Longitudinal Effects of a Motivationally Focused Strategy to Increase the Yield of Training and Consultation on Teachers’ Adoption and Fidelity of a Universal Program

Abstract

Group-based didactic training is a cornerstone implementation strategy used to support the adoption and delivery of evidencebased prevention programs (EBPP) by teachers in schools, but it is often insufficient to drive successful implementation. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a theory-based, motivational implementation strategy designed to increase the yield of EBPP training and consultation. The purpose of this study was to examine the longitudinal effects of BASIS-T on hypothesized mechanisms of behavior change (e.g., attitudes toward EBPP, self-efficacy, intentions to implement) and implementation and student outcomes associated with a well-established universal prevention program-the good behavior game (GBG). This pilot trial included 82 elementary school teachers from nine public elementary schools who were randomly assigned at the school-level to the BASIS-T (n = 43) or active comparison (n = 39) condition, with both conditions receiving training and consultation of the good behavior game by a third-party purveyor. Analyses included mixed-effects and multilevel growth modeling of adoption, mechanisms of behavior change, and student behavior outcomes. Meaningful effects were found favoring BASIS-T on immediate adoption of the GBG within the first month of school (74% vs. 40%) and self-efficacy (p < 0.05). These findings advance our understanding of the type of implementation strategies that complement pre-implementation training and post-training consultation in schools by identifying the importance of task self-efficacy as a mechanism of behavior change related to adoption for prevention programming.

Protocol for a hybrid type 3 effectiveness-implementation trial of a pragmatic individual-level implementation strategy for supporting school-based prevention programming

“…If not generalizable, we will use inverse probability weighting to increase the representativeness of estimates [ 87 ]. RQ 1a : A series of 3-level piecewise mixed effects models will be used to test our primary hypotheses: (1) the BASIS-T condition will show steeper gains than the ACC condition from T1 to T2 (e.g., more favorable attitudes towards EBPPs, increased social norms; enhanced task and maintenance self-efficacy; stronger intentions to implement) and (2) both groups will decline after training (T3–T5) as has been found in past TPB research [ 88 ], and in the BASIS-T pilot trial [ 33 ], but the BASIS-T condition will have longer sustained between-condition effects after training from T3 to T13. Dependent variables will include subscale scores on attitudes, social norms, self-efficacy, intentions, and maintenance self-efficacy.…”

“…Most implementation frameworks include critical individual implementer factors [ 30 , 31 ]. Indeed, front-line professionals—such as teachers—are ultimately responsible for the adoption and delivery of EBPPs and present their own set of implementation determinants such as attitudes, beliefs, and intentions to implement an EBPP [ 30 , 32 , 33 ]. Some school-based research has documented that individual-level determinants can be more predictive of EBPP implementation than organizational factors, such as climate or culture [ 32 , 34 ], even within supportive implementation contexts [ 35 , 36 ].…”

“…The BASIS strategy was developed via an iterative user-centered design approach [ 46 ]. Initial pilots of BASIS-T and a version designed for school-based mental health clinicians (BASIS-C) have demonstrated promise in enhancing participants’ attitudes, subjective norms, self-efficacy, and adoption [ 30 , 33 , 47 ]. The BASIS-T pilot study on which the current project is based was an attention-control randomized trial conducted with 82 elementary school teachers implementing a universal, classroom-based EBPP [ 48 – 50 ].…”

“…The BASIS-T pilot study on which the current project is based was an attention-control randomized trial conducted with 82 elementary school teachers implementing a universal, classroom-based EBPP [ 48 – 50 ]. That study found a statistically significant positive impact on implementation task self-efficacy and outcome expectancy immediately after training and significantly less decline in task self-efficacy than attention control throughout the academic year [ 33 ]. Positive attitudes towards evidence-based practices decreased for both groups over time but with a marginal time trend in favor of less decrease for the BASIS-T condition ( p = 0.08).…”