Beliefs and Attitudes for Successful Implementation in Schools (BASIS)

项目摘要 在美国，只有大约一半的经历过心理健康问题的年轻人接受了指示。 治疗，导致社会成本高昂。基于证据的做法（EBP）的精神卫生条件产生 如果这些措施真正得到忠实执行，将给儿童带来重大益处。虽然百分之七八十的精神 目前，学校为青年提供保健服务，很少有学生接受EBP。 学校实施EBP的障碍包括组织层面的障碍（缺乏资金， 行政支助不力、人员更替率高、培训不足）以及个人 水平（对干预的可接受性和适当性、时间要求、社会规范、冲突 理论观点）。虽然对执行分类给予了很大的注意， 障碍和潜在的战略，很少有努力制定和测试创新的干预措施， 加强执行。在学校，实施倡议往往是自上而下的任务， 注意影响供应商行为的个别因素，例如供应商对以下方面的态度，或 在培训后实施EBP的意图。如果不能解决这些个人层面的障碍， 成本高昂，因为成功实施EBP最终需要个人行为的改变，即使 组织因素（例如，循证政策、支持性领导、有效培训）。 与R21机制的目标一致，本研究的目标是适应和测试可行性 理论驱动的实施前干预措施在解决个人层面的障碍方面的潜在功效 EBP的实施-学校成功实施EBP的信念和态度（BASIS）-旨在 改善学校心理健康服务提供者实施EBP的情况。BASIS旨在成为一个可行的， 可扩展的一线或连续性实施增强干预措施，可促进其他努力 (e.g.,组织干预），以高质量的EBP实施为目标。 本研究的目的是：（1）适应现有的，理论驱动的实施干预（BASIS）， 以前与教育工作者一起使用，以改善SBMH提供者的EBP实施行为;以及（2） 通过以下方式评估后期临床试验的可行性：（a）确定可行性、可接受性和适当性 在学校心理健康提供者中进行的BASIS干预，以及（B）BASIS试点测试， 与注意力控制相比，注意力控制是在特定的训练之前作为实施前干预提供的， 现有EBP。关键组织因素（例如，执行气候）也将进行评估，并列入 协变量，我们将探索数据的趋势，为更大规模试验的设计提供信息。最终，BASIS提供 创新和可扩展的方法，以提高SBMH供应商的吸收和使用EBP，以增加 有精神健康问题的青年获得高质量服务的人数。

PROJECT SUMMARY Only about half of the youth in the United States who experience mental health problems receive indicated treatment, resulting in high societal cost. Evidence-based practices (EBP) for mental health conditions yield significant benefits to children when they are actually implemented with fidelity. Although 70 to 80% mental health services for youth are currently provided in schools, few students receive EBP. Barriers to EBP implementation in schools include both those at the organizational level (lack of funding, poor administrative support, high personnel turnover, inadequate training) as well as those at the individual level (perception of intervention acceptability and appropriateness, time demands, social norms, conflicting theoretical perspectives). Although significant attention has been devoted to categorizing implementation barriers and potential strategies, there have been few efforts to develop and test innovative interventions to enhance implementation. In schools, implementation initiatives often occur as top-down mandates without attention to the individual factors found to impact provider behavior, such as provider attitudes about, or intentions to implement EBP, following training. Failing to address these individual-level barriers is especially costly, as individual behavior change is ultimately required for successful EBP implementation, even when organizational factors (e.g., evidence-informed policy, supportive leadership, effective training) are in place. Consistent with the aims of the R21 mechanism, the goal of this study is to adapt and test the feasibility and potential efficacy of a theory-driven pre-implementation intervention to address individual-level barriers to EBP implementation – Beliefs and Attitudes for Successful Implementation in Schools (BASIS) – designed to improve school-based mental health providers' implementation of EBP. BASIS is intended to be a feasible and scalable first-line or adjunctive implementation enhancement intervention that is facilitative of other efforts (e.g., organizational interventions) that target high quality EBP implementation. Aims of this study are to: (1) Adapt an existing, theory-driven implementation intervention (BASIS), previously used with educators, to improve the EBP implementation behaviors of SBMH providers; and (2) Assess the viability of a later clinical trial by: (a) establishing the feasibility, acceptability, and appropriateness of the BASIS intervention among school-based mental health providers, and (b) pilot testing BASIS, as compared to an Attention Control, delivered as pre-implementation intervention prior to training in a specific, existing EBP. Key organizational factors (e.g., implementation climate) will also be evaluated and included as covariates and we will explore trends in the data to inform the design of a larger trial. Ultimately, BASIS offers an innovative and scalable approach to improving SBMH providers' uptake and use of EBP in order to increase the number of youth with mental health problems who receive high quality services.