Development and Pilot Testing of a Remote Training Strategy for the Implementation of Mental Health Evidence-Based Practices in Rural K-8 Schools

项目概要/摘要 与非农村地区相比，农村地区的卫生保健提供者较少，而且缺乏良好的培训。学校 更多地参与提供精神卫生服务，并在增加获得服务方面具有巨大潜力 儿童和青少年。需要在培训和服务提供方面进行创新，以改善心理健康 农村学校的护理质量和可用性。循证实践（EBP）可以纳入学校- 广泛的多层次系统，目前用于改善学校的气氛和安全。全校积极 行为干预和支持（PBIS）是一项基于公共卫生模式的服务提供战略， 一个例子。农村地区越来越多的学校采用基于项目的教育系统。我们的研究团队使用了 PBIS在第2级纳入EBP，用于患有精神健康障碍或有精神健康障碍风险的儿童。开大宗 农村地区儿童的服务差距，通过PBIS提供EBP可以改善获得服务的机会， 更好的长期结果。 学校工作人员，无论是否接受过心理健康培训，都可以忠实地实施第2级干预措施 和临床效果，如果得到充分的咨询支持。在城市和郊区学校，这种支持 可以在现场提供给学校工作人员。然而，提供持续的现场支持是不可行的， 农村学校由于地理位置偏远，可持续性很高。因此，远程医疗技术 被推荐用于在服务不足的农村社区培训行为健康工作人员（BHS）。 本研究的目的是使用迭代过程（快速成型）来开发和评估 远程培训策略的适当性、可行性、可接受性和初步有效性， 资源，以支持使用第2级EBP和有效支持农村学校的护理协调做法。 参与者将是受过和没有受过心理健康培训的学校工作人员以及农村地区的K-8学生。 在宾夕法尼亚州的学校谁被认为是在外部和内部的心理健康障碍的风险。 研究的目的是（1）从学校利益相关者那里获得投入， 参与式研究，（2）使用迭代快速原型法开发异步和 基于初步研究和Aim 1数据的同步远程培训策略，以及（3）进行试点试验 远程训练策略和控制条件的对比。 该研究将采用一种务实的设计，包括目标1-2的混合方法和试点 目标3的随机临床试验。参与者将是68名行为健康工作人员和156名K- 8.学校工作人员实施的干预措施是最常见的外部化和 内化心理健康障碍我们的指导框架是交互式系统框架， 传播和实施研究。我们将使用本研究的数据提交R 01资助提案 与大量农村学校一起测试独立在线培训平台的有效性。

PROJECT SUMMARY / ABSTRACT Rural areas have fewer, and less well trained, health care providers than non-rural areas. Schools have become more involved in the delivery of mental health services and hold great potential for increasing access to children and adolescents. Innovations in training and service delivery are needed to improve mental health care quality and availability in rural schools. Evidence-based practices (EBPs) can be incorporated into school- wide multi-tiered systems that are currently used to improve school climate and safety. School-wide Positive Behavioral Interventions and Supports (PBIS), a service-delivery strategy based on the public health model is one example. A growing number of schools in rural areas are employing PBIS. Our research team has used PBIS to incorporate EBPs at Tier 2 for children with, or at risk for, mental health disorders. Given the large service disparities for children in rural areas, offering EBPs through PBIS can improve access and lead to better long-term outcomes. School personnel, with or without prior mental health training, can implement Tier 2 interventions with fidelity and clinical effectiveness if given adequate consultation support. In urban and suburban schools, this support can be provided to school staff on site. However, providing ongoing on-site support is not feasible or sustainable in rural schools, due to their remote physical location. For this reason, telehealth technology has been recommended for the training of behavioral health staff (BHS) in under-served rural communities. The purpose of this study is to use an iterative process (Rapid Prototyping) to develop and evaluate the appropriateness, feasibility, acceptability, and preliminary efficacy of a remote training strategy that provides resources to support use of Tier 2 EBPs and effective support for care coordination practices in rural schools. Participants will be school personnel with and without prior mental health training and K-8 students in rural schools in Pennsylvania who are deemed at risk for externalizing and internalizing mental health disorders. The Aims of the study are to (1) obtain input from school stakeholders employing community-based participatory research, (2) use the iterative rapid prototyping approach to develop an asynchronous and synchronous remote training strategy based on preliminary studies and Aim 1 data, and (3) conduct a pilot trial of a remote training strategy vs. a control condition. The study will employ a pragmatic design comprised of a mixed-method approach for Aims 1-2, and a pilot randomized clinical trial for Aim 3. Participants will be 68 behavioral health staff and 156 children in grades K- 8. The interventions to be implemented by school personnel are EBPs for the most common externalizing and internalizing mental health disorders. Our guiding framework is the Interactive Systems Framework for dissemination and implementation research. We will use data from this study to submit an R01 grant proposal to test the effectiveness of a free-standing online training platform with a large number of rural schools.