Recognizing that exposure to violence is a significant obstacle to learning, community partners from the Los Angeles Unified School District (LAUSD) established a participatory research partnership with Center investigators to improve the quality of school services for traumatized youth. Through this communitypartnered research approach, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program was developed using the best evidence available for treating trauma-related mental health problems and taking into account the normal constraints of the school system.137""""""""139 Following a randomized controlled trial demonstrating that CBITS is an effective intervention140, this intervention has now been implemented across the U.S. However it remains unclear what factors contribute to the ability of evidence-based programs such as CBITS to be sustained and financially supported within school systems and how enhanced community partnerships can support this process. This study will examine CBITS implementation across three very different and uniquely important sites: Los Angeles, where innovations with CBITS have been fielded for the past eight years;New Orleans, where CBITS has been successfully used in post-disaster recovery efforts;and Madison, a site that has implemented CBITS for 3 Vz years, replicated the effectiveness results, and has been actively disseminating this program to neighboring districts. The results of studying these three communities in depth will provide a deeper understanding of the process of implementation from the perspectives of multiple school-community stakeholders, with findings that will be translated into a CBITS implementation toolkit with guidelines and strategies for delivering evidence-based mental health programs in schools. This study also will provide the preliminary data needed for an R01 application to evaluate the effects of improving the implementation and sustainability 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 the implementation of mental health programs. The overall objective of this 2-year pilot is to study the factors influencing 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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