The implementation of the Supportive Parents – Coping Kids (SPARCK) parent training intervention is being rigorously examined to determine its effectiveness in preventing and reducing negative mental health outcomes in children. This study, conducted across 24 municipalities in Norway, aims to understand the factors that contribute to successful implementation of SPARCK within real-world settings.
Study Design and Objectives
This research employs a hybrid effectiveness-implementation type 2 trial design, integrating a randomized controlled trial (RCT) with an implementation study. The primary goal is to investigate the relationships between implementation determinants and key implementation outcomes such as fidelity, acceptability, appropriateness, and feasibility of the SPARCK intervention. Researchers hypothesize that positive ratings of implementation determinants will correlate with better implementation and clinical outcomes for both parents and children.
The study also explores whether practitioners and leaders from municipalities involved in the co-creation of SPARCK exhibit higher initial levels of organizational readiness compared to those from municipalities directly recruited to the RCT. Furthermore, the specific implementation strategies used, modified, or omitted during the trial will be documented and analyzed.
Methodology and Data Collection
Data collection involves a quantitative longitudinal web-based survey administered at three time points to SPARCK practitioners and their leaders. The first data collection occurred during the intervention's initiation in 2023, followed by subsequent collections after approximately one and two years. Parent-reported data on child symptoms and parent-child interaction from the RCT will also be included to assess clinical outcomes.
The study includes 44 practitioners and approximately 80 municipal leaders from diverse municipalities across Norway. These participants are involved in frontline mental health services, including healthcare, school health services, and child welfare services. The municipalities were selected to represent a range of sizes, demographics, and urbanicity.
Theoretical Framework and Measures
The study is guided by several established implementation frameworks, including the Consolidated Framework for Implementation Research (CFIR), Organizational Readiness theory, Proctor's Implementation Outcomes Framework, and the Implementation Research Logic Model (IRLM). These frameworks provide a structured approach to identifying and assessing potential barriers and facilitators to implementation.
Measures include the Fidelity Questionnaire (FidQ) to assess practitioners' adherence to SPARCK, the Acceptability of Intervention Measure (AIM), the Intervention Appropriateness Measure (IAM), and the Feasibility of Intervention Measure (FIM) to evaluate implementation outcomes. Implementation determinants are measured using the Organizational Readiness for Implementing Change (ORIC) scale and the Implementation Determinants Measure (IDM), which assesses factors influencing successful implementation.
Data Analysis
Data analysis will utilize multilevel models (MLM) to account for the hierarchical structure of the data, with families nested within practitioners and leaders, who are in turn nested within municipalities. This approach will allow researchers to investigate the relationships between implementation determinants, implementation outcomes, and clinical outcomes while considering the influence of different levels of the system. Intraclass correlation coefficients (ICC) and design effects will guide decisions regarding modeling strategies.
This comprehensive study aims to provide valuable insights into the implementation of SPARCK, contributing to improved clinical outcomes, better contextual fit, and reduced time lag between research findings and their application in practice.
