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1.
Dev Psychol ; 60(2): 350-362, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38190215

RESUMEN

This article presents a short-term longitudinal study examining bidirectional associations between academic achievement and positive peer regard among Asian American and Latinx adolescents. Specifically, our investigation distinguished between positive peer regard within and across different ethnic groups in a diverse school setting. Three hundred and thirty-five middle school students (52.8% girls; 65% Asian American, 35% Latinx; assessment at the first time point Mage = 12.27 years, SD = 0.71) were followed across two consecutive school years. Participants completed a peer-nomination inventory assessing multiple dimensions of positive peer regard (i.e., reciprocal friendship, social acceptance, and respect), and grades were obtained from school records. Academic achievement was predictive of prospective positive peer regard received from same-ethnic peers only for Asian American adolescents. In contrast, academic achievement predicted prospective positive peer regard received from cross-ethnic peers only for Latinx adolescents. These results suggest that academic achievement was linked to social gains with peers from different ethnic backgrounds for Asian American and Latinx students. The findings underscore the importance of disentangling the sources of positive peer regard in multiethnic school environments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Éxito Académico , Femenino , Humanos , Adolescente , Niño , Masculino , Asiático , Estudios Longitudinales , Estudios Prospectivos , Grupo Paritario , Hispánicos o Latinos
2.
School Ment Health ; 15(1): 105-122, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35936515

RESUMEN

Group-based didactic training is a cornerstone implementation strategy used to support the adoption and delivery of evidence-based prevention programs (EBPP) by teachers in schools, but it is often insufficient to drive successful implementation. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a theory-based, motivational implementation strategy designed to increase the yield of EBPP training and consultation. The purpose of this study was to examine the longitudinal effects of BASIS-T on hypothesized mechanisms of behavior change (e.g., attitudes toward EBPP, self-efficacy, intentions to implement) and implementation and student outcomes associated with a well-established universal prevention program-the good behavior game (GBG). This pilot trial included 82 elementary school teachers from nine public elementary schools who were randomly assigned at the school-level to the BASIS-T (n = 43) or active comparison (n = 39) condition, with both conditions receiving training and consultation of the good behavior game by a third-party purveyor. Analyses included mixed-effects and multilevel growth modeling of adoption, mechanisms of behavior change, and student behavior outcomes. Meaningful effects were found favoring BASIS-T on immediate adoption of the GBG within the first month of school (74% vs. 40%) and self-efficacy (p < 0.05). These findings advance our understanding of the type of implementation strategies that complement pre-implementation training and post-training consultation in schools by identifying the importance of task self-efficacy as a mechanism of behavior change related to adoption for prevention programming. Supplementary Information: The online version contains supplementary material available at 10.1007/s12310-022-09536-z.

3.
Artículo en Inglés | MEDLINE | ID: mdl-36504561

RESUMEN

Background: Strategies to implement evidence-based interventions (EBIs) in children's mental health services have complex direct and indirect causal impacts on multiple outcomes. Ripple effects are outcomes caused by EBI implementation efforts that are unplanned, unanticipated, and/or more salient to stakeholders other than researchers and implementers. The purpose of the current paper is to provide a compilation of possible ripple effects associated with EBI implementation strategies in children's mental health services, to be used for implementation planning, research, and quality improvement. Methods: Participants were identified via expert nomination and snowball sampling. Online surveys were completed by 81 participants, each representing one of five roles: providers of mental health services to children or youth, researchers, policy makers, caregivers, and youth. A partially directed conventional content analysis with consensus decision making was used to code ripple effects. Results: Four hundred and four unique responses were coded into 66 ripple effects and 14 categories. Categories include general knowledge, skills, attitudes, and confidence about using EBIs; general job-related ripple effects; EBI treatment adherence, fidelity, and alignment; gaming the system; equity and stigma; shifting roles, role clarity, and task shifting; economic costs and benefits; EBI treatment availability, access, participation, attendance, barriers, and facilitators; clinical process and treatment quality; client engagement, therapeutic alliance, and client satisfaction; clinical organization structure, relationships in the organization, process, and functioning; youth client and caregiver outcomes; and use of EBI strategies and insights in one's own life. Conclusions: This research advances the field by providing children's mental health implementers, researchers, funders, policy makers, and consumers with a menu of potential ripple effects. It can be a practical tool to ensure compliance with guidance from Quality Improvement/Quality Assurance, Complexity Science, and Diffusion of Innovation Theory. Future phases will match potential ripple effects with salient children's mental health implementation strategies for each participant role.

