Optimal Timing for Launching Installation of Tier 2 and 3 Systems of School-Wide Positive Behavioral Interventions and Supports

2021 ◽  
pp. 109830072199608
Author(s):  
Angus Kittelman ◽  
Sterett H. Mercer ◽  
Kent McIntosh ◽  
Robert Hoselton
Keyword(s):  
Longitudinal Study ◽  
Behavioral Interventions ◽  
Structural Equation ◽  
Equation Modeling ◽  
Optimal Timing ◽  
First Year ◽  
Tier 2 ◽  
Positive Behavioral Interventions ◽  
Tier 1 ◽  
Tier 3

The purpose of this longitudinal study was to examine patterns in implementation of Tier 2 and 3 school-wide positive behavioral interventions and supports (SWPBIS) systems to identify timings of installation that led to higher implementation of advanced tiers. Extant data from 776 schools in 27 states reporting on the first 3 years of Tier 2 implementation and 359 schools in 23 states reporting on the first year of Tier 3 implementation were analyzed. Using structural equation modeling, we found that higher Tier 1 implementation predicted subsequent Tier 2 and Tier 3 implementation. In addition, waiting 2 or 3 years after initial Tier 1 implementation to launch Tier 2 systems predicted higher initial Tier 2 implementation (compared with implementing the next year). Finally, we found that launching Tier 3 systems after Tier 2 systems, compared with launching both tiers simultaneously, predicted higher Tier 2 implementation in the second and third year, so long as Tier 3 systems were launched within 3 years of Tier 2 systems. These findings provide empirical guidance for when to launch Tier 2 and 3 systems; however, we emphasize that delays in launching advanced systems should not equate to delays in more intensive supports for students.

Multitiered Systems of Supports, Response to Intervention, and Positive Behavioral Interventions and Supports

2021 ◽  
pp. 107-117
Author(s):  
Samantha Bates ◽  
LaShonda Linnen ◽  
Stephanie Columbia ◽  
Dawn Anderson-Butcher
Keyword(s):  
Response To Intervention ◽  
Social Workers ◽  
Behavioral Interventions ◽  
Evidence Based ◽  
Tier 2 ◽  
Students At Risk ◽  
Positive Behavioral Interventions ◽  
School Based ◽  
Tier 1 ◽  
Tier 3

This chapter covers the Response to Intervention framework, Positive Behavioral Interventions and Supports, and multitiered systems of supports (MTSS). The Response to Intervention framework is a central step in implementing a successful MTSS framework. MTSS delivers school-based supports across three tiers: tier 1 (universal), tier 2 (targeted), and tier 3 (individualized). The MTSS framework is a resource that enables schools to use data not only to identify students at risk for poor learning outcomes but also to monitor student progress and deliver evidence-based interventions. The chapter provides examples of ways social workers can maximize the utility of these models and school teams to improve student outcomes.

scholarly journals Detection of Broadly Neutralizing Activity within the First Months of HIV-1 Infection

2016 ◽  
Vol 90 (11) ◽  
pp. 5231-5245 ◽  
Author(s):  
V. Sanchez-Merino ◽  
A. Fabra-Garcia ◽  
N. Gonzalez ◽  
D. Nicolas ◽  
A. Merino-Mansilla ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Geometric Mean ◽  
First Year ◽  
Tier 2 ◽  
Chronic Infections ◽  
Neutralizing Activity ◽  
Recombinant Viruses ◽  
Tier 1 ◽  
Tier 3 ◽  
Hiv 1

ABSTRACTA fraction of HIV-1 patients are able to generate broadly neutralizing antibodies (bNAbs) after 2 to 4 years of infection. In rare occasions such antibodies are observed close to the first year of HIV-1 infection but never within the first 6 months. In this study, we analyzed the neutralization breadth of sera from 157 antiretroviral-naive individuals who were infected for less than 1 year. A range of neutralizing activities was observed with a previously described panel of six recombinant viruses from five different subtypes (M. Medina-Ramirez et al., J Virol85:5804–5813, 2011,http://dx.doi.org/10.1128/JVI.02482-10). Some sera were broadly reactive, predominantly targeting envelope epitopes within the V2 glycan-dependent region. The neutralization breadth was positively associated with time postinfection (P= 0.0001), but contrary to what has been reported for chronic infections, no association with the viral load was observed. Notably, five individuals within the first 6 months of infection (two as early as 77 and 96 days postinfection) showed substantial cross-neutralization. This was confirmed with an extended panel of 20 Env pseudoviruses from four different subtypes (two in tier 3, 14 in tier 2, and four in tier 1). Sera from these individuals were capable of neutralizing viruses from four different subtypes with a geometric mean 50% infective dose (ID50) between 100 and 800. These results indicate that induction of cross-neutralizing responses, albeit rare, is achievable even within 6 months of HIV-1 infection. These observations encourage the search for immunogens able to elicit this kind of response in preventive HIV-1 vaccine approaches.IMPORTANCEThere are very few individuals able to mount broadly neutralizing activity (bNA) close to the first year postinfection. It is not known how early in the infection cross-neutralizing responses can be induced. In the present study, we show that bNAbs, despite being rare, can be induced much earlier than previously thought. The identification of HIV-1-infected patients with these activities within the first months of infection and characterization of these responses will help in defining new immunogen designs and neutralization targets for vaccine-mediated induction of bNAbs.

