Schools are the primary setting within which children receive mental health (MH) services. The effectiveness of MH programs has been repeatedly demonstrated for a wide array of MH problems, including behavioral and emotional disorders, substance abuse, ADHD, and suicidality. However, despite their availability, as well as recent education and federal financial incentives for use of programs supported by empirical evidence, MH evidence-based interventions (EBIs) are rarely used in everyday practice by schools. Further, school MH EBIs that have proven effective under strict research conditions often fail to achieve their intended outcomes when delivered in the "real world". A wealth of research indicates the quality of EBI implementation is directly related to 1) the likelihood the intervention will be integrated and sustained within the school setting and 2) the strength of its treatment effects. The goal of this Phase II SBIR is to continue the research and development of CenterVention, a web-based technology infrastructure designed to promote broad-scale quality implementation of school MH EBIs. CenterVention will provide cost-effective high quality training, on-going implementation assistance, intervention resources, and adherence monitoring to support EBI implementation and sustainability within schools. Phase I prototype development and feasibility testing with key stakeholders were successfully completed, providing substantial support for the CenterVention product as well as specific recommendations for Phase II development.
The first aim of Phase II is to revise each CenterVention component to enhance its usability and value. Once the full technology infrastructure is complete, we will integrate a third, independent school MH EBI and examine the usability of this new CenterVention application with school MH providers, teachers, administrators, and intervention developers.
The second aim of Phase II is to conduct a rigorous, longitudinal test of the CenterVention product comparing two randomized conditions: Implementation-As-Usual (IAU;i.e., traditional EBI implementation with no CenterVention support) and Enhanced Implementation (EI;i.e., CenterVention-supported implementation). Five implementation outcomes will be examined: (1) readiness for EBI implementation, (2) adherence to EBI protocol, (3) satisfaction with the EBI and its implementation support, (4) sustainability of the EBI over time, and (5) treatment benefits for students.
The third aim of Phase II is to finalize all product components based on Phase II findings and evaluations and prepare CenterVention for Phase III commercialization. This SBIR project will yield a flexible, scalable technology infrastructure that can be applied to any school MH EBI to effectively decrease costs (time, financial, personnel) to both schools and intervention developers, enhance the integrity with which EBIs are implemented in the school setting, and increase dissemination of EBIs into real world everyday practice. The proposed WDT not only offers the potential for significant societal benefits, but also addresses a large, currently untapped market.
As the mental health research-practice gap has become increasingly evident, numerous federal reports have called for action to better connect research findings to clinical practice (e.g., The President's New Freedom Commission Report ;Reports of the Surgeon General on Mental Health , Youth Violence , and Culture, Race, and Ethnicity ;and the National Children's Call to Action ). Building on the recommendations of clinical and research community members during the Enhancing the Discipline of Clinical and Translational Sciences meeting (May, 2005), the National Institutes of Health (NIH) identified research efforts to bridge science and practice as the primary objective of NIH's roadmap. The proposed research directly addresses this NIH Roadmap priority as well as these federal calls for action. Each year, about 6% of America's children and adolescents receive some form of mental health (MH) care, at an annual cost of more than $11 billion. In addition, each year NIMH and other foundations fund more than $300 million for youth MH research, much of it devoted to treatment studies. The findings from the proposed research will advance our understanding of how to successfully integrate MH EBIs into everyday practice within the primary MH service setting for youth, i.e., schools. Increasing the likelihood that EBIs will be adopted, used as intended, and sustained in everyday practice in schools, in turn, will increase the likelihood that youth and society at large will benefit from evidence-based practices.