Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial

Abstract Background Rural School Support Strategies (RS3) is a bundle of implementation supports (including training, technical assistance, and a virtual learning collaborative) designed for the scale-up of universal prevention initiatives. This study addresses mechanisms of action, exploring whethe...

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Main Authors: Christopher M. Fleming, Hannah G. Calvert, Lindsey Turner
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Implementation Science Communications
Online Access:https://doi.org/10.1186/s43058-024-00691-9
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author Christopher M. Fleming
Hannah G. Calvert
Lindsey Turner
author_facet Christopher M. Fleming
Hannah G. Calvert
Lindsey Turner
author_sort Christopher M. Fleming
collection DOAJ
description Abstract Background Rural School Support Strategies (RS3) is a bundle of implementation supports (including training, technical assistance, and a virtual learning collaborative) designed for the scale-up of universal prevention initiatives. This study addresses mechanisms of action, exploring whether positive effects of RS3 on implementation fidelity are attributable to improvements in functioning of school implementation teams, and increases in organizational readiness. Methods Data are from a cluster-randomized hybrid Type 3 implementation-effectiveness trial of RS3 among rural Idaho schools implementing Positive Behavioral Interventions and Supports (PBIS). Forty public K-12 schools in Idaho, located in rural areas or townships, were recruited for the trial and were equally randomized to either the basic supports condition, including standard trainings, or to the RS3 condition. Condition was not masked. The mechanistic aims were hypothesized prior to the trial and tested with survey data from individuals on each school’s implementation team (n = 205). Surveys were collected in spring 2019 and 2020 regarding organizational readiness and team functioning. The outcome measure was PBIS implementation fidelity, measured by school teams during the summers of 2019 and 2020 using the Tiered Fidelity Inventory. School-level path models tested the effect of RS3 on implementation fidelity, controlling for baseline, school grade level, and school location. Multilevel (2–1-2) mediation models tested the degree to which individual team members’ perceptions of organizational readiness and team functioning mediated the relationship between school-level experimental condition and fidelity, controlling for the team members’ role. Results Schools receiving RS3 reported significantly greater implementation fidelity, although effects were slightly reduced (b = 8.40, p = .056, 95% CI [-0.22,17.01], β = 0.54) after inclusion of baseline and demographic controls. Models indicated a significant indirect effect of RS3 on fidelity through increased team productivity (b = 6.30, SE = 2.63, p = .017, MC 95% CI [0.83,13.86], β = 0.21), and effects through organizational readiness, change commitment, team culture, and team goal setting. Conclusions External supports may improve implementation of universal prevention initiatives in rural schools through improvements in readiness and fostering teaming in organizations. Trial registration This research was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.
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spelling doaj-art-ed63ad48ac4d4c0494c3b0daf42b44fb2025-01-12T12:25:53ZengBMCImplementation Science Communications2662-22112025-01-016111410.1186/s43058-024-00691-9Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trialChristopher M. Fleming0Hannah G. Calvert1Lindsey Turner2School of Social Work, University of Illinois Urbana-ChampaignCenter for School and Community Partnerships, Boise State UniversityCenter for School and Community Partnerships, Boise State UniversityAbstract Background Rural School Support Strategies (RS3) is a bundle of implementation supports (including training, technical assistance, and a virtual learning collaborative) designed for the scale-up of universal prevention initiatives. This study addresses mechanisms of action, exploring whether positive effects of RS3 on implementation fidelity are attributable to improvements in functioning of school implementation teams, and increases in organizational readiness. Methods Data are from a cluster-randomized hybrid Type 3 implementation-effectiveness trial of RS3 among rural Idaho schools implementing Positive Behavioral Interventions and Supports (PBIS). Forty public K-12 schools in Idaho, located in rural areas or townships, were recruited for the trial and were equally randomized to either the basic supports condition, including standard trainings, or to the RS3 condition. Condition was not masked. The mechanistic aims were hypothesized prior to the trial and tested with survey data from individuals on each school’s implementation team (n = 205). Surveys were collected in spring 2019 and 2020 regarding organizational readiness and team functioning. The outcome measure was PBIS implementation fidelity, measured by school teams during the summers of 2019 and 2020 using the Tiered Fidelity Inventory. School-level path models tested the effect of RS3 on implementation fidelity, controlling for baseline, school grade level, and school location. Multilevel (2–1-2) mediation models tested the degree to which individual team members’ perceptions of organizational readiness and team functioning mediated the relationship between school-level experimental condition and fidelity, controlling for the team members’ role. Results Schools receiving RS3 reported significantly greater implementation fidelity, although effects were slightly reduced (b = 8.40, p = .056, 95% CI [-0.22,17.01], β = 0.54) after inclusion of baseline and demographic controls. Models indicated a significant indirect effect of RS3 on fidelity through increased team productivity (b = 6.30, SE = 2.63, p = .017, MC 95% CI [0.83,13.86], β = 0.21), and effects through organizational readiness, change commitment, team culture, and team goal setting. Conclusions External supports may improve implementation of universal prevention initiatives in rural schools through improvements in readiness and fostering teaming in organizations. Trial registration This research was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.https://doi.org/10.1186/s43058-024-00691-9
spellingShingle Christopher M. Fleming
Hannah G. Calvert
Lindsey Turner
Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial
Implementation Science Communications
title Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial
title_full Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial
title_fullStr Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial
title_full_unstemmed Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial
title_short Supporting implementation of universal prevention initiatives in K-12 schools: impacts on fidelity through organizational readiness and team functioning in a cluster-randomized trial
title_sort supporting implementation of universal prevention initiatives in k 12 schools impacts on fidelity through organizational readiness and team functioning in a cluster randomized trial
url https://doi.org/10.1186/s43058-024-00691-9
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