Implementation Supports for Improving Identification and Delivery of School-based Mental Health Supports for Middle Schools Students

Official title

Evidence-Informed Mental Health Prevention, Assessment, Collaboration, and Treatment in Middle Schools

Overview

This study will assess how different types of training and support influence the way that school staff understand, and respond to, the mental and behavioral health needs of middle school students. Researchers will work with middle schools using a developed screening system (called the Early Identification System; EIS) and compare how staff and student outcomes change when schools receive two different types of training and support: 1) standard onboarding/training versus 2) participating in professional learning communities and coaching.

Detailed description

The "Evidence-Informed Mental health Prevention, Assessment, Collaboration, \& Treatment in Middle Schools" (E-IMPACTS) project will evaluate how different implementation supports promote the ability of school staff to identify, and support, the mental and behavioral health needs of middle school students.

The project will involve researchers from the University of Virginia, University of Missouri, and University of South Carolina and middle schools (i.e., grades 6-8) that have elected to use a brief, universal tool, called the Early Identification System (EIS). The EIS assesses mental and behavioral health of students and connects these data to intervention recommendations. The EIS is a fully developed and validated tool that was developed to help school staff to identify, and address, the mental or behavioral health needs in their school building. The EIS system was developed as a low/no cost system to 1) be administered fully online and 2) present school staff with actionable next steps for supporting youth mental health needs.

Using a school-level randomized controlled trial (RCT) design, this project will test if/how two different types of implementation support changes 1) the way school staff use EIS recommended practices and 2) student outcomes. Half of schools in the RCT will receive standard implementation supports for using EIS. This treatment condition, called "EIS only", involves the existing technical assistance and on-boarding provided to any school already choosing to use EIS. Schools in the other treatment condition, called EIS+ECHO, will receive additional professional development and implementation support. This will involve participating in 1) online professional learning communities following the "Extension for Community Healthcare Outcomes" (ECHO) model and 2) follow-up coaching. The E-IMPACTS ECHO model (a) connects student support teams (e.g., interdisciplinary groups of school staff) across schools with each other and with content experts (e.g., university faculty specializing in school mental health) to collaboratively problem solve challenges they may be experiencing related to supporting student mental and behavioral health needs, and (b) provides schools with follow-up supports to facilitate the implementation of strategies discussed in ECHO sessions.

The purpose of the RCT is to determine the "value-added" of the EIS + ECHO, compared to the EIS alone (EIS Only) in Virginia, Missouri, and South Carolina middle schools located in rural areas or small suburbs/cities (i.e., an active comparison condition). Researchers hypothesize that, relative to EIS Only, the EIS + ECHO condition will be associated with greater improvements in: (a) student emotional/behavioral and academic outcomes, (b) staff knowledge, self-efficacy, and practice outcomes, and (c) school-level implementation outcomes.

Interventions

• Behavioral EIS Only
  The EIS Only Condition includes middle schools who have elected to implement the EIS. The EIS: * Is an online tool to that enables schools to identify students in need of additional mental or behavioral health support and provides recommendations for evidence-based practices. * Asks teachers and students to report on 7 areas of student social-emotional functioning * Facilitates schools' understanding of social-emotional student needs and recommended evidence-based practices at a variety of leve
• Behavioral EIS + ECHO
  EIS + ECHO supports include supports from the EIS Only condition plus: * Monthly ECHO sessions for student support teams (SSTs; e.g., interdisciplinary groups of staff tasked to support student mental health). The ECHO experience involves: * Didactic training to support EIS implementation and effective identification and support of student mental and behavioral health needs. * Case-based learning and collaborative problem-solving related to EIS implementation and effective identification a

Primary outcome measures

• Change in youth mental health measured by the Early identification System [Time frame: 2 time points (over 9 months)]
• Change in staff knowledge of evidence-based school mental health practices as measured by the Perceptions of Response To Intervention Skills Survey [Time frame: 2 time points (over 9 months)]
• Change in staff behaviors of evidence-based school mental health practices as measured by the Perceptions of Practices Survey [Time frame: 2 time points (over 9 months)]
• Change in staff burnout as measured by the Maslach Burnout Inventory [Time frame: 2 time points (over 9 months)]
• Change in schoolwide school mental health implementation outcomes as measured by the School-wide Evaluation Tool [Time frame: 2 time points (over 9 months)]
• Change in schoolwide school mental health implementation outcomes as measured by the Individual School-wide Evaluation Tool [Time frame: 2 time points (over 9 months)]

Secondary outcome measures (2)

• Number of students with disciplinary referrals [Time frame: 2 time points (over 12 months)]
• Student grades [Time frame: 2 time points (over 12 months)]

Eligibility criteria

Inclusion criteria

• Public middle schools (must include grades 6-8) planning to implement the EIS
• Located in rural areas, towns, \& suburbs / cities (NCES locales)
• All children attending the schools and staff employed by the schools are eligible for inclusion

Exclusion criteria

• Previous use of EIS (i.e., use of all screening data and intervention hub)
• <70% response rate on pre-intervention implementation of EIS

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Prevention

Study locations

United States · 3 centers

• University of Missouri — Columbia
• University of South Carolina — Columbia
• University of Virginia — Charlottesville

Identifiers

NCT: NCT06047041 · 5320

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