Kuriyan Aparajita, Kinkler Grace, Cidav Zuleyha, Kang-Yi Christina, Eiraldi Ricardo, Salas Eduardo, Wolk Courtney Benjamin
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, United States.
JMIR Res Protoc. 2021 Feb 8;10(2):e26567. doi: 10.2196/26567.
Public schools in the United States are the main providers of mental health services to children but are often ill equipped to provide quality mental health care, especially in low-income urban communities. Schools often rely on partnerships with community organizations to provide mental health services to students. However, collaboration and communication challenges often hinder implementation of evidence-based mental health strategies. Interventions informed by team science, such as Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), have the potential to improve treatment implementation and collaboration within schools.
The objective of this study is to improve communication and collaboration strategies among mental health and school staff by adapting an evidence-based team science intervention for school settings. We present a protocol for a hybrid effectiveness-implementation study to adapt TeamSTEPPS using stakeholder feedback, develop a tailored implementation plan, and pilot the adapted content in eight schools.
Study participants will be recruited from public and charter schools and agencies overseeing school mental health services in the local metro area. We will characterize current services by conducting a needs assessment including stakeholder interviews, observations, and review of administrative data. Thereafter, we will establish an advisory board to understand challenges and develop possible solutions to guide additional TeamSTEPPS adaptations along with a complementary implementation plan. In aim 3, we will implement the adapted TeamSTEPPS plus tailored implementation strategies in eight schools using a pre-post design. The primary outcome measures include the feasibility and acceptability of the adapted TeamSTEPPS. In addition, self-report measures of interprofessional collaboration and teamwork will be collected from 80 participating mental health and school personnel. School observations will be conducted prior to and at three time points following the intervention along with stakeholder interviews. The analysis plan includes qualitative, quantitative, and mixed methods analysis of feasibility and acceptability, school observations, stakeholder interviews, and administrative data of behavioral health and school outcomes for students receiving mental health services.
Recruitment for the study has begun. Goals for aim 1 are expected to be completed in Spring 2021.
This study utilizes team science to improve interprofessional collaboration among school and mental health staff and contributes broadly to the team science literature by developing and specifying implementation strategies to promote sustainability. Results from this study will provide knowledge about whether interventions to improve school culture and climate can ready both mental health and school systems for implementation of evidence-based mental health practices.
ClinicalTrials.gov NCT04440228; https://clinicaltrials.gov/ct2/show/NCT04440228.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/26567.
美国的公立学校是为儿童提供心理健康服务的主要机构，但往往缺乏提供高质量心理健康护理的能力，尤其是在低收入城市社区。学校通常依靠与社区组织的合作关系为学生提供心理健康服务。然而，协作和沟通方面的挑战常常阻碍循证心理健康策略的实施。基于团队科学的干预措施，如提高绩效与患者安全的团队策略和工具（TeamSTEPPS），有可能改善学校内部的治疗实施和协作。
本研究的目的是通过为学校环境调整基于证据的团队科学干预措施，来改善心理健康和学校工作人员之间的沟通与协作策略。我们提出了一项混合效果-实施研究方案，以利用利益相关者的反馈来调整TeamSTEPPS，制定量身定制的实施计划，并在八所学校试点调整后的内容。
研究参与者将从公立和特许学校以及当地大都市地区监督学校心理健康服务的机构中招募。我们将通过进行需求评估来描述当前服务的特征，包括利益相关者访谈、观察和行政数据审查。此后，我们将成立一个咨询委员会，以了解挑战并制定可能的解决方案，以指导进一步调整TeamSTEPPS以及制定补充实施计划。在目标3中，我们将采用前后设计在八所学校实施调整后的TeamSTEPPS以及量身定制的实施策略。主要结果指标包括调整后的TeamSTEPPS的可行性和可接受性。此外，将从80名参与的心理健康和学校工作人员那里收集跨专业协作和团队合作的自我报告指标。将在干预前以及干预后的三个时间点进行学校观察，并进行利益相关者访谈。分析计划包括对可行性和可接受性、学校观察、利益相关者访谈以及接受心理健康服务的学生的行为健康和学校成果的行政数据进行定性、定量和混合方法分析。
该研究的招募工作已经开始。目标1预计于2021年春季完成。
本研究利用团队科学来改善学校和心理健康工作人员之间的跨专业协作，并通过制定和明确促进可持续性的实施策略，为团队科学文献做出了广泛贡献。本研究的结果将提供有关改善学校文化和氛围的干预措施是否能够使心理健康和学校系统做好实施循证心理健康实践准备的知识。
ClinicalTrials.gov NCT04440228；https://clinicaltrials.gov/ct2/show/NCT04440228。
国际注册报告识别码（IRRID）：DERR1-10.2196/26567。
