Remote Training in Rural Schools
Condition: Behavior Disorders
MeSH terms: Mental Disorders
Study type: Interventional

Summary: 
      Rural areas have fewer, and less well trained, health care providers than non-rural areas.
      Schools have become more involved in the delivery of mental health services and hold great
      potential for increasing access to children and adolescents. Innovations in training and
      service delivery are needed to improve mental health care quality and availability in rural
      schools. Evidence-based practices (EBPs) can be incorporated into school-wide multi-tiered
      systems that are currently used to improve school climate and safety. School-wide Positive
      Behavioral Interventions and Supports (PBIS), a service-delivery strategy based on the public
      health model is one example. Investigators will use an iterative process (Rapid Prototyping)
      to develop and evaluate the appropriateness, feasibility, acceptability, and preliminary
      efficacy of a remote training strategy that provides resources to support use of Tier 2 EBPs
      and effective support for care coordination practices in rural schools.
    


Intervention name(s): Coping Power Program (CPP); Cognitive behavioral therapy (CBT) for Anxiety Treatment in Schools (CATS); Check-in/Check-out (CI/CO)
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): CPP is an evidence-based intervention designed for students with externalizing behavior disorder. CPP consists of twelve 45-minute sessions. This EBP has been found to be effective at reducing aggressive behavior, covert delinquent behavior and substance abuse among aggressive boys, with gains maintained at one-year follow-up. Growth curve analyses showed that CPP had linear effects for three years after intervention on reductions in aggressive behavior and academic behavior problems.; CATS is an adaptation of Friends for Life (FRIENDS). The adapted protocol retains the core elements of evidence-based CBT for anxiety and the FRIENDS group format. Investigators implemented planned adaptations to the protocol based on collective experience. Changes were made to the language, cultural methods, number of sessions, and activities while maintaining the 5 essential components of the treatment. This resulted in a briefer (8-session) and more feasible, engaging and culturally appropriate protocol for urban under-resourced schools than the original FRIENDS.; CI/CO is a targeted, Tier 2 intervention for students at risk of developing externalizing and internalizing mental health disorders. CI/CO is designed to provide immediate feedback (i.e., at the end of each class period) to students, based on the use of a daily report card. This feedback is developmentally sensitive. CI/CO implementers meet individually with students for a brief 'check-in' in the morning and a brief 'check-out' in the afternoon. Research on the use of CI/CO has shown it to be effective in reducing externalizing and internalizing problems with elementary school students. CI/CO will be offered to individual students for a three-month period of time, which is the same time-frame needed for the implementation of CPP.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Positive-behavior Interventions and Supports; Evidence-based Practices; Tier 2; Mental Health; Rural Schools