Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study

Background This study assessed the feasibility and acceptability of a multilevel, multi-component implementation strategy for measurement-based care (MBC) called Feedback and Outcomes for Clinically Useful Student Services (FOCUSS). FOCUSS includes six components selected in our prior work with a na...

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Main Authors: Elizabeth H. Connors, Sophia Selino, Daniel Almirall, Nicolina Fusco, Jacob K. Tebes
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Implementation Research and Practice
Online Access:https://doi.org/10.1177/26334895251363416
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author Elizabeth H. Connors
Sophia Selino
Daniel Almirall
Nicolina Fusco
Jacob K. Tebes
author_facet Elizabeth H. Connors
Sophia Selino
Daniel Almirall
Nicolina Fusco
Jacob K. Tebes
author_sort Elizabeth H. Connors
collection DOAJ
description Background This study assessed the feasibility and acceptability of a multilevel, multi-component implementation strategy for measurement-based care (MBC) called Feedback and Outcomes for Clinically Useful Student Services (FOCUSS). FOCUSS includes six components selected in our prior work with a national sample of school mental health stakeholders. This is among the first demonstrations of MBC with school-employed clinicians. We explored proof of concept by observing MBC adoption rates achieved by the end of the school year and other related implementation outcome data. Method A mixed-method, single-arm pilot study was conducted during one academic year with 10 school-employed mental health clinicians in two K-12 public school districts in Connecticut. Clinician adoption was assessed by monthly fidelity monitoring of measures clinicians entered in the feedback system. Clinician self-reported practices, attitudes, feasibility, acceptability, and appropriateness of using MBC with K-12 students was assessed by pre-training, 3-, 6-, and 9-month surveys. School year-end qualitative interviews explored clinician implementation experiences using MBC and FOCUSS implementation supports to inform future changes to FOCUSS in a district-wide trial. Results Clinicians were asked to implement MBC with five students; 60% of the clinicians achieved or exceeded this target, and MBC was adopted with 65 students. Other implementation outcomes were comparable to related studies. Qualitative feedback indicated that MBC is clinically valuable in schools by providing consistency and structure to sessions, is compatible with school mental health, and well regarded by students and parents. FOCUSS implementation supports were regarded as helpful, and individual performance feedback emails appeared to be a necessary component of FOCUSS to boost post-training implementation. Conclusion This is among the first studies of MBC implementation with school-employed mental health professionals in the United States. Results demonstrate proof of concept for MBC implementation with school social workers, psychologists and counselors and support subsequent district-wide use of FOCUSS to install MBC in schools.
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spelling doaj-art-983a0eb3a6ab4c0d93235d44c841fd002025-08-20T04:02:41ZengSAGE PublishingImplementation Research and Practice2633-48952025-08-01610.1177/26334895251363416Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept studyElizabeth H. Connors0Sophia Selino1Daniel Almirall2Nicolina Fusco3Jacob K. Tebes4 Department of Psychiatry, , New Haven, CT, USA Department of Psychiatry, , New Haven, CT, USA Institute for Social Research and Department of Statistics, , Ann Arbor, MI, USA Wheelock College of Education and Human Development, , Boston, MA, USA Department of Psychiatry, , New Haven, CT, USABackground This study assessed the feasibility and acceptability of a multilevel, multi-component implementation strategy for measurement-based care (MBC) called Feedback and Outcomes for Clinically Useful Student Services (FOCUSS). FOCUSS includes six components selected in our prior work with a national sample of school mental health stakeholders. This is among the first demonstrations of MBC with school-employed clinicians. We explored proof of concept by observing MBC adoption rates achieved by the end of the school year and other related implementation outcome data. Method A mixed-method, single-arm pilot study was conducted during one academic year with 10 school-employed mental health clinicians in two K-12 public school districts in Connecticut. Clinician adoption was assessed by monthly fidelity monitoring of measures clinicians entered in the feedback system. Clinician self-reported practices, attitudes, feasibility, acceptability, and appropriateness of using MBC with K-12 students was assessed by pre-training, 3-, 6-, and 9-month surveys. School year-end qualitative interviews explored clinician implementation experiences using MBC and FOCUSS implementation supports to inform future changes to FOCUSS in a district-wide trial. Results Clinicians were asked to implement MBC with five students; 60% of the clinicians achieved or exceeded this target, and MBC was adopted with 65 students. Other implementation outcomes were comparable to related studies. Qualitative feedback indicated that MBC is clinically valuable in schools by providing consistency and structure to sessions, is compatible with school mental health, and well regarded by students and parents. FOCUSS implementation supports were regarded as helpful, and individual performance feedback emails appeared to be a necessary component of FOCUSS to boost post-training implementation. Conclusion This is among the first studies of MBC implementation with school-employed mental health professionals in the United States. Results demonstrate proof of concept for MBC implementation with school social workers, psychologists and counselors and support subsequent district-wide use of FOCUSS to install MBC in schools.https://doi.org/10.1177/26334895251363416
spellingShingle Elizabeth H. Connors
Sophia Selino
Daniel Almirall
Nicolina Fusco
Jacob K. Tebes
Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study
Implementation Research and Practice
title Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study
title_full Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study
title_fullStr Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study
title_full_unstemmed Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study
title_short Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study
title_sort measurement based care implementation by k 12 public school clinicians a mixed methods proof of concept study
url https://doi.org/10.1177/26334895251363416
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