Abstract
Schools are sometimes slow to adopt evidence-based strategies for improving the mental health outcomes of students. This study used a discrete-choice conjoint experiment to model factors influencing the decision of educators to adopt strategies for improving children’s mental health outcomes. A sample of 1,010 educators made choices between hypothetical mental health practice change strategies composed by systematically varying the four levels of 16 practice change attributes. Latent class analysis yielded two segments with different practice change preferences. Both segments preferred small-group workshops, conducted by engaging experts, teaching skills applicable to all students. Participants expressed little interest in Internet options. The support of colleagues, administrators, and unions exerted a strong influence on the practice change choices of both segments. The Change Ready segment, 77.1 % of the sample, was more intent on adopting new strategies to improve the mental health of students. They preferred that schools, rather than the provincial ministry of education, make practice change decisions, coaching was provided to all participants, and participants received post-training follow-up sessions. The Demand Sensitive segment (22.9 %) was less intent on practice change. They preferred that individual teachers make practice change decisions, recommended discretionary coaching, and chose no post-training follow-up support. This study emphasizes the complex social, organizational, and policy context within which educators make practice change decisions. Efforts to disseminate strategies to improve the mental health outcomes of students need to be informed by the preferences of segments of educators who are sensitive to different dimensions of the practice change process. In the absence of a broad consensus of educators, administrators, and unions, potentially successful practice changes are unlikely to be adopted.
Highlights
Schools represent an important context in which to prevent, identify, and intervene to reduce children’s mental health problems (Atkins, Hoagwood, Kutash, & Seidman, 2010; Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007)
Efforts to disseminate strategies to improve the mental health outcomes of students need to be informed by the preferences of segments of educators who are sensitive to different dimensions of the practice change process
research questions (RQ) 1: Which practice change attributes influence the choices of educators? RQ 2: Are there segments with different mental health practice change preferences?
Summary
Schools represent an important context in which to prevent, identify, and intervene to reduce children’s mental health problems (Atkins, Hoagwood, Kutash, & Seidman, 2010; Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007). Efforts to introduce school-based mental health services fail when programs are incompatible with prevailing educational policies, practices, or philosophies, lack administrative backing, are inadequately funded, or provide insufficient training and follow-up support (Forman et al, 2009). This study, used a discrete-choice conjoint experiment (DCE) to model the preferences of educators for the design of an approach to the implementation of evidence-based practices to improve the mental health of students. Attributes of the practice change process, for example, might include training time, coaching, or follow-up support. An experimental design algorithm combines the study’s attribute levels into a set of hypothetical practice change options. Different combinations of these options are presented in a series of choice sets (Fig. 1). The choices respondents make allow investigators to estimate the relative importance of each attribute and the level of each attribute that is preferred
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