Beliefs and Attitudes for Successful Implementation in Schools (BASIS)

Study Overview
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Brief Summary
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The goal of this study is to adapt and test the feasibility and potential efficacy of a theory-driven pre-implementation intervention to address individual-level barriers to EBP implementation - Beliefs and Attitudes for Successful Implementation in Schools (BASIS) - designed to improve school mental health providers' implementation of EBPs. BASIS is intended to be a feasible and scalable first-line or adjunctive implementation enhancement intervention that is facilitative of other efforts (e.g., organizational interventions) that target high quality EBP implementation. Aims of this study are to: (1) Adapt an existing, theory-driven implementation intervention (BASIS), previously used with educators, to improve the EBP implementation behaviors of school mental health providers; and (2) Assess the viability of a later clinical trial by: (a) establishing the feasibility, acceptability, and appropriateness of the BASIS intervention among school mental health providers, and (b) Pilot testing BASIS, as compared to an Attention Control, delivered as pre-implementation intervention prior to training in a specific, existing EBP. Key organizational factors (e.g., implementation climate) will also be evaluated and included as covariates and we will explore trends in the data to inform the design of a larger trial. Ultimately, BASIS offers an innovative and scalable approach to improving school mental health providers' uptake and use of EBPs in order to increase the number of youth with mental health problems who receive high quality services.

Official Title
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Beliefs and Attitudes for Successful Implementation in Schools (BASIS)

Conditions
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Intervention Adoption, Implementation

Intervention / Treatment
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* Behavioral: BASIS
* Behavioral: Attention Control


Participation Criteria
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Eligibility Criteria
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Inclusion: School mental health providers (school psychologists, school social workers, etc.) recruited from middle and high schools in two economically and ethnically diverse districts in the Seattle area.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: BASIS<br>Received a 3-hour BASIS implementation strategy. | Behavioral: BASIS<br> <br> |
| Active Comparator: Attention Control<br>Received a 3-hour session designed to control for dose, information provided, and presenter effects. | Behavioral: Attention Control<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Attitudes toward Evidence-Based Practices | Evidence-Based Practice Attitudes Scale (EBPAS) is a widely used 26-item tool designed to assess evidence-based practice (EBP) attitudes with items measured on a 0-4 scale and 6 subscales: (1) likelihood of adopting if the EBP were a requirement; (2) likelihood of adopting if the EBP were appealing to you; (3) openness to new practices; (4) perceived divergence between current practices and EBPs; (5) fit of EBPs with current practices; and (6) burden of EBPs. Subscale and total scores are mean scores of items with a range of 0-4. Higher scores reflect more favorable attitudes (perceived divergence is reverse-coded). | Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up | 
| Change in Subjective Norms | Subjective Norms Scale is based on Theory of Planned Behavior (TPB) constructs. Two subscales measure two types implementation-related subjective norms: injunctive norms and descriptive norms. Four items load on each subscale and mean score range from -3 to +3, with positive scores reflecting more positive subjective injunctive and descriptive norms. | Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up | 
| Change in Perceived Behavioral Control | Perceived Behavioral Control Scale is a modified version of the Teacher's Self-Efficacy Scale, which has 10 items assessing perceived behavioral control in implementing evidence-based practices. Items are scored on a 1-4 scale with a total mean score ranging from 1-4. Higher scores reflect greater (i.e., more favorable) perceived behavioral control. | Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in School Implementation Citizenship Behaviors | The School Implementation Citizenship Behaviors Scale (S-ICBS) includes 15 items and measures clinicians' perceptions of how school staff engage with evidence-based practices in their specific school context. There are 4 subscales: (1) helping others; (2) keeping informed; (3) taking initiative; and (4) advocacy. Subscale and total scores are mean scores of items with a range of 0-4. Higher scores reflect greater (i.e., more favorable) implementation citizenship behavior. | Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up | 
| Change in Intentions to Implement | The Modified Intentions to Use Scale has 9 items assessing school mental health providers' intentions to implement evidence-based practices. A total mean score is computed with a range of 0-4 and higher scores indicate more favorable intentions. Two versions of this scale were administered. At baseline, all providers were asked about general intentions to implement evidence-based practices. After training, clinicians were asked about intentions to implement the specific intervention for which they had received training. | Pre-intervention/baseline, post-intervention (1-2 weeks), 4-month follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pre-implementation intervention, implementation strategy, individual-level barriers