of a Universal Program

Group-based didactic training is a cornerstone implementation strategy used to support the adoption and delivery of evidence-based prevention programs (EBPP) by teachers in schools, but it is often insufficient to drive successful implementation. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a theory-based, motivational implementation strategy designed to increase the yield of EBPP training and consultation. The purpose of this study was to examine the longitudinal effects of BASIS-T on hypothesized mechanisms of behavior change (e.g., attitudes toward EBPP, self-efficacy, intentions to implement) and implementation and student outcomes associated with a well-established universal prevention program-the good behavior game (GBG). This pilot trial included 82 elementary school teachers from nine public elementary schools who were randomly assigned at the school-level to the BASIS-T (n = 43) or active comparison (n = 39) condition, with both conditions receiving training and consultation of the good behavior game by a third-party purveyor. Analyses included mixed-effects and multilevel growth modeling of adoption, mechanisms of behavior change, and student behavior outcomes. Meaningful effects were found favoring BASIS-T on immediate adoption of the GBG within the first month of school (74% vs. 40%) and self-efficacy (p < 0.05). These findings advance our understanding of the type of implementation strategies that complement pre-implementation training and post-training consultation in schools by identifying the importance of task self-efficacy as a mechanism of behavior change related to adoption for prevention programming.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12310-022-09536-z.