4.
Psychol Sch ; 59(9): 1825-1843, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36060419

RESUMEN

Objectives: We conducted a mixed-method focus group study to (a) assess the appropriateness and likely effectiveness of strategies that target individual behavior change mechanisms associated with perceived barriers of lack of time and unsupportive leadership and (b) identify recommendations regarding strategies for overcoming the barriers. Method: Sample included 39 school-based staff (80% female, 77% White) across two districts in the Midwest. Mixed methods included a simultaneous approach. Results: Lack of time and supportive leadership continue to pervade school-based implementation efforts. Recommendations centered around the need for school leaders to give teachers the power to re-prioritize how they spend their time as well as providing protected, facilitated time for teachers to collaborate and learn practical skills targeting self-advocacy. Conclusion: Our findings provide compelling evidence for the use of implementation methodology to strategically target mechanisms of individual behavior change during the process of incorporating new and innovative practices in schools.

5.
School Ment Health ; 14(4): 951-966, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35464191

RESUMEN

Student-teacher relationships are important to student outcomes and may be especially pivotal at the high school transition and for minoritized racial/ethnic groups. Although interventions exist to improve student-teacher relationships, none have been shown to be effective among high school students or in narrowing racial/ethnic disparities in student outcomes. This study was conducted to examine the effects of an equity-explicit student-teacher relationship intervention (Equity-Explicit Establish Maintain Restore, or E-EMR) for high school teachers and students. A cluster-randomized pilot trial was conducted with 94 ninth grade teachers and 417 ninth grade students in six high schools. Teachers in three schools were randomized to receive E-EMR training and follow-up supports for one year. Teachers in three control schools conducted business as usual. Student-teacher relationships, sense of school belonging, academic motivation, and academic engagement were collected via student self-report in September and January of their ninth-grade year. Longitudinal models revealed non-significant main effects of E-EMR. However, there were targeted benefits for students who started with low scores at baseline, for Asian, Latinx, multicultural, and (to a lesser extent) Black students. We also found some unexpected effects, where high-performing and/or advantaged groups in the E-EMR condition had less favorable outcomes at post, compared to those in the control group, which may be a result of the equity-explicit focus of E-EMR. Implications and directions for future research are discussed.

6.
Dev Psychol ; 58(5): 963-976, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35298193

RESUMEN

In adolescence, being rejected by one's peers is positively associated with aggression. However, whether self-perceptions of being rejected or accepted by peers, and biases in these perceptions, are linked to aggression remains unclear, as the literature points to 2 perspectives: Youth are more likely to be aggressive when they (a) know or believe that they are rejected or (b) overestimate their acceptance. By addressing some of the limitations of prior studies, this study aimed to clarify how self-perceptions of status are related to concurrent and future aggression, and whether high levels of aggression are predictive of biased self-perceptions of acceptance and rejection. Data were collected in 2 consecutive school years from 572 high school students (Mage = 15.06, SD = .75; 55.4% girls). The ethnic/racial composition of the sample was 47.5% Asian, 43.1% Latino/Hispanic, 4.0% White, and 5.3% other. For well-liked youth, awareness of one's acceptance was positively associated with concurrent relational aggression, whereas for highly rejected youth, awareness of one's rejection was positively associated with concurrent overt aggression. Awareness of being rejected (i.e., high levels of both self-perceived and actual rejection) was associated with elevated levels of aggression over time. There was no evidence that youth with high levels of aggression had more biased perceptions of their status (concurrently or longitudinally) than youth with low levels of aggression. These findings help clarify how youth's status-related perceptions relate to the development of aggression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Asunto(s)
Agresión , Grupo Paritario , Adolescente , Etnicidad , Femenino , Humanos , Masculino , Autoimagen , Estudiantes
7.
J Youth Adolesc ; 50(6): 1268-1280, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33481133

