Beliefs and Attitudes for Successful Implementation in Schools (BASIS)

项目总结 在美国，只有大约一半的有心理健康问题的年轻人表示 治疗，导致较高的社会成本。针对精神健康状况的循证实践(EBP)产生 当它们实际被忠实地实施时，对孩子们有重大的好处。尽管70%到80%的人精神上 目前学校为青少年提供健康服务，很少有学生接受EBP。 在学校实施EBP的障碍包括组织层面的障碍(缺乏资金， 行政支助差、人员流动率高、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、冲突的感知 理论观点)。尽管已经投入了大量的注意力来分类实施 尽管存在障碍和潜在的战略，但开发和测试创新干预措施的努力很少 强化落实。在学校，执行倡议往往是自上而下的任务，而没有 注意影响提供商行为的个别因素，例如提供商对以下问题的态度 在培训之后，打算实施EBP。未能解决这些个人层面的障碍尤其是 代价高昂，因为成功实施EBP最终需要改变个人行为，即使在 组织因素(例如，循证政策、支持性领导、有效培训)已经到位。 与R21机制的目标一致，本研究的目标是适应和测试其可行性 以及理论驱动的实施前干预的潜在有效性，以解决个人层面的障碍 EBP实施-在学校成功实施的信念和态度(基础)-旨在 改善校本精神卫生服务提供者对EBP的落实情况。基础是旨在成为一种可行和 可扩展的一线或附属实施增强干预，可促进其他工作 (例如，组织干预)，目标是高质量的EBP实施。 这项研究的目的是：(1)调整现有的、理论驱动的实施干预措施(基础)， 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) 评估以后临床试验的可行性：(A)确定可行性、可接受性和适当性 对校本精神健康提供者进行的基础干预，以及(B)试点测试基础，如 与注意力控制相比，注意控制作为实施前干预在培训之前提供， 现有的EBP。还将对关键组织因素(例如，执行环境)进行评估，并将其列入如下内容 协变量，我们将探索数据中的趋势，为更大规模试验的设计提供信息。归根结底，基础报价 一种创新和可扩展的方法，以提高SBMH提供商对EBP的接受和使用，以提高 接受高质量服务的有心理健康问题的青年人数。

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.