A precision-based approach to implement evidence-based interventions for students with externalizing behaviors in developing countries: A single case experimental study in China.

Abstract

The prevalence of externalizing behaviors imposes a far-reaching negative impact on students' social, behavioral, and academic outcomes, which constitute a public health issue in low-resource and populous developing countries (e.g., China). Compared to the "one-size-fits-all" approach (OSFA; forcing a single evidence-based intervention [EBI] on any struggling students) that is prevalent in many countries, a precision-based approach (e.g., Student Intervention Matching System; SIMS) to intervention programming can better meet students' heterogeneous needs by matching individual characteristics to active components of EBIs. But precision-based approaches cannot fulfill their potential in developing countries unless the contextual implementation barriers (e.g., high student-teacher ratio) are remedied with attention to feasibility, acceptability, and cultural compatibility. This collaborative pilot study with Chinese school stakeholders examined the efficacy, feasibility, acceptability, and cultural compatibility of SIMS to match behavioral EBIs to students with externalizing behaviors. A concurrent multiple-baseline across-participant design was used with six students (three dyads). Visual and quantitative analyses evidenced the superior efficacy of SIMS in improving externalizing behaviors compared to the OSFA approach. Social validity data endorsed the feasibility, acceptability, and cultural compatibility of SIMS and the matched EBIs perceived by school stakeholders (educators, students, and parents). Implications, limitations, and future directions for adapting precision-based approaches in low-resource and populous countries were discussed. Impact and ImplicationsPrecision-based approaches (PBA) to intervention programming hold promises as a cost-effective solution for school mental health in low-resource and populous countries. This study supported the preliminary efficacy, feasibility, acceptability, and cultural compatibility of an adapted PBA (i.e., Student Intervention Matching System) that matches evidence-based interventions to the individual characteristics and needs of students with externalizing behaviors in China. The discussion shed light on practical approaches to adapting PBAs across cultures.

Happy Together: Multilevel Associations Between Chinese Adolescents' and Teachers' School-Specific Subjective Wellbeing

“…For instance, compared to those in individualist cultures, people in collectivist cultures value their group identity greatly and strive to achieve group cohesion (Wang et al, 2019). Hence, adolescents in collectivist cultures may likely experience a higher level of school connectedness (a dimension of school-specific SWB) than those in individualist cultures (Zhang, 2023). Theoretically, the Confucian education philosophy implies a significant association between Chinese adolescents' and their teachers' general and school-specific SWB (Shenghong & Dan, 2004), because it emphasizes a teacher's role as both an authority figure and a role model for their students regarding life in and out of schools.…”

Adopting global perspectives in school psychology.

“…Several articles in this special issue address school psychology services within low- and middle-income countries. Zhang (2024), for example, explored an individualized approach to addressing behavioral concerns with a focus on feasibility, cultural compatibility, and adaptability within China. At a systems level, Dang et al (2024) evaluated barriers and solutions to use of implementation science in the work of school-based mental health researchers and practitioners.…”