RESUMEN

Dating relationships are normative in middle adolescence, but the academic and social implications of different types of dating involvement remains unclear. To address this gap, this longitudinal study evaluates the association between dating status (i.e., never date, rarely date, casually date, steady relationship) and academic and social functioning in a sample of adolescents. Across two school years, 455 adolescents (53.8% female; 56.5% Asian American, 43.5% Latinx; T1 Mage = 15.04 years) reported on their dating status and peers provided nominations of popularity and aggression. Grades and standardized test scores were obtained from school records. For Asian American youth, abstaining from dating was negatively associated with subsequent popularity. Casual dating and being in a steady relationship were associated with relational and overt peer aggression over time. Gender moderated this association, such that boys in steady relationships, and girls in casual relationships were more relationally aggressive one year later. Implications are discussed in terms of problem behavior theory and adolescent intersexual competition.


Asunto(s)
Conducta del Adolescente , Interacción Social , Adolescente , Agresión , Femenino , Humanos , Relaciones Interpersonales , Estudios Longitudinales , Masculino , Grupo Paritario
8.
Adm Policy Ment Health ; 48(3): 420-439, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-32940884

RESUMEN

A meta-analysis was conducted to examine the relative rates of youth mental health service utilization across settings among the general population and among those with elevated mental health symptoms or clinical diagnoses. Rates of school-based mental health were compared to outpatient, primary care, child welfare, juvenile justice, and inpatient. Nine studies presented rates of mental health service use for general-population youth in the U.S., and 14 studies presented rates for youth with elevated symptoms or clinical diagnoses. Random effects meta-analysis was used to calculate mean proportions of youth receiving care in each sector. Of general population youth, 7.28% received school mental health services. Rates for other sectors are as follows: 7.26% in outpatient settings, 1.76% in primary care, 1.80% in inpatient, 1.35% in child welfare, and 0.90% juvenile justice. For youth with elevated mental health symptoms or diagnoses, 22.10% of youth were served by school-based mental health services, 20.56% outpatient settings, 9.93% primary care, 9.05% inpatient, 7.90% child welfare, and 4.50% juvenile justice. Schools and outpatient settings are the most common loci of mental health care for both the general population and samples of youth with elevated symptoms or clinical diagnoses, although substantial amounts of care are also provided in a range of other settings. Results hold potential for informing resource allocation, legislation and policy, intervention development, and research. Given that mental health services are delivered across many settings, findings also point to the need for interconnection across child-serving sectors, particularly schools and outpatient clinics.


Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Adolescente , Niño , Protección a la Infancia , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Atención Primaria de Salud , Instituciones Académicas
9.
Prev Sci ; 22(6): 722-736, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33226575

RESUMEN

Training and consultation are core implementation strategies used to support the adoption and delivery of evidence-based prevention programs (EBPPs), but are often insufficient alone to effect teacher behavior change. Motivational interviewing (MI) and related behavior change techniques (e.g., strategic education, social influence, implementation planning) delivered in a group format offer promising supplements to training and consultation to improve EBPP implementation. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a theoretically informed, motivational implementation strategy delivered in a group format prior to and immediately after EBPP training. The purpose of this study was to examine the proximal effects of BASIS-T on hypothesized mechanisms of behavior change (e.g., attitudes, subjective norms, intentions to implement) in the context of teachers receiving training and consultation to implement the Good Behavior Game. As part of a pilot trial, 83 elementary school teachers from 9 public elementary schools were randomly assigned (at the school-level to reduce contamination across participants) to a BASIS-T (n = 44) or active comparison control (n = 39) condition, with both conditions receiving Good Behavior Game (GBG) training and consultation. A series of mixed effects models revealed meaningful effects favoring BASIS-T on a number of hypothesized mechanisms of behavior change leading to increased motivation to implement GBG. The implications, limitations, and directions for future research on the use of MI with groups of individuals and other behavior change techniques to increase the yield of training and consultation are discussed.


