Recognizing that exposure to violence is a significant obstacle to learning, community partners from the LosAngeles Unified School District (LAUSD) established a participatory research partnership with Centerinvestigators to improve the quality of school services for traumatized youth. Through this communitypartneredresearch approach, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) programwas developed using the best evidence available for treating trauma-related mental health problems and takinginto account the normal constraints of the school system.137'139 Following a randomized controlled trialdemonstrating that CBITS is an effective intervention140, this intervention has now been implemented acrossthe U.S. However it remains unclear what factors contribute to the ability of evidence-based programs such asCBITS to be sustained and financially supported within school systems and how enhanced communitypartnerships can support this process.This study will examine CBITS implementation across three very different and uniquely important sites: LosAngeles, where innovations with CBITS have been fielded for the past eight years; New Orleans, where CBITShas been successfully used in post-disaster recovery efforts; and Madison, a site that has implemented CBITSfor 3 Vz years, replicated the effectiveness results, and has been actively disseminating this program toneighboring districts. The results of studying these three communities in depth will provide a deeperunderstanding of the process of implementation from the perspectives of multiple school-communitystakeholders, with findings that will be translated into a CBITS implementation toolkit with guidelines andstrategies for delivering evidence-based mental health programs in schools. This study also will provide thepreliminary data needed for an R01 application to evaluate the effects of improving the implementation andsustainability of CBITS in schools.Although policymakers have emphasized the provision of evidence-based treatments in community settings,there has been a paucity of research studying what organizational factors specific to schools influence theimplementation of mental health programs. The overall objective of this 2-year pilot is to study the factorsinfluencing the organizational structures and cultures, policies, and funding environments across multiple U.S.school settings that have recent experience in implementing CBITS.
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