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ViewAttendees 5

Symposia

Dissemination & Implementation Science

Session: Multilevel Determinants of Evidence-Based Practice Implementation: From the Structural to the Individual

1 - (SYM 96) a Pragmatic, Pre-implementation Strategy Targeting Front-line Practitioner Implementation Intentions and Behaviors: Results from a Randomized Trial

Saturday, November 18, 2023
2:30 PM – 4:00 PM PST
Location: Sol Duc (708). Level 7



Background: Focusing on individual-level mechanisms of behavior change may be a parsimonious approach to augment standard implementation supports (training, consultation). Schools are the most common setting for youth mental healthcare, but evidence-based practices are infrequently delivered. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a pragmatic (4-hour), multifaceted implementation strategy that precedes training and consultation and targets mechanisms derived from the Theory of Planned Behavior (attitudes, social norms, self-efficacy, intentions) to enhance implementation outcomes (e.g., adoption). This session will present data from a randomized type 2 effectiveness-implementation trial comparing BASIS to an attention control (AC) to support implementation of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in schools.



Methods: Data were collected from N=130 school-based mental health providers across 6 timepoints from baseline to 1-month post-BASIS delivery and TF-CBT training. Participants were mostly white (87%) and female (92%) and were randomly assigned to BASIS (n=63) or AC (n=67) using nearest neighbor matching on baseline mechanisms (e.g., self-efficacy) and other characteristics. Piecewise mixed effects models tested for average differences between conditions post-training, rates of change during training, and rates of change from training to 1-month follow-up.



Results: Attitudes toward EBPs, self-efficacy, and intentions to implement significantly increased during training, and significantly decreased after training. Social norms did not change after training but decreased between training and follow-up. There were no differences between conditions on rates of change during or after training, or on average scores post-training. Adoption/use of TF-CBT within a month of training was not statistically different between groups, with 24% of BASIS and 32% of AC administering a screening instrument to at least one student, and 14% of BASIS and 16% of AC beginning TF-CBT with at least one student. Additional analyses will extend findings over a 12-month period.



Conclusion: BASIS is intended to isolate individual-level mechanisms of implementation. The current findings suggest that BASIS did not significantly influence its proximal mechanisms or on TF-CBT adoption at one month. Results will be discussed in the context of prior studies of the brief BASIS pre-implementation strategy, which have shown significant effects on implementation mechanisms and outcomes.