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Using a Multicomponent Implementation Strategy to Increase Adoption and Effectiveness of a Universal Mental Health
Rachel Baffsky1,2, Quincy J J Wong3, Patricia Cullen2
1Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
Summary
A multicomponent strategy significantly boosted early adoption of the PAX Good Behavior Game in schools. While initial uptake improved, long-term effectiveness and optimal support strategies require further investigation.
Area of Science:
- Child and Adolescent Mental Health
- Educational Psychology
- Implementation Science
Background:
- The PAX Good Behavior Game is a proven school-based intervention for childhood emotional and behavioral problems.
- Effective implementation of such programs in schools is crucial for mental health prevention but lacks established strategies.
- Understanding implementation support is vital for integrating evidence-based practices into routine school settings.
Purpose of the Study:
- To evaluate the impact of a multicomponent implementation strategy on the adoption and efficacy of the PAX Good Behavior Game in primary schools.
- To compare outcomes between schools receiving the PAX Good Behavior Game with an implementation toolkit versus those receiving the game alone.
- To assess the relationship between program adoption and its perceived acceptability, appropriateness, and feasibility.
Main Methods:
- A cluster randomized controlled trial was conducted in 25 primary schools in New South Wales, Australia.
- Schools were randomized to receive the PAX Good Behavior Game plus an implementation toolkit or the game only.
- Primary outcome was program adoption rate; secondary outcome was change in students' emotional and behavioral problems (Strengths and Difficulties Questionnaire).
Main Results:
- Early program adoption was significantly higher in the intervention group (93.6%) compared to the control group (45.2%).
- No significant difference in adoption rates was observed at 6 months between the groups.
- Emotional and behavioral problems decreased in both groups, with no significant differential effects at 6 months.
Conclusions:
- A multicomponent implementation strategy can accelerate early adoption of school-based programs like the PAX Good Behavior Game.
- While early adoption is enhanced, sustained implementation and effectiveness require further study.
- Positive relationships exist between adoption and perceived program attributes, suggesting implementation support influences school buy-in.
Keywords:
EffectivenessGood Behavior GameImplementationMental health preventionSchoolSuicide preventionTrialMore Related Videos
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