Sustainment of Mental Health Supports in Under-Resourced Urban Schools

资源贫乏城市学校心理健康支持的维持

基本信息

批准号：
10388108
负责人：
Ricardo B Eiraldi
金额：
$ 77.68万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-08 至 2026-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10388108
关键词：
Administrator Anxiety Disorders Behavior Therapy Child Clinical effectiveness Consultations Data Disease Evidence based practice Friends Goals Health Benefit Human Resources Hybrids Interactive Systems Framework Intervention Interview Life Link Mediating Mediator of activation protein Mental Health Mental Health Services Mental disorders Methods Modeling Outcome Participant Perception Phase Process Professional counselor Public Health Randomized Randomized Controlled Trials Remote Consultation Research Resources Risk Safety Schools Series Severities Site Structure Students Supervision Symptoms Training Training Support acceptability and feasibility arm base burnout coping cost effective cost effectiveness design dissemination research educational atmosphere experience group intervention health training implementation fidelity implementation outcomes implementation research improved programs school district service delivery training opportunity urban school

项目摘要

PROJECT SUMMARY / ABSTRACT The school is a key setting for the delivery of mental health services to children. School-wide positive behavior interventions and supports (PBIS), a service delivery strategy based on the public health model, is a useful vehicle for implementing mental health EBPs. In PBIS, schools implement universal (Tier 1) interventions to improve school climate and safety, and can employ targeted (Tier 2) group interventions for children with or at risk for mental health disorders. Very little research has been conducted on using mental health EBPs at Tier 2. Adequate and ongoing training opportunities are frequently identified as “essential practices” needed to successfully sustain the benefits of interventions. School personnel, with or without prior mental health training, can implement Tier 2 interventions with fidelity and clinical effectiveness when provided adequate support. School mental health programs that successfully implement targeted group interventions often use ongoing supervision from internal supervisors. A number of studies have shown that more experienced school personnel can successfully be trained to serve as coaches and supervisors for those implementing EBPs. In order for these schools to receive the potential public mental health benefits of targeted mental health interventions in schools, an efficient, scalable, cost-effective and sustainable model of training and consultation that can be transferred from experts to school coaches and from coaches to EBP implementers is needed. Little is known about which models of support for sustainment are effective, feasible, and cost-effective. The aims of the study are (a) to compare fidelity, cost-effectiveness, and student outcomes of Tier 2 mental health interventions across 2 sustainment conditions, (b) assess mediators and moderators of consultation support on implementation fidelity, and (c) assess perceived feasibility and acceptability of consultation support. The study proposes to use a 2-arm, randomized controlled trial, Type 2 Hybrid cluster randomized design. Sixty school personnel from 12 schools will receive full initial implementation support for 1 year and then will be randomly assigned to receive one of 2 sustainment conditions: (a) remote consultation provided by school district coaches who themselves will be receiving remote support from expert external consultants (Sustainment 1 [S1]); and (b) consultation as usual provided by district coaches with no external support (Sustainment 2 [S2]). S1 will have a period of diminished support followed by a period of no support. The interventions to be implemented by school personnel are EBPs for the most common externalizing and internalizing mental health disorders. Our guiding framework is the Interactive Systems Framework (ISF) for dissemination and implementation research. The results of the proposed study will provide a scalable and cost- effective strategy for the sustainment of PBIS mental health supports in under-resourced schools.

项目概要/摘要学校是向全校儿童提供积极行为心理健康服务的关键场所。干预和支持（PBIS）是一种基于公共卫生模型的服务提供策略，是一种有用的实施心理健康 EBP 的工具在 PBIS 中，学校实施普遍（第一级）干预措施。改善学校氛围和安全，并可以对患有或患有以下疾病的儿童采取有针对性的（第 2 级）团体干预措施：关于在 Tier 上使用心理健康 EBP 的研究很少。 2. 充足且持续的培训机会经常被认为是实现目标所需的“基本做法” 成功维持干预措施的益处，无论是否经过事先心理健康培训，在提供充分支持的情况下，能够以保真度和临床有效性实施第 2 级干预措施。成功实施目标群体干预措施的学校心理健康项目通常使用持续的多项研究表明，经验丰富的学校。人员可以成功地接受培训，成为实施 EBP 的教练和主管。命令这些学校获得有针对性的心理健康的潜在公共心理健康福利对学校的干预，一种高效、可扩展、具有成本效益和可持续的培训和咨询模式需要可以从专家转移到学校教练，从教练转移到 EBP 实施者。对于哪些维持支持模式有效、可行且具有成本效益，人们知之甚少。该研究的目的是 (a) 比较 Tier 2 心理测试的保真度、成本效益和学生成绩跨 2 个维持条件的健康干预措施，(b) 评估协商的中介者和主持者支持实施保真度，以及 (c) 评估咨询的可行性和可接受性支持。该研究建议使用 2 组随机对照试验、2 型混合整群随机设计。来自 12 所学校的 60 名学校人员将获得为期一年的全面初步实施支持，然后将随机分配接受 2 个维持条件之一：(a) 学校提供的远程咨询地区教练本身将获得外部专家顾问的远程支持（维持 1 [S1]）；以及 (b) 在没有外部支持的情况下由地区教练照常提供咨询（维持 2 [S2]）。 S1 将有一段减少支持的时期，然后是一段没有支持的时期。由学校人员实施的干预措施是针对最常见的外化和我们的指导框架是交互式系统框架（ISF）。拟议研究的结果将提供可扩展且成本低廉的研究成果。在资源贫乏的学校维持 PBIS 心理健康支持的有效策略。