Fleming Christopher M, Calvert Hannah G, Turner Lindsey
School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL, USA.
Center for School and Community Partnerships, Boise State University, Boise, ID, USA.
Implement Sci Commun. 2025 Jan 6;6(1):4. doi: 10.1186/s43058-024-00691-9.
Rural School Support Strategies (RS3) is a bundle of implementation supports (including training, technical assistance, and a virtual learning collaborative) designed for the scale-up of universal prevention initiatives. This study addresses mechanisms of action, exploring whether positive effects of RS3 on implementation fidelity are attributable to improvements in functioning of school implementation teams, and increases in organizational readiness.
Data are from a cluster-randomized hybrid Type 3 implementation-effectiveness trial of RS3 among rural Idaho schools implementing Positive Behavioral Interventions and Supports (PBIS). Forty public K-12 schools in Idaho, located in rural areas or townships, were recruited for the trial and were equally randomized to either the basic supports condition, including standard trainings, or to the RS3 condition. Condition was not masked. The mechanistic aims were hypothesized prior to the trial and tested with survey data from individuals on each school's implementation team (n = 205). Surveys were collected in spring 2019 and 2020 regarding organizational readiness and team functioning. The outcome measure was PBIS implementation fidelity, measured by school teams during the summers of 2019 and 2020 using the Tiered Fidelity Inventory. School-level path models tested the effect of RS3 on implementation fidelity, controlling for baseline, school grade level, and school location. Multilevel (2-1-2) mediation models tested the degree to which individual team members' perceptions of organizational readiness and team functioning mediated the relationship between school-level experimental condition and fidelity, controlling for the team members' role.
Schools receiving RS3 reported significantly greater implementation fidelity, although effects were slightly reduced (b = 8.40, p = .056, 95% CI [-0.22,17.01], β = 0.54) after inclusion of baseline and demographic controls. Models indicated a significant indirect effect of RS3 on fidelity through increased team productivity (b = 6.30, SE = 2.63, p = .017, MC 95% CI [0.83,13.86], β = 0.21), and effects through organizational readiness, change commitment, team culture, and team goal setting.
External supports may improve implementation of universal prevention initiatives in rural schools through improvements in readiness and fostering teaming in organizations.
This research was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.
农村学校支持策略（RS3）是一系列实施支持措施（包括培训、技术援助和虚拟学习协作），旨在扩大普遍预防举措的规模。本研究探讨其作用机制，探究RS3对实施保真度的积极影响是否归因于学校实施团队功能的改善以及组织准备度的提高。
数据来自爱达荷州农村学校中对RS3进行的一项整群随机混合3型实施效果试验，这些学校正在实施积极行为干预与支持（PBIS）。招募了爱达荷州40所位于农村地区或乡镇的公立K-12学校参与试验，并将它们平均随机分配到基本支持组（包括标准培训）或RS3组。分组情况未设盲。在试验前设定了机制性目标，并使用来自各学校实施团队成员（n = 205）的调查数据进行检验。在2019年春季和2020年收集了关于组织准备度和团队功能的调查。结果指标是PBIS实施保真度，由学校团队在2019年和2020年夏季使用分层保真度清单进行测量。学校层面的路径模型检验了RS3对实施保真度的影响，并控制了基线、学校年级水平和学校位置。多层次（2-1-2）中介模型检验了个体团队成员对组织准备度和团队功能的认知在学校层面实验条件与保真度之间关系的中介程度，并控制了团队成员的角色。
接受RS3的学校报告的实施保真度显著更高，不过在纳入基线和人口统计学控制因素后，效果略有降低（b = 8.40，p = 0.056，95% CI [-0.22,17.01]，β = 0.54）。模型表明，RS3通过提高团队生产力对保真度有显著的间接影响（b = 6.30，SE = 2.63，p = 0.017，MC 95% CI [0.83,13.86]，β = 0.21），以及通过组织准备度、变革承诺、团队文化和团队目标设定产生影响。
外部支持可能通过提高准备度和促进组织中的团队协作来改善农村学校普遍预防举措的实施。
本研究于2018年11月9日在ClinicalTrials.gov（NCT03736395）上进行了前瞻性注册。