scholarly journals Helping Children with Emotional Difficulties

2018 ◽  
Vol 30 (2) ◽  
Author(s):  
Lee R. Pearce
Keyword(s):  
Behavioral Interventions ◽  
Skills Training ◽  
Fifth Grade ◽  
Future Research ◽  
Tier 2 ◽  
Prosocial Skills ◽  
Tier 1 ◽  
Rti Model ◽  
Tier 3 ◽  
Rural Elementary School

This article describes a Response to Intervention (RTI) model of service delivery implemented within a rural elementary school for students in kindergarten through fifth grade experiencing significant emotional and behavioral difficulties. A multi-tiered model is presented that includes school wide interventions in Tier 1, as well as a six separate interventions applied within Tier 2 and Tier 3. These included applied behavioral analysis, social skills training, counseling,  differentiated instruction, cognitive behavioral interventions and parent involvement designed to assist identified students with improving prosocial skills. Nine children were treated within this program model over a two year period, resulting in two students being placed in special education under the category of emotional disturbance by the project’s termination. Positive and negative aspects of the project’s implementation are reviewed, along with directions for future research.  

The Growth of Effective Mental Health Services in Schools in the United States

Education ◽  
2019 ◽  
Author(s):  
Mark Weist ◽  
David Riddle ◽  
Ashley Quell ◽  
Cameron Massey ◽  
Crystal McWhirter
Keyword(s):  
Mental Health ◽  
Behavioral Interventions ◽  
School Mental Health ◽  
The United States ◽  
Tier 2 ◽  
Mental Health Systems ◽  
Positive Behavioral Interventions ◽  
School Based Health Centers ◽  
Tier 3 ◽  
Systems Framework

This chapter provides a review of the movement toward more comprehensive mental health systems in schools through mental health-education system partnerships. We review factors contributing to the growth of this field including experiences in school nursing, school-based health centers, regulations regarding special education, and progressively expanding federal support. We then discuss integration of these expanded school mental health (SMH) programs with multitiered systems of support (MTSS) in schools, such as Positive Behavioral Interventions and Supports (PBIS). Specifically, the Interconnected Systems Framework (ISF) for SMH and PBIS represents a platform for effective programs and services at Tier 1, involving promotion/prevention; Tier 2, involving early intervention; and Tier 3, more intensive intervention. Key strategies associated with the ISF and effective practices at each of these tiers are reviewed, including emphases on effective team and culturally responsive and evidence-based practices. The chapter concludes with a review of future directions for SMH.

Strategies for Including Students With Extensive Support Needs in SWPBIS

2021 ◽  
pp. 273247452110003
Author(s):  
Virginia L. Walker ◽  
Sheldon L. Loman
Keyword(s):  
Professional Development ◽  
Behavioral Interventions ◽  
Support Needs ◽  
Tier 2 ◽  
Self Assessment ◽  
Positive Behavioral Interventions ◽  
Behavioral Needs ◽  
Tier 1

Schools that implement School-wide Positive Behavioral Interventions and Supports (SWPBIS) offer a multitiered continuum of supports that increases in intensity to support the behavioral needs of all students within a school. Although the number of schools that have adopted SWPBIS continues to rise, students with extensive support needs (ESN) may be excluded from various aspects of SWPBIS at the Tier 1 and Tier 2 levels. Given that SWPBIS is intended to be fully inclusive, the purpose of this article is to provide educators and other staff with practical tools and guidelines for including students with ESN in Tiers 1 and 2 of SWPBIS. We also present additional considerations for self-assessment, collaborative teaming, and professional development for including students with ESN in SWPBIS.

