A practical protocol for situating evidence-based mental health programs and practices within school-wide positive behavioral interventions and supports

Runge, Timothy J.; Knoster, Tim; Moerer, Deanna; Breinich, Todd; Palmiero, James

doi:10.1080/1754730x.2017.1285708

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…The five frameworks within the AIFs are: (1) usable innovation, (2) implementation drivers, (3) implementation teams, (4) improvement cycles, and (5) implementation stages 54 . The tool was previously used in schools when situating evidence‐based mental health programs within school‐wide behavioral interventions to ensure a match between student needs and the potential program 55 . It was also adapted by the Kentucky Department of Education and Head Start programs for educators and early childhood specialists to assess how new and existing programs fit into their setting 56…”

Section: Methodsmentioning

confidence: 99%

“…54 The tool was previously used in schools when situating evidence-based mental health programs within schoolwide behavioral interventions to ensure a match between student needs and the potential program. 55 It was also adapted by the Kentucky Department of Education and Head Start programs for educators and early childhood specialists to assess how new and existing programs fit into their setting. 56 District-wide PA policy strength and comprehensiveness: District wellness policies within the low-resource ISD were evaluated using the PE and PA section of the validated Wellness School Assessment Tool 3.0 57 (https:// www.wellsat.org/).…”

Section: Procedures and Instrumentsmentioning

confidence: 99%

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Aligning Organizational Priorities and System Policies to Support Implementation Scale‐Up of a Tailored Classroom‐Based Physical Activity Intervention in Low‐Resource Schools*

Hasson

Eisman

Wassmann

et al. 2023

Journal of School Health

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Background A mismatch between organizational priorities and system‐level policies can negatively impact implementation and sustainment of classroom‐based physical activity (PA) interventions. The purpose of this study was twofold: (1) present methods to systematically identify organization‐ and system‐level implementation barriers, and (2) align organizational priorities and system policies by designing multi‐level implementation strategies. This alignment will support implementation scale‐up of a tailored PA intervention in one low‐resource intermediate school district (ISD; 16 districts, 32 schools) in central Michigan. Methods Multi‐level assessments of organizational readiness were conducted using the Hexagon Discussion and Analysis Tool to assess intervention‐context fit, the Wellness School Assessment Tool 3.0 to evaluate district PA policy strength and comprehensiveness, and semi‐structured interviews were conducted to assess administrative support and priorities related to PA programming. Results Our assessments revealed three implementation barriers: limited structural capacity to sustain teacher training, limited resources across districts and school buildings to support teachers, and misalignment of ISD and district PA policies and priorities. Conclusions Greater attention to organizational capacity and existing infrastructure should be considered a priori to support effective implementation and sustainment of PA interventions in low‐resource schools.

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Section: Methodsmentioning

confidence: 99%

Section: Procedures and Instrumentsmentioning

confidence: 99%

Aligning Organizational Priorities and System Policies to Support Implementation Scale‐Up of a Tailored Classroom‐Based Physical Activity Intervention in Low‐Resource Schools*

Hasson

Eisman

Wassmann

et al. 2023

Journal of School Health

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“…The interview questions were structured around the six components of the original National Implementation Research Network’s Hexagon Tool: evidence, resource availability, readiness, needs, fit, and capacity to implement [ 39 , 40 ]. While this tool is primarily designed to guide decisions on the type of evidence-based intervention to implement, it can also be used post-implementation to evaluate an intervention [ 41 , 42 ]. Interviews were audio recorded and transcribed verbatim by a transcriptionist.…”

Section: Methodsmentioning

confidence: 99%

Integrating a brief alcohol intervention with tobacco addiction treatment in primary care: qualitative study of health care practitioner perceptions

