Browsing by Subject "implementation science"

Now showing 1 - 3 of 3
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    ADVANCING TAILORED IMPLEMENTATION OF EVIDENCE-BASED PRACTICE IN SCHOOL MENTAL HEALTH
    (2022-05) Larson, Madeline
    Approximately 1 in 5 youth aged 8–18 experiences a mental health problem (e.g., anxiety, depression, conduct, trauma) that requires mental health services; however, only about half receive evidence-based services, 70-80% of which are received in schools. There is an urgent need to address the implementation gap that limits youth access to quality mental health services and compromises longer term youth mental health outcomes. Improving mental health service implementation in schools requires the development and use of effective implementation strategies tailored to address context-specific barriers. Currently, implementation strategies are often selected based on a one-size-fits-all approach; however, to increase the likelihood that they will exert their desired effect, there is a need to use evidence-based knowledge and include participatory involvement of stakeholders to select and adapt strategies that are matched to site-specific barriers and deemed feasible for use in a given setting. The purpose of this development study was to engage school-based stakeholders in mixed method inquiry that facilitated the design of an implementation facilitation approach, the Facilitated Implementation Tailoring (FIT) technique. Our findings highlight the need to engage end-users at the outset of implementation strategy design. While all stakeholders welcomed the use of facilitation for school-based implementation efforts, several major and minor revisions to the FIT strategy were recommended following synthesis of stakeholder. Major revisions recommended included using a flexible yet structured “Pick-and-Choose" model that was comprehensive yet not over packaged to respond to stakeholders’ preferences and based needs. In addition, minor changes were suggested. Implications for theory and practice as well as limitations and future research are discussed.
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    Exploring Determinants of Early Childhood Special Educators' Practice Selections for Young Children with Autism Spectrum Disorder
    (2020-07) Hugh, Maria
    Evidence-Based Practices (EBPs) can only improve children's outcomes when implemented. There is much to still learn about Early Childhood Special Education (ECSE) teachers' implementation of EBPs when it comes to their selection and use of practices to facilitate social communication development for children with autism spectrum disorder (ASD). Understanding what practices teachers consider for use can inform the development of implementation supports at the initial Exploration and Adoption-Decision stages of implementation. To detect malleable determinants of practice selection, this study addressed these aims: (a) identify ECSE teachers' familiarity and current use of EBPs and unsubstantiated practices, (b) identify their practice selections, and (c) determine whether teachers' beliefs predicted practice selections. A web-based survey gathered responses from 222 ECSE teachers related to these objectives. Overall, teachers' familiarity with and current use of EBPs and unsubstantiated practices varied. Most teachers were highly familiar with and often used certain EBPs (e.g., reinforcement), and fewer teachers used others despite familiarity (e.g., discrete trial teaching). Aligned with the Theory of Planned Behavior, the researcher ascertained teachers' beliefs (self-efficacy, attitude, subjective norms) about EBPs. Teachers' had the most positive overall beliefs for naturalistic intervention and least for discrete trial teaching. The researcher used Discrete Choice Analysis, a method of exploring individuals' choices, to investigate teachers' selection decisions, and to find that beliefs predicted their practice selections. Together, these findings suggest that there are individual determinants of practice selection that can be acted on by tailoring preimplementation supports to improve implementation from the start.
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    Using Implementation Science to Improve Adoption of Curriculum-Based Assessments Among Early Childhood Teachers
    (2023-06) Selameab, Tehout
    Despite the importance of child assessment data in early childhood education, teachers struggle with its use in their work. This study uses an implementation science approach to explore facilitators and barriers to teacher use of child assessment practices in three Head Start centers and tests a specific strategy to improve teacher practice. This study explores two research questions: (1) How do teachers perceive their current assessment practices in terms of use and level of difficulty? What do teachers believe about child assessment practices? How do teachers perceive their use of child assessment data for individualizing instruction? What do organizational leaders believe are the individual and organizational level facilitators and barriers related to child assessment practices? (2) What is the impact of employing one specific implementation strategy identified by teacher/center leaders on the quality of teacher-child assessment practices? Data was generated from 43 teacher surveys, 7 interviews with center leaders, and an audit of child assessment data entered by 16 teachers in the study sites. The study found that teachers report they are skilled in completing child observations, collecting observation data, entering data into an assessment database, and using data for lesson planning. Teachers are less confident in choosing a developmental level for each child. Most teachers in the study trust their judgment of student progress more than assessment, but many also consider assessment practices part of their professional responsibility. Teachers were less likely to agree that assessment practices benefit their students, make their jobs easier or were supported by their coworkers. Head Start leaders revealed several organizational-level facilitators of teacher assessment practices, including policies requiring assessment and mandated organizational support, such as financial resources for ongoing professional development, technology solutions, and compliance practices that keep assessment practices in place. Individual-level facilitators that support teacher assessment practices include an educated workforce with long tenures and commitment to the classroom. Barriers to teacher adoption of child assessment practices reported by leaders include English language comprehension of complex child development concepts, insufficiently protected time, a high volume of required observation data, and teaching team incompatibility. A few leaders felt assessment practices were inconsistent with this local Head Start's organizational culture around relationships. Teachers and leaders in this study hypothesized that a lower data volume would help improve teacher assessment practices. This feedback inspired a small-scale study where the required data was halved for three months. An audit process of child observation records assessed four data quality elements of child assessment data completed by teachers before and after the reduction in required data. Teachers completed the first three elements in both pre-and post-intervention periods, with similar average scores. The individualization of observation notes showed modest improvement between pre-and post-intervention periods. The overall average score for all data quality elements increased slightly from 30.0 (pre-intervention) to 32.7 (post-intervention). This study provides Head Start leadership with targeted data for decision-making. This study demonstrates how implementation science frameworks and evaluative thinking can be used to tackle practical problems in complex settings. Following a systematic assessment of known implementation facilitators and barriers, this study piloted a specific implementation strategy for improving teacher practice and generated targeted data for improving teacher practice. Replicating the approach used in this study –the use of targeted studies of specific implementation strategies – will improve teacher use of child assessment practices.