Asunto(s)
Personal Docente , Entrevista Motivacional , Humanos , Motivación , Maestros , Instituciones Académicas
10.
J Sch Health ; 90(12): 1004-1018, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33184887

RESUMEN

BACKGROUND: Student-teacher relationships are associated with the social and emotional climate of a school, a key domain of the Whole School, Whole Community, Whole Child Model. Few interventions target student-teacher relationships during the critical transition to high school, or incorporate strategies for enhancing equitable relationships. We conducted a mixed-methods feasibility study of a student-teacher relationship intervention, called Equity-Explicit Establish-Maintain-Restore (E-EMR). METHODS: We tested whether students (N = 133) whose teachers received E-EMR training demonstrated improved relationship quality, school belonging, motivation, behavior, and academic outcomes from pre- to post-test, and whether these differences were moderated by race. We also examined how teachers (N = 16) integrated a focus on equity into their implementation of the intervention. RESULTS: Relative to white students, students of the color showed greater improvement on belongingness, behavior, motivation, and GPA. Teachers described how they incorporated a focus on race/ethnicity, culture, and bias into E-EMR practices, and situated their relationships with students within the contexts of their own identity, the classroom/school context, and broader systems of power and privilege. CONCLUSIONS: We provide preliminary evidence for E-EMR to change teacher practice and reduce educational disparities for students of color. We discuss implications for other school-based interventions to integrate an equity-explicit focus into program content and evaluation.


Asunto(s)
Relaciones Interpersonales , Maestros , Estudiantes , Adolescente , Humanos , Proyectos Piloto , Instituciones Académicas
11.
Adm Policy Ment Health ; 47(4): 531-544, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-31938974

RESUMEN

Implementation of measurement-based care (MBC) by child-serving community mental health providers, particularly school-based providers, is low. To inform user-centered design of measurement feedback systems (MFSs) and MBC implementation more broadly, semi-structured interviews were conducted with 61 middle and high school students. Interviews explored student preferences for and perceived helpfulness of different assessment methods and use of MFS in counseling. Results indicate that student preference for digitally-administered assessment is equivocal, with preferences being influenced by student perceptions of the ease of use, impersonalization, and confidentiality. Students with exposure to the MFS found it helpful when used by their provider to share assessment feedback.


Asunto(s)
Retroalimentación Formativa , Informática Médica , Trastornos Mentales/diagnóstico , Estudiantes/psicología , Adolescente , Niño , Medicina Basada en la Evidencia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa , Estados Unidos , Adulto Joven
12.
Artículo en Inglés | MEDLINE | ID: mdl-33763536

RESUMEN

Research has produced a steady stream of evidence-based practices (EBP) that can promote youth behavioral health, but widespread implementation is often poor. To narrow the "science to practice gap," an implementation strategy was developed to enhance school-based mental health providers' intentions to implement EBP. The current study adopted a user-testing approach to inform the iterative development of this implementation strategy, which consisted of strategic education, social influence techniques, and motivational interviewing. Segments of the implementation strategy were demonstrated live for a representative sample of the intended audience. Participants rated each segment on acceptability, appropriateness, and likely impact on intentions to use EBP. Ratings were tallied in real time and presented to participants to spur discussion. Qualitative input was coded via conventional content analyses. Results indicated that that implementation strategies may need to be tailored to the specific EBP. In addition, implementation goal setting was well-received by some participants but not others, suggesting a difficulty of conducting motivational interviewing in group settings. Participants also perceived themselves as familiar with EBP and strong advocates of school mental health services. The paper concludes with a discussion of how this research has influenced the ongoing development of the strategy and implications for EBP implementation efforts.

13.
PLoS One ; 14(11): e0224363, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31697698

RESUMEN

This pilot quasi-experimental trial tested a gender-responsive cognitive behavioral group intervention with 87 court-involved female adolescents (5 juvenile courts) who were at indicated risk for substance use disorder. Participants in the intervention (n = 57) received twice weekly group sessions for 10 weeks (20 sessions) focused on building emotional, thought and behavior regulation skills and generalizing these skills to relationally-based scenarios (GOAL: Girls Only Active Learning). Youth in the control condition (n = 30) received services as usual, which included non-gender-specific aggression management training, individual counseling and no services. The GOAL program was found to be acceptable to youth and parents and feasible to implement within a juvenile court setting using skilled facilitators. Compared to services as usual, the program significantly and meaningfully reduced self-reported delinquent behavior (ß = 0.84, p < 0.05) over 6 months, and exhibited trend level effects for reduced substance use (ß = 0.40, p = 0.07). The program had mixed or no effects on family conflict and emotion regulation skills. These findings are discussed in light of treatment mechanisms and gender-responsive services.


