Trial reportImplementation science : IS2022
Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan.
Trial report in Implementation science : IS, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03541317 (Improving Student Mental Health), which is not on this map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Student Mental Health: Adaptive School-based Implementation of CBT
Who cites it
19 citing papers in PubMed, 29 citations in OpenAlex.
- Student mental health outcomes of a clustered SMART for developing an adaptive implementation strategy to support school-based CBT delivery.Journal of affective disorders · 2024Trial
- Analysis of real-world scale-up processes for school-based mental health interventions.Administration and policy in mental health · 2026Article
- Game, Set, and Match: A Scoping Review of Matching Characteristics for Control and Intervention Groups in Adaptive Behavioral Interventions for Physical Activity or Healthy Eating Designs for Populations with Overweight and Obesity.Behavioral medicine (Washington, D.C.) · 2026Review
- A review of use of external data and update on reporting standards in Sequential Multiple-Assignment Randomised Trials.Clinical trials (London, England) · 2026Review
- Meeting Student Mental Health Needs in Survival Mode: A Qualitative Analysis of School Professional Mental Health Delivery at Michigan High Schools in Response to COVID-19.School mental health · 2026Article
- Achieving cardiovascular health equity in community mental health: study protocol for a cluster-randomized hybrid Type 3 effectiveness-implementation trial.Implementation science : IS · 2025Article
- Approvers, Disapprovers, and Strugglers: a Q-methodology study of rectal cancer MRI proforma use.The British journal of radiology · 2025Article
- Rapid Adaptation to Prevent Drug Use (RAPD): protocol of a pilot randomized trial to enhance the impact of an evidence-based intervention for youth.Pilot and feasibility studies · 2025Article
- Can theory-driven implementation interventions help clinician champions promote opioid stewardship after childbirth? Protocol for a pragmatic implementation study.Frontiers in global women's health · 2025Article
- Implementation Science in School Mental Health: A 10-Year Progress Update and Development of a New Research Agenda.School mental health · 2024Article
- Intervention Optimization: A Paradigm Shift and Its Potential Implications for Clinical Psychology.Annual review of clinical psychology · 2024Review
- Adaptive Designs in Implementation Science and Practice: Their Promise and the Need for Greater Understanding and Improved Communication.Annual review of public health · 2024Review
- Matters of Fidelity: School Provider Adherence and Competence in a Clustered Study of Adaptive Implementation Strategies.Evidence-based practice in child and adolescent mental health · 2024Article
- Partnering with Schools to Adapt a Team Science Intervention: Processes and Challenges.School mental health · 2024Article
- Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.Implementation science communications · 2023Article
- How does facilitation in healthcare work? Using mechanism mapping to illuminate the black box of a meta-implementation strategy.Implementation science communications · 2023Article
- Correction: Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan.Implementation science : IS · 2022Article
- Implementation strategies for school-based universal prevention: A qualitative pilot study of Enhanced and standard Replicating Effective Programs.Implementation research and practiceArticle
- Individual and organizational factors as predictors of early evidence-based practice adoption in Michigan high schools: Baseline data from an implementation trial.Implementation research and practiceArticle
Corrections and comments
- Erratum issued
Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSchools increasingly provide mental health services to students, but often lack access to implementation strategies to support school-based (and school professional [SP]) delivery of evidence-based practices. Given substantial heterogeneity in implementation barriers across schools, development of adaptive implementation strategies that guide which implementation strategies to provide to which schools and when may be necessary to support scale-up.
methodsA clustered, sequential, multiple-assignment randomized trial (SMART) of high schools across Michigan was used to inform the development of a school-level adaptive implementation strategy for supporting SP-delivered cognitive behavioral therapy (CBT). All schools were first provided with implementation support informed by Replicating Effective Programs (REP) and then were randomized to add in-person Coaching or not (phase 1). After 8 weeks, schools were assessed for response based on SP-reported frequency of CBT delivered to students and/or barriers reported. Responder schools continued with phase 1 implementation strategies. Slower-responder schools (not providing ≥ 3 CBT components to ≥10 students or >2 organizational barriers identified) were re-randomized to add Facilitation to current support or not (phase 2). The primary aim hypothesis was that SPs at schools receiving the REP + Coaching + Facilitation adaptive implementation strategy would deliver more CBT sessions than SPs at schools receiving REP alone. Secondary aims compared four implementation strategies (Coaching vs no Coaching × Facilitation vs no Facilitation) on CBT sessions delivered, including by type (group, brief and full individual). Analyses used a marginal, weighted least squares approach developed for clustered SMARTs.
resultsSPs (n = 169) at 94 high schools entered the study. N = 83 schools (88%) were slower-responders after phase 1. Contrary to the primary aim hypothesis, there was no evidence of a significant difference in CBT sessions delivered between REP + Coaching + Facilitation and REP alone (111.4 vs. 121.1 average total CBT sessions; p = 0.63). In secondary analyses, the adaptive strategy that offered REP + Facilitation resulted in the highest average CBT delivery (154.1 sessions) and the non-adaptive strategy offering REP + Coaching the lowest (94.5 sessions).
conclusionsThe most effective strategy in terms of average SP-reported CBT delivery is the adaptive implementation strategy that (i) begins with REP, (ii) augments with Facilitation for slower-responder schools (schools where SPs identified organizational barriers or struggled to deliver CBT), and (iii) stays the course with REP for responder schools.
trial registrationClinicalTrials.gov, NCT03541317 , May 30, 2018.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.