Schools are sometimes slow to adopt evidence-based strategies for improving the mental health outcomes of students. This study used a discrete-choice conjoint experiment to model factors influencing the decision of educators to adopt strategies for improving children’s mental health outcomes. A sample of 1,010 educators made choices between hypothetical mental health practice change strategies composed by systematically varying the four levels of 16 practice change attributes. Latent class analysis yielded two segments with different practice change preferences. Both segments preferred small-group workshops, conducted by engaging experts, teaching skills applicable to all students. Participants expressed little interest in Internet options. The support of colleagues, administrators, and unions exerted a strong influence on the practice change choices of both segments. The Change Ready segment, 77.1 % of the sample, was more intent on adopting new strategies to improve the mental health of students. They preferred that schools, rather than the provincial ministry of education, make practice change decisions, coaching was provided to all participants, and participants received post-training follow-up sessions. The Demand Sensitive segment (22.9 %) was less intent on practice change. They preferred that individual teachers make practice change decisions, recommended discretionary coaching, and chose no post-training follow-up support. This study emphasizes the complex social, organizational, and policy context within which educators make practice change decisions. Efforts to disseminate strategies to improve the mental health outcomes of students need to be informed by the preferences of segments of educators who are sensitive to different dimensions of the practice change process. In the absence of a broad consensus of educators, administrators, and unions, potentially successful practice changes are unlikely to be adopted.

E-Mental Health options could engage students who may not wait for standard services.

Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

Objective: We used qualitative methods to explore the views of students regarding design and implementation factors limiting the effectiveness of the antibullying programs. Method: Using a purposeful strategy, we recruited 97 Grades 5 to 8 students from 12 demographically stratified schools. Interviewers conducted thirteen 45-min focus groups. Audio recordings were transcribed and coded thematically. Results: Three higher order themes emerged. First, students felt that antibullying presentations, posters, and activities sometimes failed to engage students. Antibullying communications that were boring, repetitive, negatively worded, or delivered by presenters lacking credibility were of limited value. Second, students felt that ineffective monitoring and consequences undermined antibullying programs. Students thought teachers failed to detect many bullying episodes, did not respond quickly enough when bullying was reported, adopted ineffective consequences, and failed to sustain helpful programs. Teachers who responded unfairly, were influenced by reputational biases, or dealt with students disrespectfully compromised antibullying interventions. Third, some students disengaged and pushed back by failing to attend to presentations, denying their involvement in bullying, discrediting programs and speakers, disrupting antibullying activities, and defiantly victimizing peers. Conclusions: Poor design and implementation may limit the outcome of antibullying programs. Pushback from a small group of students may have a negative influence on the responses of a wider group of peers. A negative response from students may reduce the commitment of the educators who implement antibullying initiatives. From the perspective of students, schools need to develop more engaging presentations, improve monitoring and supervision, develop more effective responses to bullying, and deal with students in an unbiased and respectful way.

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