Asunto(s)
Trastorno de Personalidad Antisocial/prevención & control , Cognición/fisiología , Emociones/fisiología , Trastornos Relacionados con Sustancias/prevención & control , Adolescente , Trastorno de Personalidad Antisocial/fisiopatología , Trastorno de Personalidad Antisocial/psicología , Conducta/fisiología , Niño , Conflicto Familiar/psicología , Femenino , Humanos , Aprendizaje/fisiología , Proyectos Piloto , Trastornos Relacionados con Sustancias/fisiopatología , Trastornos Relacionados con Sustancias/psicología
14.
J Youth Adolesc ; 48(11): 2165-2178, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31625069

RESUMEN

As American school districts become increasingly diverse, understanding the processes that promote positive intergroup relations is a critical task. The role of cross-ethnic friendships is one important factor, given the significance of these reciprocated peer relationships for social development. The current study examines the short-term longitudinal impact of cross-ethnic friendships on peer group attitudes and emotional adjustment. 524 student participants (54.8% female; Mage = 15.06 years, SD = 0.75; 47% Latino, 53% Asian-American) were followed for one year with two spring data collections. Students completed a self-report inventory assessing depressive symptoms and a peer nomination inventory assessed friendship, liking, disliking, popularity, and unpopularity. Cross-ethnic friendships were predictive of positive attitudes toward peers from other ethnic/racial groups and were also linked to declines in depressive symptoms for boys. Moreover, these positive effects did not come at a social cost, as cross-ethnic friendships were not associated with rejection by same-ethnic peers. Cross-ethnic friendships provide a unique environment that contributes to positive intergroup attitudes and beneficial socioemotional development for some youth.


Asunto(s)
Asiático/psicología , Depresión/psicología , Amigos/psicología , Hispánicos o Latinos/psicología , Distancia Psicológica , Identificación Social , Adolescente , Depresión/etnología , Femenino , Amigos/etnología , Humanos , Relaciones Interpersonales , Estudios Longitudinales , Masculino , Grupo Paritario , Influencia de los Compañeros , Estudiantes/psicología , Estados Unidos
15.
Implement Sci ; 14(1): 54, 2019 05 30.
Artículo en Inglés | MEDLINE | ID: mdl-31146788

RESUMEN

BACKGROUND: Individual-level implementation determinants, such as clinician attitudes, commonly influence the successful adoption of evidence-based practices, but few explicit strategies have been tested with regard to their ability to impact these key mechanisms of change. This paper reports on an initial test of a blended, theoretically informed pre-implementation strategy designed to target malleable individual-level determinants of behavior change. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a brief and pragmatic pre-implementation strategy that uses strategic education, social influence techniques, and group-based motivational interviewing to target implementation attitudes, perceived social norms, perceived behavioral control, and behavioral intentions to implement among mental health clinicians working in the education sector. METHODS: As part of a pilot trial, 25 school mental health clinicians were randomized to BASIS (n = 12) or an attention control placebo (n = 13), with both conditions receiving training and consultation in an evidence-based intervention for youth experiencing trauma (the Cognitive Behavioral Intervention for Trauma in Schools). Theorized mechanisms of change (attitudes, perceived social norms, perceived behavioral control, and behavioral intentions) were assessed at baseline, post-training, and 4-month follow-up. Clinician participation in post-training consultation and intervention adoption were also tracked. RESULTS: A series of regression models and independent sample t tests indicated that BASIS had significant, medium to large effects on the majority of its proximal mechanisms from baseline to post-training. BASIS was also associated with a greater latency between initial training in the intervention and discontinuation of participation in post-training consultation, with clinicians in the BASIS condition persisting in consultation for an average of 134 days versus 32 days for controls, but this difference was not statistically significant. At 4-month follow-up, most differences in the theorized mechanisms had attenuated, and approximately the same small number of BASIS clinicians adopted the trauma intervention as controls. CONCLUSION: Findings suggest that the brief BASIS pre-implementation strategy had a significant influence on its proximal mechanisms of change, but that these changes did not persist over time or translate into adoption of the trauma intervention. Implications for theory refinement, revisions to the BASIS protocol, and next steps for research surrounding individual-level implementation strategies are discussed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03791281 . Registered 31 December 2018-Retrospectively registered.


