Beliefs and Attitudes for Successful Implementation in Schools (BASIS)

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 mental health providers' implementation of EBPs. 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 school mental health 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 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 school mental health providers' uptake and use of EBPs in order to increase the number of youth with mental health problems who receive high quality services.

Study Overview

• Status: Completed
• Conditions: Implementation; Intervention Adoption
• Intervention / Treatment: Behavioral: Attention Control; Behavioral: BASIS

• Study Type: Interventional
• Enrollment (Actual): 35
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Washington
    • Seattle, Washington, United States, 98115-8160
      • University of Washington School Mental Health Assessment, Research, and Training (SMART) Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion:

School mental health providers (school psychologists, school social workers, etc.) recruited from middle and high schools in two economically and ethnically diverse districts in the Seattle area.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: BASIS; Received a 3-hour BASIS implementation strategy.	Behavioral: BASIS
Active Comparator: Attention Control; Received a 3-hour session designed to control for dose, information provided, and presenter effects.	Behavioral: Attention Control

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Attitudes toward Evidence-Based Practices	Evidence-Based Practice Attitudes Scale (EBPAS) is a widely used 26-item tool designed to assess evidence-based practice (EBP) attitudes with items measured on a 0-4 scale and 6 subscales: (1) likelihood of adopting if the EBP were a requirement; (2) likelihood of adopting if the EBP were appealing to you; (3) openness to new practices; (4) perceived divergence between current practices and EBPs; (5) fit of EBPs with current practices; and (6) burden of EBPs. Subscale and total scores are mean scores of items with a range of 0-4. Higher scores reflect more favorable attitudes (perceived divergence is reverse-coded).	Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up
Change in Subjective Norms	Subjective Norms Scale is based on Theory of Planned Behavior (TPB) constructs. Two subscales measure two types implementation-related subjective norms: injunctive norms and descriptive norms. Four items load on each subscale and mean score range from -3 to +3, with positive scores reflecting more positive subjective injunctive and descriptive norms.	Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up
Change in Perceived Behavioral Control	Perceived Behavioral Control Scale is a modified version of the Teacher's Self-Efficacy Scale, which has 10 items assessing perceived behavioral control in implementing evidence-based practices. Items are scored on a 1-4 scale with a total mean score ranging from 1-4. Higher scores reflect greater (i.e., more favorable) perceived behavioral control.	Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in School Implementation Citizenship Behaviors	The School Implementation Citizenship Behaviors Scale (S-ICBS) includes 15 items and measures clinicians' perceptions of how school staff engage with evidence-based practices in their specific school context. There are 4 subscales: (1) helping others; (2) keeping informed; (3) taking initiative; and (4) advocacy. Subscale and total scores are mean scores of items with a range of 0-4. Higher scores reflect greater (i.e., more favorable) implementation citizenship behavior.	Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up
Change in Intentions to Implement	The Modified Intentions to Use Scale has 9 items assessing school mental health providers' intentions to implement evidence-based practices. A total mean score is computed with a range of 0-4 and higher scores indicate more favorable intentions. Two versions of this scale were administered. At baseline, all providers were asked about general intentions to implement evidence-based practices. After training, clinicians were asked about intentions to implement the specific intervention for which they had received training.	Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up

Collaborators and Investigators

• Sponsor: University of Washington
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Aaron R Lyon, PhD, University of Washington

Publications and helpful links

General Publications

• Lyon AR, Cook CR, Duong MT, Nicodimos S, Pullmann MD, Brewer SK, Gaias LM, Cox S. The influence of a blended, theoretically-informed pre-implementation strategy on school-based clinician implementation of an evidence-based trauma intervention. Implement Sci. 2019 May 30;14(1):54. doi: 10.1186/s13012-019-0905-3.

Study record dates

Study Major Dates

• Study Start (Actual): August 15, 2016
• Primary Completion (Actual): July 31, 2018
• Study Completion (Actual): July 31, 2018

Study Registration Dates

• First Submitted: December 21, 2018
• First Submitted That Met QC Criteria: December 29, 2018
• First Posted (Actual): January 2, 2019

Study Record Updates

• Last Update Posted (Actual): January 2, 2019
• Last Update Submitted That Met QC Criteria: December 29, 2018
• Last Verified: December 1, 2018

More Information

Terms related to this study

• Keywords: implementation strategy; pre-implementation intervention; individual-level barriers
• Other Study ID Numbers: 52139; 1R21MH108714 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No