TeamSTEPPS in School Mental Health

Adapting and Implementing TeamSTEPPS in School Mental Health

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based approach for teams that can be adapted for school mental health. TeamSTEPPS has been widely disseminated in health care settings with promising outcomes. TeamSTEPPS is designed to build competencies in the areas of leadership, situation monitoring, mutual support, and communication and has been associated with improvements in teamwork and communication as well as patient outcomes, such as decreased seclusion in psychiatric hospitals. This approach has yet to be extended as an implementation strategy in school or community mental health teams. If an evidence-based team approach like TeamSTEPPS can be successfully applied to school mental health teams, it could provide a cost-effective strategy for improving student mental health services and bolstering existing EBP implementation efforts, which to date generally have been insufficient in producing long-term clinician behavior change. In Aim 1 the investigators will capture key stakeholder perspectives about challenges in collocated school mental health services through formative work to inform collaborative planning and capacity building activities in Aim 2. Then, in Aim 2 the investigators will identify inter-organizational challenges and required components of TeamSTEPPS to adapt. The investigators will establish an advisory board and adapt TeamSTEPPS. The product of Aim 2 will be an adapted TeamSTEPPS, directed toward both school mental health and school-employed personnel, and specific, tailored implementation strategies to improve services in schools in conjunction with TeamSTEPPS. Finally, In Aim 3 the investigators will explore the feasibility, acceptability, and utility of TeamSTEPPS and the strategies generated in Aim 2 on inter-professional collaboration, teamwork, and student outcomes in eight schools.

Study Overview

• Status: Completed
• Conditions: Child Behavior Problem; Interprofessional Relations; Multidisciplinary Communication
• Intervention / Treatment: Behavioral: TeamSTEPPS

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • University of Pennsylvania

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Must be one of the following: mental health providers, teachers, leaders from schools (e.g., principals), leaders from community mental health agencies (i.e., executive directors, clinical supervisors), and leadership personnel from the payer or partner school district.

Exclusion Criteria:

• There are no exclusion criteria proposed for school and agency-employed personnel. Participants will not be excluded given their gender, demographics, and/or past experience.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Schools implementing TeamSTEPPS; Select schools will take a participatory approach to collaboratively identify solutions to challenges in collocated school-based mental health services based upon the feedback of stakeholders and use TeamSTEPPS to support mental health team-school collaboration.

Behavioral: TeamSTEPPS; TeamSTEPPS is an evidence-based approach for teams that can be adapted for school mental health. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), has been widely disseminated in health care settings with promising outcomes. TeamSTEPPS is designed to build competencies in the areas of leadership, situation monitoring, mutual support, and communication and has been associated with improvements in teamwork and communication as well as patient outcomes, such as decreased seclusion in psychiatric hospitals.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of Intervention Measure (FIM)	Reliable and validated 4-item tool to assess perceptions of the feasibility of an intervention (in this case, TeamSTEPPS training). Each item may be scored 1 = "completely disagree", 2 = "disagree", 3 = "neither agree nor disagree", 4 = "agree", or 5 = "completely agree." An overall mean score (possible score range from 1 to 5) across the 4 items is computed, where higher scores indicate more positive perceptions of intervention feasibility.	assessed immediately post-training in TeamSTEPPS (on average, 4 hours after completion of baseline measures)
Acceptability of Intervention Measure (AIM)	Reliable and validated 4-item observational tool to assess perceptions of the acceptability of an intervention (in this case, TeamSTEPPS training). Each item may be scored 1 = "completely disagree", 2 = "disagree", 3 = "neither agree nor disagree", 4 = "agree", or 5 = "completely agree." An overall mean score (possible score range from 1 to 5) across the 4 items is computed, where higher scores indicate greater perceptions of intervention acceptability.	assessed immediately post-training in TeamSTEPPS (on average, 4 hours after completion of baseline measures)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Oxford Non-Technical Skills (NOTECHS) Scale	Validated 4-item observational tool to assess teamwork and cognitive skills in teams. Items reflect team skills in leadership and management; teamwork and cooperation; problem-solving and decision making; and situational awareness. An observer codes team behavior in each domain using 3-5 items rated from 1 (Below Standard) to 4 (Excellent). An overall mean score, ranging from 1 to 4, is computed across items, where higher scores indicate stronger teamwork skills.	Assessed at baseline (i.e., on average, 1 week prior to training in TeamSTEPPS), immediately post-training in TeamSTEPPS (on average, 1 week after completion of baseline observation), and at 6- and 12-month follow-ups.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Expanded School Mental Health Collaboration Instrument (ESMHCI)	59-item tool to assess perceptions of aspects of collaboration between school professionals and mental health professionals from collaborating agencies on a continuous scale. An average score is calculated, with higher scores indicating strengths and lower scores indicating areas to consider improving or targeting. Responses for all items on the scale are measured on one of two, four-point Likert-type scales (1 = never to 4 = often for items related to Types of Collaboration; and 1 = strongly disagree to 4 = strongly agree for items related to Influences on Collaboration and Perceived Benefits of Collaboration). A mean total score is computed, with possible scores ranging from 1 to 4, with higher scores indicating stronger collaboration.	Assessed at baseline (i.e., pre-training in TeamSTEPPS) and and at 6- and 12-month follow-ups. Six- and 12-month follow-up scores were averaged to create a single follow-up score.
TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ)	Self-report measure of individual perceptions of group-level team skills and behavior. It is based upon the five core components of teamwork that comprise TeamSTEPPS, totaling 35 items. Items are rated continuously on a five-point scale from strongly disagree = 1 to strongly agree = 5. A mean total score is computed by averaging all items (possible score range = 1 to 5). Higher scores indicate more favorable perceptions of teamwork.	Assessed at baseline (i.e., pre-training in TeamSTEPPS) and at 6- and 12-month follow-ups. Six- and 12-month follow-up scores were averaged to create a single follow-up score.
TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ)	Self-report measure of individual attitudes related to the core components of teamwork captured within TeamSTEPPS. Six items measure each of the core teamwork constructs, for a total of 30 items. Items are rated continuously on a five-point scale from strongly disagree = 1 to strongly agree = 5. A mean total score is calculated across items with a possible score range of 1 to 5. Higher scores indicated more positive attitudes toward teamwork.	Assessed at baseline (i.e., pre-training in TeamSTEPPS) and at 6- and 12-month follow-ups. Six- and 12-month follow-up scores were averaged to create a single follow-up score.

