Implementation strategies for school-based universal prevention: A qualitative pilot study of Enhanced and standard...

Area of Science:

• Public Health
• Educational Psychology
• Implementation Science

Background:

• School-based universal prevention programs, such as the Michigan Model for Health (MMH), aim to improve youth behavioral health but face implementation hurdles.
• Previous research highlighted a need for trauma-sensitive content within the MMH to address priority student issues.
• The Enhanced Replicating Effective Programs (REP) strategy offers a multicomponent approach to support program providers in addressing youth health priorities.

Purpose of the Study:

• To evaluate the feasibility, acceptability, and appropriateness of Enhanced REP compared to standard REP in delivering the MMH.
• To assess teacher perceptions of implementation strategies in high schools serving low-income students.

Main Methods:

• A pilot cluster-randomized controlled trial was conducted across eight high schools.
• The study compared Enhanced REP (tailored curriculum, training, facilitation with trauma-sensitive content) against standard REP (standard curriculum, initial training, as-needed assistance).
• Semistructured interviews with teachers at three time points gathered data on implementation perceptions.

Main Results:

• Teachers perceived Enhanced REP as satisfactory and suitable for delivering the MMH.
• School environment factors, particularly administrative support, significantly impacted feasibility compared to standard REP.
• Teachers using Enhanced REP reported greater success in meeting student needs than those in the standard REP group.

Conclusions:

• While standard REP may suffice in some settings, many schools require more intensive strategies like Enhanced REP for effective implementation.
• Enhanced REP demonstrates potential for tailored curriculum delivery and support, but organizational and leadership support are critical for success.
• Future research should explore organizational-level strategies and compare the effectiveness of Enhanced versus standard REP.