TeamSTEPPS in School Mental Health

Study Overview
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Brief Summary
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Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based approach for teams that can be adapted for school mental health. TeamSTEPPS has been widely disseminated in health care settings with promising outcomes. TeamSTEPPS is designed to build competencies in the areas of leadership, situation monitoring, mutual support, and communication and has been associated with improvements in teamwork and communication as well as patient outcomes, such as decreased seclusion in psychiatric hospitals. This approach has yet to be extended as an implementation strategy in school or community mental health teams. If an evidence-based team approach like TeamSTEPPS can be successfully applied to school mental health teams, it could provide a cost-effective strategy for improving student mental health services and bolstering existing EBP implementation efforts, which to date generally have been insufficient in producing long-term clinician behavior change. In Aim 1 the investigators will capture key stakeholder perspectives about challenges in collocated school mental health services through formative work to inform collaborative planning and capacity building activities in Aim 2. Then, in Aim 2 the investigators will identify inter-organizational challenges and required components of TeamSTEPPS to adapt. The investigators will establish an advisory board and adapt TeamSTEPPS. The product of Aim 2 will be an adapted TeamSTEPPS, directed toward both school mental health and school-employed personnel, and specific, tailored implementation strategies to improve services in schools in conjunction with TeamSTEPPS. Finally, In Aim 3 the investigators will explore the feasibility, acceptability, and utility of TeamSTEPPS and the strategies generated in Aim 2 on inter-professional collaboration, teamwork, and student outcomes in eight schools.

Official Title
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Adapting and Implementing TeamSTEPPS in School Mental Health

Conditions
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Child Behavior Problem, Multidisciplinary Communication, Interprofessional Relations

Intervention / Treatment
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* Behavioral: TeamSTEPPS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must be one of the following: mental health providers, teachers, leaders from schools (e.g., principals), leaders from community mental health agencies (i.e., executive directors, clinical supervisors), and leadership personnel from the payer or partner school district. Exclusion Criteria: There are no exclusion criteria proposed for school and agency-employed personnel. Participants will not be excluded given their gender, demographics, and/or past experience.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Schools implementing TeamSTEPPS<br>Select schools will take a participatory approach to collaboratively identify solutions to challenges in collocated school-based mental health services based upon the feedback of stakeholders and use TeamSTEPPS to support mental health team-school collaboration. | Behavioral: TeamSTEPPS<br>* TeamSTEPPS is an evidence-based approach for teams that can be adapted for school mental health. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), has been widely disseminated in health care settings with promising outcomes. TeamSTEPPS is designed to build competencies in the areas of leadership, situation monitoring, mutual support, and communication and has been associated with improvements in teamwork and communication as well as patient outcomes, such as decreased seclusion in psychiatric hospitals.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of Intervention Measure (FIM) | Reliable and validated 4-item tool to assess perceptions of the feasibility of an intervention (in this caseTeamSTEPPS). Scores can range from 4 to 20. A score of 4 indicates it was very unfeasible and a score of 20 indicates it was very feasible. Each item may be scored 1 = completely disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, and 5 = completely agree. | 3-12 months | 
| Acceptability of Intervention Measure (AIM) | Reliable and validated 4-item observational tool to assess perceptions of the acceptability of an intervention (in this caseTeamSTEPPS). Scores can range from 4 to 20. A score of 4 indicates it was very unacceptable and a score of 20 indicates it was very acceptable. Each item may be scored 1 = completely disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, and 5 = completely agree. | 3-12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oxford Non-Technical Skills (NOTECHS) scale | Validated 4-item tool to assess teamwork and cognitive skills. It measures leadership and management; teamwork and cooperation; problem-solving and decision making; and situational awareness. An observer codes team behavior in each domain using 3-5 items rated from 1 (Below Standard) to 4 (Excellent). Sub-team specific modifiers further examine the unique contributions of various staff roles. It has been previously modified for use with medical teams with demonstrated reliability and validity. Final scores indicate below standard, basic standard, standard, or excellent performance. | 3-12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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school-based mental health, TeamSTEPPS