Abstract
BackgroundUrban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program.Methods/DesignThe study follows six K – 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost.DiscussionFindings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children.Trial registrationClinicalTrials.gov identifier: NCT01941069
Highlights
Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students
The present study directly addresses these important barriers by enhancing school capacity to deploy Evidence-based intervention (EBI)
We have redoubled our efforts at helping schools to increase parental collaboration and support, which lead to more parent participation
Summary
Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. Low-income and ethnically diverse children lag well behind their middle class, Caucasian counterparts in rate of service utilization [3,4] Access barriers, such as lack of specialized services in low-income communities, high cost,and poor service quality, and stigma have been found to affect service utilization by ethnically diverse children [5,6,7,8,9]. Schools can play a significant role in addressing mental health services disparities in low-income urban communities [19,20]
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