Factors Predicting Sustained Implementation of a Universal Behavior Support Framework

2018 ◽  
Vol 47 (5) ◽  
pp. 307-316 ◽  
Author(s):  
Kent McIntosh ◽  
Sterett H. Mercer ◽  
Rhonda N. T. Nese ◽  
M. Kathleen Strickland-Cohen ◽  
Angus Kittelman ◽  
...  
Keyword(s):  
Behavioral Interventions ◽  
Structural Equation ◽  
Strong Predictor ◽  
Critical Mass ◽  
Implementation Fidelity ◽  
Equation Modeling ◽  
Behavior Support ◽  
Grade Levels ◽  
Positive Behavioral Interventions ◽  
District Implementation

In this 3-year prospective study, we tested the extent to which school-, practice-, and district-level variables predicted sustained implementation for schools in various stages of implementation of school-wide positive behavioral interventions and supports (SWPBIS) Tier 1 (universal) systems. Staff from 860 schools in 14 U.S. states completed a research-validated measure of factors associated with sustained implementation of school interventions during Year 1 of this study. Analyses included multigroup structural equation modeling of school and district implementation fidelity data. Results indicated that adequate implementation fidelity and better Team Use of Data for decision making in Study Year 1 were the strongest predictors of sustained implementation in Year 3. In addition, the number of other schools in the district adopting SWPBIS was a similarly strong predictor. A critical mass of schools implementing was also predictive, especially for schools earlier in implementation. School characteristics were not predictive, except for grade levels served, which was an inconsistent predictor by stage.

Suicide Risk Among College Student

Crisis ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 416-423 ◽  
Author(s):  
Richard Shadick ◽  
Faedra Backus Dagirmanjian ◽  
Baptiste Barbot
Keyword(s):  
Sexual Minority ◽  
Students Of Color ◽  
Structural Equation ◽  
Suicide Risk ◽  
Equation Modeling ◽  
First Year ◽  
Chi Square ◽  
First Year College ◽  
Marginalized Groups ◽  
First Year College Students

Abstract. Background: Research on young adults in the general population has identified a relationship between sexual minority identification and risk for suicide. Differential rates of suicidal ideation and attempts have also been found across racial and ethnic groups. Aims: This study examined risk for suicide among university students, based on membership in one or more marginalized groups (sexual minority and racial minority identification). Method: Data were collected from first-year college students (N = 4,345) at an urban university. Structural equation modeling was employed to model a suicidality construct, based on which a "risk for suicide" category system was derived. Chi-square and logistic regression analyses were then conducted to estimate the relationship between the background variables of interest and suicide risk. Results: Students who identified as lesbian, gay, or bisexual (LGB) were associated with higher suicide risk than their heterosexual peers. Students of color were slightly less at risk than their heterosexual peers. However, LGB students of color were associated with elevated suicide risk relative to heterosexual peers. Conclusion: Results indicate that belonging to multiple marginalized groups may increase one's risk for suicide, though these effects are not simply additive. Findings highlight the complexity of the intersection between marginalized identities and suicidality.

The Embedded Paradox of Organizational Turnover and Professional Autonomy

2021 ◽  
pp. 104973152098453
Author(s):  
Guanghuai Zheng ◽  
Haijuan Liu ◽  
Yean Wang ◽  
Beili Chen
Keyword(s):  
Structural Equation Modeling ◽  
Longitudinal Study ◽  
Social Workers ◽  
Turnover Intention ◽  
Structural Equation ◽  
Educational Background ◽  
Professional Autonomy ◽  
Equation Modeling ◽  
Analysis Method ◽  
Person Environment Fit

Purpose: This study aims to investigate the effects of professional autonomy (PA) and person–environment fit (person–job [PJ] fit and person–organization [PO] fit) on turnover intention (TI). Methods: We take a total of 1,133 professional social workers with formal educational background from the China Social Work Longitudinal Study 2019 as our sample and use structural equation modeling as our analysis method. Results: We find that an increase in person–environment fit is significantly associated with a decrease in Chinese social workers’ organizational TI, and this relationship is mediated by PA. However, PA has greater power to buffer the effects of PJ fit than those of PO fit on TI. Conclusions: This finding improves existing understanding of the paradox of social workers embedded in the community. An occupational environment that promotes PA is urgently needed to address this paradox and to prevent social workers’ TI.

scholarly journals Global Inland Capture and Culture Finfisheries Follow Different Trends When Evaluated by the Human Development Index

2021 ◽  
Vol 13 (15) ◽  
pp. 8420
Author(s):  
Peter W. Sorensen ◽  
Maria Lourdes D. Palomares
Keyword(s):  
Socioeconomic Factors ◽  
Human Development ◽  
Human Development Index ◽  
Developed Countries ◽  
Global Scale ◽  
Tier 2 ◽  
Development Index ◽  
Tier 1 ◽  
Catch Reconstruction ◽  
Tier 3