Minian

Noormohamed

Lingam

et al. 2021

Addict Sci Clin Pract

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Background Randomized trials of complex interventions are increasingly including qualitative components to further understand factors that contribute to their success. In this paper, we explore the experiences of health care practitioners in a province wide smoking cessation program (the Smoking Treatment for Ontario Patients program) who participated in the COMBAT trial. This trial examined if the addition of an electronic prompt embedded in a Clinical Decision Support System (CDSS)—designed to prompt practitioners to Screen, provide a Brief intervention and Referral to Treatment (SBIRT) to patients who drank alcohol above the amounts recommended by the Canadian Cancer Society guidelines—influenced the proportion of practitioners delivering a brief intervention to their eligible patients. We wanted to understand the factors influencing implementation and acceptability of delivering a brief alcohol intervention for treatment-seeking smokers for health care providers who had access to the CDSS (intervention arm) and those who did not (control arm). Methods Twenty-three health care practitioners were selected for a qualitative interview using stratified purposeful sampling (12 from the control arm and 11 from the intervention arm). Interviews were 45 to 90 min in length and conducted by phone using an interview guide that was informed by the National Implementation Research Network’s Hexagon tool. Interview recordings were transcribed and coded iteratively between three researchers to achieve consensus on emerging themes. The preliminary coding structure was developed using the National Implementation Research Network’s Hexagon Tool framework and data was analyzed using the framework analysis approach. Results Seventy eight percent (18/23) of the health care practitioners interviewed recognized the need to simultaneously address alcohol and tobacco use. Seventy four percent (17/23), were knowledgeable about the evidence of health risks associated with dual alcohol and tobacco use but 57% (13/23) expressed concerns with using the Canadian Cancer Society guidelines to screen for alcohol use. Practitioners acknowledged the value of adding a validated screening tool to the STOP program’s baseline questionnaire (19/23); however, following through with a brief intervention and referral to treatment proved challenging due to lack of training, limited time, and fear of stigmatizing patients. Practitioners in the intervention arm (5/11; 45%) might not follow the recommendations from CDSS if these recommendations are not perceived as beneficial to the patients. Conclusions The results of the study show that practitioners’ beliefs were reflective of the current social norms around alcohol use and this influenced their decision to offer a brief alcohol intervention. Future interventions need to emphasize both organizational and sociocultural factors as part of the design. The results of this study point to the need to change social norms regarding alcohol in order to effectively implement interventions that target both alcohol and tobacco use in primary care clinics. Trial registration ClinicalTrials.gov NCT03108144. Retrospectively registered 11 April 2017, https://www.clinicaltrials.gov/ct2/show/NCT03108144

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“…While this tool is primarily designed to guide decisions on the type of evidence based intervention to implement, we also used this framework to examine the barriers and facilitators to the success of the COMBAT intervention post-implementation. The Hexagon Tool has been used in other studies postimplementation to evaluate an intervention (29,30). Interviews were audio recorded and transcribed verbatim by a transcriptionist.…”

Section: Data Collectionmentioning

confidence: 99%

Integrating brief alcohol interventions with tobacco addictions treatment in primary care: qualitative study of health care practitioner perceptions

Minian

Noormohamed

Lingam

et al. 2019

Preprint

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Background Randomized trials of complex interventions are increasingly including qualitative components to further understand factors that contribute to the success of complex interventions. In this paper, we explore the experiences of health care professionals who participated in the COMBAT trial; a web-based intervention implemented in the Ontario-wide Smoking Treatment for Ontario Patients (STOP) Program to prompt primary care practitioner delivery of a brief alcohol intervention as part of a smoking cessation program. This study conducted qualitative interviews with primary care practitioners to understand the factors influencing implementation and acceptability of the intervention. Methods Twenty three primary care practitioners were selected for a qualitative interview using intensity sampling, ensuring representation across study arms, organization types, and rates of intervention delivery. Interviews were 45 to 90 minutes in length and conducted by phone using an interview guide that was informed the National Implementation Research Network’s Hexagon tool. Interview recordings were transcribed and coded iteratively between three researchers to achieve consensus on emerging themes. Results Most interviewed practitioners recognized the need to simultaneously address risky alcohol use and tobacco use, and shared that this type of work fits within the priorities of their respective clinics. Although most practitioners were knowledgeable about the evidence of health risks associated with dual alcohol and tobacco use, most still felt they could have benefited from additional training – beyond the two webinars delivered by the STOP program – prior to the launch of the COMBAT initiative. Practitioners acknowledged the value of adding a validated screening tool to the STOP program’s baseline questionnaire; however, following through with a brief intervention and referral to treatment proved challenging due to limited time. Conclusions While practitioners recognized the value of the COMBAT initiative, insufficient training and time were frequently reported as barriers to adoption and delivery. The results of the study also show that practitioners’ beliefs were reflective of the current social norms around alcohol use and this influenced their decision to offer a brief alcohol intervention to patients. Future designs of primary care-based interventions need emphasize organizational and sociocultural factors as part of the design.

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A practical protocol for situating evidence-based mental health programs and practices within school-wide positive behavioral interventions and supports

Cited by 5 publications

References 18 publications

Aligning Organizational Priorities and System Policies to Support Implementation Scale‐Up of a Tailored Classroom‐Based Physical Activity Intervention in Low‐Resource Schools*

Aligning Organizational Priorities and System Policies to Support Implementation Scale‐Up of a Tailored Classroom‐Based Physical Activity Intervention in Low‐Resource Schools*

Integrating a brief alcohol intervention with tobacco addiction treatment in primary care: qualitative study of health care practitioner perceptions

Integrating brief alcohol interventions with tobacco addictions treatment in primary care: qualitative study of health care practitioner perceptions

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