Study protocol: cluster randomized trial of consultation strategies for the sustainment of mental health interventions in under-resourced urban schools: rationale, design, and methods

BMC Psychology

Quinn A. Rabenau-McDonnell¹  Kathryn Henson¹  Rachel Comly¹  Abbas F. Jawad¹  Tara Wilson¹  Ricardo Eiraldi²  Courtney Benjamin Wolk³  Abraham Wandersman⁴  Laura E. Rutherford⁵  Henry A. Glick⁶  Muniya S. Khanna⁷  Barry L. McCurdy⁸  Steven A. Rufe⁹  Kristina M. Popkin⁹  Jayme Banks⁹ 

[1] Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Room 8293, 19146-2305, Philadelphia, PA, USA;Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Room 8293, 19146-2305, Philadelphia, PA, USA;Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, 19104, Philadelphia, PA, USA;Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., 19104, Philadelphia, PA, USA;Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locus Walk # 210, 19104, Philadelphia, PA, USA;Department of Psychology, University of South Carolina-Columbia, Pendleton Street, Barnwell College, Suite #220, 29208, Columbia, SC, USA;Devereux Center for Effective Schools, 2012 Renaissance, Blvd., 19406, King of Prussia, PA, USA;Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locus Walk # 210, 19104, Philadelphia, PA, USA;Wharton School, University of Pennsylvania, 3620 Locust Walk, 19104, Philadelphia, PA, USA;OCD and Anxiety Institute, 3138 Butler Pike # 200, 19462, Plymouth Meeting, PA, USA;Philadelphia College of Osteopathic Medicine, 4170 City Avenue, 19131, Philadelphia, PA, USA;School District of Philadelphia, 440 North Broad Street, 19130, Philadelphia, PA, USA;

关键词: Sustainment;    Implementation;    PBIS;    Mental health supports;    Urban schools;    Effectiveness;   

DOI  :  10.1186/s40359-022-00733-8

来源: Springer

【 摘 要 】

BackgroundThe school is a key setting for the provision of mental health services to children, particularly those underserved through traditional service delivery systems. School-wide Positive Behavioral Interventions and Supports (PBIS) is a tiered approach to service delivery based on the public health model that schools use to implement universal (Tier 1) supports to improve school climate and safety. As our prior research has demonstrated, PBIS is a useful vehicle for implementing mental and behavioral health evidence-based practices (EBPs) at Tier 2 for children with, or at risk for, mental health disorders. Very little research has been conducted regarding the use of mental health EBPs at Tier 2 or how to sustain implementation in schools.Methods/designThe main aim of the study is to compare fidelity, penetration, cost-effectiveness, and student outcomes of Tier 2 mental health interventions across 2 sustainment approaches for school implementers in 12 K-8 schools. The study uses a 2-arm, cluster randomized controlled trial design. The two arms are: (a) Preparing for Sustainment (PS)—a consultation strategy implemented by school district coaches who receive support from external consultants, and (b) Sustainment as Usual (SAU)—a consultation strategy implemented by school district coaches alone. Participants will be 60 implementers and 360 students at risk for externalizing and anxiety disorders. The interventions implemented by school personnel are: Coping Power Program (CPP) for externalizing disorders, CBT for Anxiety Treatment in Schools (CATS) for anxiety disorders, and Check-in/Check-out (CICO) for externalizing and internalizing disorders. The Interactive Systems Framework (ISF) for Dissemination and Implementation guides the training and support procedures for implementers.DiscussionWe expect that this study will result in a feasible, effective, and cost-effective strategy for sustaining mental health EBPs that is embedded within a multi-tiered system of support. Results from this study conducted in a large urban school district would likely generalize to other large, urban districts and have an impact on population-level child mental health.Trial registration ClinicalTrials.gov identifier number NCT04869657. Registered May 3, 2021.

【 授权许可】

CC BY