Asunto(s)
Actitud del Personal de Salud , Práctica Clínica Basada en la Evidencia , Personal de Salud/educación , Servicios de Salud Mental/organización & administración , Servicios de Salud Escolar/organización & administración , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Entrevista Motivacional , Proyectos Piloto , Proyectos de Investigación , Estados Unidos
16.
Sch Psychol ; 34(2): 212-221, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30489118

RESUMEN

Despite research demonstrating the importance of student-teacher relationships for student functioning, little is known about strategies to enhance such relationships, particularly in secondary school. The current study examined effects of a professional development for middle school teachers on the Establish-Maintain-Restore (EMR) approach. EMR aims to enhance teachers' skills in cultivating relationships with students and involves brief training (3 hr) and ongoing implementation supports. In a randomized controlled trial, 20 teachers and 190 students were assigned to EMR or control. Observers rated academically engaged time and disruptive behavior, and teachers reported on relationship quality. Multilevel models showed that EMR resulted in significant improvements in student-teacher relationships (Hedge's g = .61, 95% CI [0.21, 1.02]), academically engaged time (g = .81, 95% CI [0.01, 1.63]), and disruptive behavior (g = 1.07, 95% CI [0.01, 2.16]). Results indicate potential promise for EMR. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Conducta del Adolescente/psicología , Conducta Infantil/psicología , Relaciones Interpersonales , Problema de Conducta/psicología , Competencia Profesional , Maestros/psicología , Instituciones Académicas , Estudiantes/psicología , Formación del Profesorado/métodos , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino
17.
Implement Sci ; 13(1): 24, 2018 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-29415749

RESUMEN

BACKGROUND: Integrated healthcare delivered by work groups in nontraditional service settings is increasingly common, yet contemporary implementation frameworks typically assume a single organization-or organizational unit-within which system-level processes influence service quality and implementation success. Recent implementation frameworks predict that inter-organizational alignment (i.e., similarity in values, characteristics, activities related to implementation across organizations) may facilitate the implementation of evidence-based practices (EBP), but few studies have evaluated this premise. This study's aims examine the impact of overlapping organizational contexts by evaluating the implementation contexts of externally employed mental health clinicians working in schools-the most common integrated service delivery setting for children and adolescents. Aim 1 is to estimate the effects of unique intra-organizational implementation contexts and combined inter-organizational alignment on implementation outcomes. Aim 2 is to examine the underlying mechanisms through which inter-organizational alignment facilitates or hinders EBP implementation. METHODS/DESIGN: This study will conduct sequential, exploratory mixed-methods research to evaluate the intra- and inter-organizational implementation contexts of schools and the external community-based organizations that most often employ school-based mental health clinicians, as they relate to mental health EBP implementation. Aim 1 will involve quantitative surveys with school-based, externally-employed mental health clinicians, their supervisors, and proximal school-employed staff (total n = 120 participants) to estimate the effects of each organization's general and implementation-specific organizational factors (e.g., climate, leadership) on implementation outcomes (fidelity, acceptability, appropriateness) and assess the moderating role of the degree of clinician embeddedness in the school setting. Aim 2 will explore the mechanisms through which inter-organizational alignment influences implementation outcomes by presenting the results of Aim 1 surveys to school-based clinicians (n = 30) and conducting semi-structured qualitative interviews. Qualitative data will be evaluated using an integrative inductive and deductive approach. DISCUSSION: The study aims are expected to identify intra- and inter-organizational constructs that are most instrumental to EBP implementation success in school-based integrated care settings and illuminate mechanisms that may account for the influence of inter-organizational alignment. In addition to improving school-based mental health, these findings will spur future implementation science that considers the relationships across organizations and optimize the capacity of implementation science to guide practice in increasingly complex systems of care.