To assess whether and how socioeconomic factors might be influencing global freshwater finfisheries, inland fishery data reported to the FAO between 1950 and 2015 were grouped by capture and culture, country human development index, plotted, and compared. We found that while capture inland finfishes have greatly increased on a global scale, this trend is being driven almost entirely by poorly developed (Tier-3) countries which also identify only 17% of their catch. In contrast, capture finfisheries have recently plateaued in moderately-developed (Tier-2) countries which are also identifying 16% of their catch but are dominated by a single country, China. In contrast, reported capture finfisheries are declining in well-developed (Tier-1) countries which identify nearly all (78%) of their fishes. Simultaneously, aquacultural activity has been increasing rapidly in both Tier-2 and Tier-3 countries, but only slowly in Tier-1 countries; remarkably, nearly all cultured species are being identified by all tier groups. These distinctly different trends suggest that socioeconomic factors influence how countries report and conduct capture finfisheries. Reported rapid increases in capture fisheries are worrisome in poorly developed countries because they cannot be explained and thus these fisheries cannot be managed meaningfully even though they depend on them for food. Our descriptive, proof-of-concept study suggests that socioeconomic factors should be considered in future, more sophisticated efforts to understand global freshwater fisheries which might include catch reconstruction.

Incorporation of plasma-based next-generation sequencing to improve guideline-concordant molecular testing in patients with newly diagnosed metastatic nonsquamous non-small cell lung cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 14-14
Author(s):  
Charu Aggarwal ◽  
Melina Elpi Marmarelis ◽  
Wei-Ting Hwang ◽  
Dylan G. Scholes ◽  
Aditi Puri Singh ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Practice Change ◽  
Molecular Testing ◽  
Tier 2 ◽  
Newly Diagnosed ◽  
Next Generation ◽  
First Line ◽  
Tier 1 ◽  
Tier 3 ◽  
The Impact

14 Background: Current NCCN guidelines recommend comprehensive molecular profiling for all newly diagnosed patients with metastatic non-squamous NSCLC to enable the delivery of personalized medicine. We have previously demonstrated that incorporation of plasma based next-generation gene sequencing (NGS) improves detection of clinically actionable mutations in patients with advanced NSCLC (Aggarwal et al, JAMA Oncology, 2018). To increase rates of comprehensive molecular testing at our institution, we adapted our clinical practice to include concurrent use of plasma (P) and tissue (T) based NGS upon initial diagnosis. P NGS testing was performed using a commercial 74 gene assay. We analyzed the impact of this practice change on guideline concordant molecular testing at our institution. Methods: A retrospective cohort study of patients with newly diagnosed metastatic non-squamous NSCLC following the implementation of this practice change in 12/2018 was performed. Tiers of NCCN guideline concordant testing were defined, Tier 1: complete EGFR, ALK, BRAF, ROS1, MET, RET, NTRK testing, Tier 2: included above, but with incomplete NTRK testing, Tier 3: > 2 genes tested, Tier 4: single gene testing, Tier 5: no testing. Proportion of patients with comprehensive molecular testing by modality (T NGS vs. T+P NGS) were compared using one-sided Fisher’s exact test. Results: Between 01/2019, and 12/2019, 170 patients with newly diagnosed metastatic non-Sq NSCLC were treated at our institution. Overall, 98.2% (167/170) patients underwent molecular testing, Tier 1: n = 100 (59%), Tier 2: n = 39 (23%), Tier 3/4: n = 28 (16.5%), Tier 5: n = 3 (2%). Amongst these patients, 43.1% (72/167) were tested with T NGS alone, 8% (15/167) with P NGS alone, and 47.9% (80/167) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS: 95.7% (79/80) compared to T alone: 62.5% (45/72), p < 0.0005. Prior to the initiation of first line treatment, 72.4% (123/170) patients underwent molecular testing, Tier 1: n = 73 (59%), Tier 2: n = 27 (22%) and Tier 3/4: n = 23 (18%). Amongst these, 39% (48/123) were tested with T NGS alone, 7% (9/123) with P NGS alone and 53.6% (66/123) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS, 100% (66/66) compared to 52% (25/48) with T NGS alone (p < 0.0005). Conclusions: Incorporation of concurrent T+P NGS testing in treatment naïve metastatic non-Sq NSCLC significantly increased the proportion of patients undergoing guideline concordant molecular testing, including prior to initiation of first-line therapy at our institution. Concurrent T+P NGS should be adopted into institutional pathways and routine clinical practice.

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