Training and Technical Assistance Increase the Fidelity of Implementation of a Universal Prevention Initiative in Rural Schools: Results from a 3-Year Cluster-Randomized Trial

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Publicat a:Prevention Science vol. 26, no. 1 (Jan 2025), p. 56
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Springer Nature B.V.
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245 1 |a Training and Technical Assistance Increase the Fidelity of Implementation of a Universal Prevention Initiative in Rural Schools: Results from a 3-Year Cluster-Randomized Trial 
260 |b Springer Nature B.V.  |c Jan 2025 
513 |a Evidence Based Healthcare Journal Article 
520 3 |a The need for well-implemented evidence-based interventions (EBIs) for the prevention of behavioral issues among children and adolescents is substantial. In rural areas, the need often matches or surpasses that of urban areas. Schools have a wide reach for prevention-focused EBIs. However, implementation in rural schools is often hindered by limited resources and capacity. Rural School Support Strategies (RS3) are a bundle of implementation supports that address implementation challenges in rural settings. They include providing additional leadership and coaching training, individualized technical assistance (mostly virtual), and monthly meetings of a virtual learning collaborative. A cluster-randomized Hybrid Type 3 implementation-effectiveness trial tested RS3 for implementing school-wide positive behavioral interventions and supports (PBIS), a universal prevention approach to improving student behavior, academic outcomes, and school climate. Forty rural schools received a multi-day training on PBIS each summer for 3 years. Half were randomized to also receive RS3 support. Linear and logistic regression models examined the effect of treatment condition and dosage of support on implementation fidelity for Tier 1 (universal) PBIS. Condition and dosage (number of hours) of support increased the odds of schools achieving the 70% threshold for adequate implementation fidelity. In the first year, the higher dosage of technical assistance events increased the likelihood of schools reaching fidelity, whereas later in the trial, the higher dosage of attendance at the virtual learning collaborative sessions yielded significant improvements in fidelity. Implications for accelerating the implementation of universal prevention initiatives in schools—particularly in rural settings—are discussed. This study was prospectively registered on ClinicalTrials.gov (NCT03736395), on November 9, 2018. 
653 |a Collaborative learning 
653 |a Rural schools 
653 |a Intervention 
653 |a Training 
653 |a Collaboration 
653 |a Prevention programs 
653 |a Coaching 
653 |a Implementation 
653 |a Urban areas 
653 |a Fidelity 
653 |a Prevention 
653 |a Leadership 
653 |a Rural areas 
653 |a Adolescents 
653 |a First year 
653 |a Technical assistance 
653 |a Rural communities 
653 |a Behavior 
653 |a Dosage 
653 |a Student behavior 
653 |a Cooperative learning 
653 |a Schools 
653 |a School environment 
653 |a Rural Education 
653 |a Social Problems 
653 |a Student Improvement 
653 |a Student Participation 
653 |a Evidence Based Practice 
653 |a Educational Environment 
653 |a Methods Research 
653 |a Partnerships in Education 
653 |a Public Health 
653 |a School Support 
653 |a Suburban Schools 
653 |a Health Needs 
653 |a Outcomes of Education 
653 |a Behavior Problems 
653 |a Programming 
773 0 |t Prevention Science  |g vol. 26, no. 1 (Jan 2025), p. 56 
786 0 |d ProQuest  |t Political Science Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3165221216/abstract/embedded/Q8Z64E4HU3OH5N8U?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3165221216/fulltextPDF/embedded/Q8Z64E4HU3OH5N8U?source=fedsrch