Asunto(s)
Atención a la Salud , Práctica Clínica Basada en la Evidencia/organización & administración , Servicios de Salud Mental/organización & administración , Salud Mental , Adolescente , Niño , Femenino , Humanos , Liderazgo , Masculino , Innovación Organizacional
18.
Cognit Ther Res ; 40(5): 705-716, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27795599

RESUMEN

This study tested potential moderators and mediators of an indicated depression prevention program for middle school students, Positive Thoughts and Actions (PTA). Participants were 120 students randomly assigned to PTA, or a brief, individually administered supportive intervention (Individual Support Program, or ISP). Youths completed measures of depressive symptoms at baseline, post-intervention, and 12-month follow-up. Hierarchical regression was used to test three moderators-ethnic minority status, gender, and baseline depressive symptoms-and three mediators representing functional outcomes targeted by PTA-parent-child communication, attitude towards school, and health behavior. Ethnic minority status did not moderate PTA effects at post-intervention but did moderate PTA effects at 12-month follow-up. At 12 months, PTA appeared to be more effective for White participants than ethnic minority youth. Follow-up analyses suggested this moderation effect was due to the tendency of ethnic minority youth, especially those with fewer symptoms at baseline, to drop out by 12 months. Neither gender nor baseline depressive symptoms moderated the effects of PTA. Although PTA improved health behavior and attitudes toward school, there was no evidence that any of these functional outcomes measured mediated the impact of PTA on depressive symptoms. Future directions are discussed.

19.
Int J Ment Health Promot ; 18(1): 19-63, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27441029

RESUMEN

Evidence-based assessment (EBA) comprises the use of research and theory to select methods and processes that have demonstrated reliability, validity, and clinical usefulness for prescribed populations. EBA can lead to positive clinical change, and recent work has suggested that it is perceived to be useful by school mental health providers. However, virtually nothing is known about student perceptions of assessment use. Semi-structured interviews were conducted with 31 ethnically diverse middle and high school students (71% female) receiving mental health services in school-based health centers. Findings indicated that the majority of students found assessments to be useful, and perceived three primary functions of assessments: structuring the therapy session, increasing students' self-awareness, and improving communication with the provider. Barriers to acceptability were also found for a minority of respondents. Some students found the nature of standardized assessments to be confining, and others expressed that they wanted more feedback from their counselors about their responses. Idiographic assessments demonstrated especially high acceptability in this sample, with students reporting that tracking idiographic outcomes increased self-awareness, spurred problem-solving, and helped them to reach behavioral goals. Implications for school mental health service improvements are discussed.

20.
J Youth Adolesc ; 45(9): 1786-99, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27138174

RESUMEN

Adolescents who have been exposed to violence in the community often experience subsequent difficulties with academic achievement. Because competence in the classroom is a salient developmental task during the adolescent years, outcomes in this critical context can then have broader implications for social and psychological functioning. In the current study, we tested a hypothesized progression in which the association between violence exposure and deficient achievement is presumed to potentiate friendships with academically disengaged peers. We followed 415 urban adolescents (53 % girls; average age of 14.6 years) for a one-year period, with two annual assessment of psychosocial functioning. Exposure to violence in the community and academic engagement were assessed with a self-report inventory; reciprocated friendships were assessed with a peer interview; and achievement was indexed based on a review of school records. Consistent with our hypotheses, neighborhood violence was associated with deficient classroom achievement. Poor achievement, in turn, mediated associations between community violence exposure and low academic engagement among friends. Our findings highlight pathways though which exposure to community violence potentially predicts later dysfunction.


Asunto(s)
Fracaso Escolar , Exposición a la Violencia/psicología , Grupo Paritario , Características de la Residencia , Adolescente , Agresión/psicología , Femenino , Amigos/psicología , Humanos , Los Angeles , Masculino , Factores de Riesgo , Instituciones Académicas , Autoinforme , Ajuste Social , Encuestas y Cuestionarios , Población Urbana
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