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

Not Applicable
Recruiting
Conditions
Mental Health Issue
Interventions
Behavioral: EIS Only
Behavioral: EIS + ECHO
Registration Number
NCT06047041
Lead Sponsor
University of Virginia
Brief Summary

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.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
21350
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
EIS OnlyEIS OnlyEIS Only (active comparator) condition schools involve technical assistance to support the implementation EIS.
EIS + ECHOEIS + ECHOEIS + ECHO (experimental) condition involves all of the activities included in the "EIS Only" condition and will include enhanced implementation supports. Enhanced implementation supports involve 1) monthly collaborative learning ECHO sessions for school student support team staff to support implementation of EIS and evidence-based mental and behavioral health practices and 2) individual school teams will also receive follow-up supports to promote the implementation strategies presented during ECHO sessions.
Primary Outcome Measures
NameTimeMethod
Change in staff knowledge of evidence-based school mental health practices as measured by the Perceptions of Response To Intervention Skills Survey2 time points (over 9 months)

Staff perceptions of the skills they possess related to evidence-based screening, monitoring, and intervention will be measured using a modified version of the Perceptions of Response To Intervention Skills Survey - Revised (PRSS; α \> .90 for all factors). Response options range from not skilled (1) to very highly scaled (5).

Change in schoolwide school mental health implementation outcomes as measured by the School-wide Evaluation Tool2 time points (over 9 months)

The School-Wide Evaluation Tool (SET; Sugai et al., 2001) measure the implementation of evidence-based programs within a tiered system. The SET measures school-wide activities related to the implementation of school mental health systems, targeted interventions, and individualized interventions. A trained assessor will track implementation of evidence-based programs in both conditions.

Change in staff burnout as measured by the Maslach Burnout Inventory2 time points (over 9 months)

Maslach Burnout Inventory (MBI; Maslach \& Jackson, 1981). Measures staff experiences of emotional exasperation and fatigue. Staff will complete the emotional exhaustion factor from the MBI - Educators Survey (MBI-ES, α \> .80; Wheeler et a., 2011). Response options range from never (0) to daily (6).

Change in schoolwide school mental health implementation outcomes as measured by the Individual School-wide Evaluation Tool2 time points (over 9 months)

The Individual Student Systems Evaluation Tool (ISSET; Debnam, Pas, \& Bradshaw, 2012) measures the implementation of evidence-based programs within a tiered system. The ISSET measures foundations, targeted interventions, and individualized interventions. A trained assessor will track implementation in both conditions.

Change in youth mental health measured by the Early identification System2 time points (over 9 months)

De-identified, student-level behavioral data collected via the Early Identification System. The measure is a psychometrically validated mental and behavioral health screening system measuring domains including attention problems, internalizing problems, and externalizing problems.

Change in staff behaviors of evidence-based school mental health practices as measured by the Perceptions of Practices Survey2 time points (over 9 months)

Perceptions of Practices Survey (PPS; Castillo et al., 2016) measures the extent to which schools implement evidence-based screening, intervention, and progress monitoring practices to support student mental health (α = .96 for the behavior factor; Marshall, 2016). Staff will indicate on a 5-point scale how frequently the practice occurred in their school.

Secondary Outcome Measures
NameTimeMethod
Number of students with disciplinary referrals2 time points (over 12 months)

De-identified data on school on student discipline referrals will be measured across treatment conditions.

Student grades2 time points (over 12 months)

De-identified data on school on student academic achievement will be measured across treatment conditions.

Trial Locations

Locations (3)

University of Missouri

🇺🇸

Columbia, Missouri, United States

University of South Carolina

🇺🇸

Columbia, South Carolina, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

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