Purpose: The purpose of this project is to develop a web-based professional development program for school mental health providers to gain the skills needed to implement evidence-based practices (EBPs) for student attention and behavior problems. Such problems are among the most common reason for referrals to school mental health providers. Providers, however, typically receive insufficient training in EBPs. High quality effective training programs integrate didactic instruction, active learning strategies, and real-time ongoing coaching and supervision, but this can be expensive and difficult to implement widely. Web-based training provides a viable tool for expanding the reach of effective professional development. This project will fill this gap by developing and pilot testing a web-based professional development program, CLS-R, for school mental health providers. The research team will adapt the CLS-R from the Collaborative Life Skills Program (CLS), an existing evidence-supported collaborative school-home intervention for attention and behavior problems that incorporates active learning strategies, live observation and coaching with immediate performance feedback, and weekly progress monitoring.

Project Activities: The research team will use an iterative development process to develop and pilot test CLS-R. During the first year, utilizing multiple design and retest cycles, the research team will adapt existing CLS training materials and procedures for a web-based format based on feedback from school mental health providers and school administrators. During the second year, the research team will conduct open trials of the preliminary version of CLS-R, evaluate usability, feasibility, and acceptability, and make refinements. During the third year, researchers will conduct a pilot test, using a randomized controlled trial to evaluate and compare the feasibility, usability, fidelity and preliminary outcomes of the newly developed CLS-R with the traditional face-to-face CLS model.

Products: The products of this project include a fully developed CLS-R program for attention and behavior problems, as well as peer-reviewed publications and presentations.

Structured Abstract

Setting: The research will take place in urban elementary schools in California.

Sample: Over this four year project, researchers will work with a total of approximately 28 school mental health providers, 2 administrators, and 96 elementary students in second through fifth grade School staff will refer students to the project.

Intervention: CLS-R is based on the Collaborative Life Skills (CLS) program, an existing treatment program for students with attention and/or behavior problems. Researchers will adapt CLS into a web-based format (CLS-R) with all training and consultation for school mental health providers provided remotely via videoconferencing. Components of CLS-R include teacher consultation, teacher and parent use of daily report cards, parent training, and child skills groups. The research team will deliver CLS-R via web-accessed training materials and videos, expert consultation including live session observation, coaching, modeling, immediate feedback, weekly group consultation, and ongoing support to assist school mental health providers in sustaining their newly acquired skills.

Research Design and Methods: The research team will use an iterative process to develop and evaluate CLS-R. Focus groups will be help with a Development Team, comprised of mental health providers and school and district administrators, who will provide feedback and guidance on CLS-R features and procedures in order to maximize the usability, feasibility, accessibility, and sustainability of the web-based professional development. The research team will review results of focus group analyses with their tele-mental health expert consultant to obtain input regarding how to best translate identified user needs and preferences into prototypes of CLS-R components. Prototypes of each of the CLS-R components will be created and tested through multiple design and retest cycles. Once developed, the team will conduct four open trials of CLS-R followed by focus groups to evaluate usability, feasibility, and acceptability; and to make refinements. Lastly, the research team will conduct a cluster randomized controlled trial to evaluate and compare CLS-R and CLS on usability, acceptability, feasibility, utility and sustainability of school mental health providers' use of skills learned.

Control Condition: The research team will compare CLS-R to CLS, which uses in-person rather than web-based training. Both approaches will utilize the same training content.

Key Measures: The research team will use the Stem Usability Scale (SUS) to obtain SMHP and trainer usability ratings of each CLS-R technology component. They will assess school mental health provider outcomes, including program implementation quality and fidelity; EBP skill use, knowledge, motivation, and competence, using existing researcher developed CLS measures that will be updated throughout the development process. The research team will also assess teacher and parent implementation of strategies via copies of teacher-completed daily report cards, and parent-reported weekly behavioral strategy use at home. Student measures include student academic (Children's Organizational Skills Scale, Homework Problems Checklist, Academic Competency Evaluation Scale), social (Social Skills Improvement Scale) and ADHD symptoms and behavioral functioning (Child Symptom Inventory, Social Skills Improvement Scale).

Data Analytic Strategy: CLS-R usability and feasibility will focus on qualitative analysis of themes from focus groups, quantitative analyses of rating scales, and descriptive analyses of functionality. The research team will analyze open trials descriptively to evaluate fidelity, usability and acceptability; and repeated measures analyses will evaluate changes in school mental health provider and student outcomes. For the pilot study, researchers will use descriptive statistics to compare process measures, school mental health provider outcomes and parent and teacher implementation across conditions. The research team will also evaluate student outcomes for clinical significance, and use multilevel models to compare mean student outcome scores controlling for clustering effects and baseline functioning.

Related Projects:
Collaborative School-Home Behavioral Intervention for ADHD (R324A080041)
Efficacy of the Collaborative Life Skills Program (R324A120358)