Evidence-Informed Mental health Prevention, Assessment, Collaboration, and Treatment in Middle Schools (E-IMPACTS)

1在COVID-19大流行之后，早期青少年的心理健康需求急剧增加， 2增加-自杀企图增加了50%，抑郁和焦虑增加了40%， 3.因心理健康问题住院的人数增加了30%。在接受治疗的青少年中 4对于精神或行为健康挑战，56%的人在K-12学校接受服务-这意味着基于学校的 5心理健康支持是解决学生心理健康需求的一个潜在可行的设置（绿色 6等，2013年）。然而，这些服务要求学校工作人员具备识别和 7在学校落实学生适当的心理和行为健康需求。农村学校 小社区特别难以获得适当的资源来支持学生的心理健康。 9健康，但在线技术为这个问题提供了一个有希望的解决方案。要了解在线支持如何 10可以提高学校心理健康服务的质量和青少年心理健康结果，E- 11 IMPPERT试验将严格评估两个在线活动的整合：第一（1），在线循证 12心理和行为健康筛查工具，称为早期识别系统（EIS）和第二（2），虚拟 13个专业学习社区和社区医疗保健成果扩展后的辅导 14（ECHO）模型。ECHO已被用于改善其他健康环境中的患者结局， 15有希望的影响时，在学校环境中应用，以解决学生的心理和行为需求。建筑 在这项前期工作的基础上，E-IMPLENT试验将使用一项有42所中学参加的学校随机对照试验 该试验将测量对青少年心理健康的直接影响（基线后） 18项成果，包括内化和外化行为（目标1）以及员工对培训的反应， 19知识和循证心理健康干预措施的实施（目标2），同时审查成本和 20个学校层面的因素调节实施循证实践（目标3）。学校将随机 21个分配用于接收EIS和ECHO支持（n = 27）或分配用于访问EIS的活动控制条件 22独自一人学校工作人员将使用EIS筛查青少年的心理或行为健康需求（约21，000名学生） 23和学校工作人员（约1350人）将完成调查（基线-岗位），评估知识和执行情况， 24心理健康通过欧共体人道处提供的辅导将侧重于全校范围的预防或 通过EIS数据获得的25项干预策略，用于解决观察到的心理或行为健康需求。结果 26将推进关于这些在线活动如何促进以学校为基础的心理健康的实施的知识。 27健康活动和成果。

1 In the wake of the COVID-19 pandemic, the mental health needs of early adolescents have dramatically 2 increased – suicide attempts have increased by 50%, depression and anxiety has increased by 40%, and 3 hospitalizations due to mental health concerns have increased by 30%. Among adolescents receiving treatment 4 for mental or behavioral health challenges, 56% receive services in K-12 schools – meaning that school-based 5 mental health supports are one potentially viable setting for addressing mental health needs of students (Green 6 et al., 2013). However, these services require school staff to have the knowledge and ability to identify and 7 implement appropriate mental and behavioral health needs of students in their schools. Schools located in rural 8 and small communities have particular difficulties accessing appropriate resources to support student mental 9 health but online technology presents a promising solution to this problem. To understand how online supports 10 may improve the quality of school-based mental health services and adolescent mental health outcomes, the E- 11 IMPACTS trial will rigorously evaluate the integration of two online activities: first (1), an online evidence-based 12 mental and behavioral health screening tool, called the Early Identification System (EIS) and second (2), a virtual 13 professional learning community and coaching following the Extension for Community Healthcare Outcomes 14 (ECHO) model. ECHO has been used to improve patient outcomes in other health contexts and demonstrates 15 promising impact when applied in school-settings to address mental and behavioral needs of students. Building 16 on this prior work, the E-IMPACTS trial will use a school randomized controlled trial with 42 middle schools 17 located in VA, MO, and SC. The trial will measure immediate impact (baseline-post) on adolescent mental health 18 outcomes inclusive of internalizing and externalizing behaviors (Aim 1) as well as staff reaction to training, their 19 knowledge and implementation of evidence-based mental health interventions (Aim 2) while examining cost and 20 school-level factors moderating implementation of evidence-based practices (Aim 3). Schools will be randomly 21 assigned to receive both EIS and ECHO supports (n = 27) or to an active control condition with access to EIS 22 alone. School staff will use EIS to screen adolescents for mental or behavioral health needs (~21,000 students) 23 and school staff (~1350) will complete surveys (baseline-post) assessing knowledge and implementation of 24 mental health practices. Coaching provided through ECHO will focused on school-wide prevention or early 25 intervention strategies for addressing mental or behavioral health needs observed obtained via EIS data. Results 26 will advance knowledge about how these online activities can advance implementation of school-based mental 27 health activities and outcomes.