Multilevel Barriers and Facilitators to Sustainability of a Universal Trauma-Informed School-Based Mental Health Intervention Following an Efficacy Trial: A Qualitative Study.
Multilevel Barriers and Facilitators to Sustainability of a Universal Trauma-Informed School-Based Mental Health Intervention Following an Efficacy Trial: A Qualitative Study.
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DOI：
10.1007/s12310-020-09402-w
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发表时间：
2021-03
影响因子：
2.6
通讯作者：
Mendelson T
中科院分区：
文献类型：
--
作者：
Arnold KT;Porter KMP;Frattaroli S;Durham RE;Clary LK;Mendelson T
关于在研究支持结束后影响预防性学校心理健康干预措施可持续性的因素，相关研究有限。本研究评估了在有效性试验实施后，城市学校维持 “放松、觉察、自评”（RAP，Relax, be Aware, do a Personal rating）俱乐部这一基于创伤知情的普适性心理健康干预项目的障碍与促进因素。2016年至2018年间，巴尔的摩市的13所学校实施了 “放松、觉察、自评” 俱乐部项目。我们通过对管理人员（n = 10）和接受过干预实施培训的学校工作人员（n = 11）进行半结构化访谈，以及查阅干预保真度记录（n = 137）和与实施该项目的学校工作人员及研究团队成员的督导通话记录（n = 10），来评估 “放松、觉察、自评” 俱乐部项目的可持续性。尽管大多数学校工作人员认为 “放松、觉察、自评” 俱乐部项目可接受且有益，但这13所学校无一继续维持该干预措施。可持续性面临的障碍包括接受干预实施培训的学校工作人员自我效能感低、学校人员流动、在常规校历中开展该项目存在空间和时间方面的后勤难题、在研究范畴之外维持项目的资金不足，以及学校人员与研究人员之间关于可持续性的规划有限且缺乏持续沟通。提高试验后项目可持续性的建议包括在实施前阶段与学校共同制定可持续性计划，在实施阶段加强对学校工作人员的持续支持，以及在实施后阶段利用学术 - 社区合作来推动可持续性和扩大干预规模。提高有益的校本心理健康项目的可持续性，有可能减少心理健康方面的差距并促进健康公平。
Limited research exists about factors that influence the sustainability of preventive school mental health interventions when research support ends. This study assessed barriers and facilitators to sustaining RAP (Relax, be Aware, do a Personal rating) Club, a trauma-informed universal mental health intervention, in urban schools following efficacy trial implementation. Between 2016-2018, 13 Baltimore City schools implemented RAP Club. We evaluated RAP Club sustainability using semi-structured interviews with administrators (n=10) and school staff trained to deliver the intervention (n=11), as well as review of intervention fidelity logs (n=137) and notes from supervision calls (n=10) with school staff and research team members who implemented the program. Although most school staff described RAP Club as acceptable and beneficial, none of the 13 schools sustained the intervention. Barriers to sustainability included low self-efficacy among school staff trained to deliver the intervention, school staff turnover, logistical challenges with space and time in the regular school calendar to deliver the program, insufficient funding to sustain the program outside of the research context, and limited planning and ongoing communication between school personnel and researchers about sustainability. Recommendations for increasing post-trial program sustainability include developing sustainability plans with schools during the pre-implementation phase, enhancing ongoing support for school staff during the implementation phase, and using academic-community partnerships to facilitate sustainability and intervention scale-up during the post-implementation phase. Increasing sustainability of beneficial school-based mental health programs has the potential to reduce mental health disparities and promote health equity.
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DOI：
10.1080/1754730x.2015.1037848
发表时间：
2015
期刊：
Advances in school mental health promotion
影响因子：
--
作者：
Eiraldi R;Wolk CB;Locke J;Beidas R
通讯作者：
Beidas R
DOI：
10.1007/s11121-020-01144-0
发表时间：
2020-11
期刊：
Prevention science : the official journal of the Society for Prevention Research
影响因子：
--
作者：
Arnold KT;Pollack Porter KM;Frattaroli S;Durham RE;Mmari K;Clary LK;Mendelson T
通讯作者：
Mendelson T
影响因子：
2.2
作者：
Mendelson T;Clary LK;Sibinga E;Tandon D;Musci R;Mmari K;Salkever D;Stuart EA;Ialongo N
通讯作者：
Ialongo N
DOI：
10.1080/1754730x.2008.9715730
发表时间：
2008-01-01
期刊：
ADVANCES IN SCHOOL MENTAL HEALTH PROMOTION
影响因子：
--
作者：
Domitrovich, Celene E.;Bradshaw, Catherine P.;Ialongo, Nicholas S.
通讯作者：
Ialongo, Nicholas S.
影响因子：
3.6
作者：
Han, SS;Weiss, B
通讯作者：
Weiss, B