Collaborators and Investigators

• Sponsor: University of Pennsylvania
• Investigators: Principal Investigator: Courtney Benjamin Wolk, PhD, University of Pennsylvania

Publications and helpful links

General Publications

• Kuriyan A, Kinkler G, Cidav Z, Kang-Yi C, Eiraldi R, Salas E, Wolk CB. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to Improve Collaboration in School Mental Health: Protocol for a Mixed Methods Hybrid Effectiveness-Implementation Study. JMIR Res Protoc. 2021 Feb 8;10(2):e26567. doi: 10.2196/26567.

Study record dates

Study Major Dates

• Study Start (Actual): May 23, 2022
• Primary Completion (Actual): April 30, 2024
• Study Completion (Actual): April 30, 2024

Study Registration Dates

• First Submitted: June 8, 2020
• First Submitted That Met QC Criteria: June 18, 2020
• First Posted (Actual): June 19, 2020

Study Record Updates

• Last Update Posted (Actual): November 12, 2025
• Last Update Submitted That Met QC Criteria: October 22, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: school-based mental health; TeamSTEPPS
• Additional Relevant MeSH Terms: Behavioral Symptoms; Problem Behavior
• Other Study ID Numbers: 834488

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: We will make data from our trial available for other researchers by uploading it to the National Clinical Trials Database. The proposed research will include data from 95 school mental health providers, teachers, and administrators and supervisors overseeing school mental health services in Philadelphia public schools. The final dataset will include quantitative (socio-demographic characteristics, school characteristics, outcomes, and contextual predictors of implementation) data. We will collect identifiers required to create a Global Unique Identifier (GUID) that will allow for inclusions in the National Database of Clinical Trials. We also will include recommended language in our consent forms related to obtain participant permission to upload their data to the National Database.
• IPD Sharing Time Frame: The descriptive data will be uploaded every six months during data collection periods of the study. All other data will be submitted at time of the publication of the manuscripts describing our main findings.
• IPD Sharing Access Criteria: Any data directly shared with other investigators would entail a data-use agreement, signed by the research team, our system partners, and the individual(s) requesting data, and that accounts for (1) commitment to using the data only for research and as outlined and approved in the agreement; (2) IRB approval at the host institution, (3) a plan for securing the data using appropriate technology, and (4) an agreed upon plan to destroy or return the data upon completion. In such cases, we will make the data and associated documentation available to users under our own auspices, such as by sending an encrypted hard-drive to users.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

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