Feasibility of delivering parent-implemented NDBI interventions in low-resource regions: a pilot randomized controlled study

Background This implementation feasibility study was conducted to determine whether an evidence-based parent-implemented distance-learning intervention model for young children at high likelihood of having ASD could be implemented at fidelity by Part C community providers and by parents in low-resource communities. Methods The study used a community-academic partnership model to adapt an evidence-based intervention tested in the current pilot trial involving randomization by agency in four states and enrollment of 35 coaches and 34 parent-family dyads. After baseline data were gathered, providers in the experimental group received 12–15 h of training while control providers received six webinars on early development. Providers delivered 6 months of intervention with children-families, concluding with data collection. Regression analyses were used to model outcomes of the coach behaviors, the parent fidelity ratings, and child outcomes. Results A block design model-building approach was used to test the null model followed by the inclusion of group as a predictor, and finally the inclusion of the planned covariates. Model fit was examined using changes in R2 and F-statistic. As hypothesized, results demonstrated significant gains in (1) experimental provider fidelity of coaching implementation compared to the control group; and (2) experimental parent fidelity of implementation compared to the control group. There were no significant differences between groups on child developmental scores. Conclusions Even though the experimental parent group averaged less than 30 min of intervention weekly with providers in the 6 months, both providers and parents demonstrated statistically significant gains on the fidelity of implementation scores with moderate effect sizes compared to control groups. Since child changes in parent-mediated models are dependent upon the parents’ ability to deliver the intervention, and since parent delivery is dependent upon providers who are coaching the parents, these results demonstrated that two of these three links of the chain were positively affected by the experimental implementation model. However, a lack of significant differences in child group gains suggests that further work is needed on this model. Factors to consider include the amount of contact with the provider, the amount of practice children experience, the amount of contact both providers and parents spend on training materials, and motivational strategies for parents, among others. Trial registration Registry of Efficacy and Effectiveness Studies: #4360, registered 1xx, October, 2020 – Retrospectively registered, https://sreereg.icpsr.umich.edu/sreereg/

Using Implementation Science Active Implementation Frameworks to Implement an Instructional Framework to Increase Teacher Capacity for Instructional Access for Students With Disabilities

This article discusses the use of the Active Implementation Frameworks (AIF; Fixsen et al., 2005; Fixsen & Blasé, 2011) in a grant-funded project to implement the use of Universal Design for Learning as an instructional intervention to improve the access to quality instruction for students with disabilities. The discussion is based upon data specific to the AIF Implementation Drivers that facilitate and ensure the success of initiatives. The data illustrate the extent that characteristics of the respective schools and districts participating in the project impacted the fidelity of implementation processes and their associated outcomes.

Urban Secondary School Administrators and Faculty Perceptions of Multitiered System of Supports/Response to Intervention

MTSS promises a school-wide early warning system, high-quality instruction, and evidence-based interventions. However, research has focused mainly on the elementary level. This study examined the beliefs and perceptions of over 300 administrators and teachers currently implementing MTSS in secondary schools using survey research. Results showed that special education teachers and administrators had significantly higher MTSS/RtI beliefs and perceptions of their own academic and behavioral MTSS/RtI instructional and intervention skills. Recommendations include the need for extensive and intensive professional development, delineation of role clarity, increased fidelity of implementation, and staff accountability.

Reducing alcohol-related risks among adolescents: a feasibility study of the SHAHRP program in Brazilian schools

The SHAHRP program was effective reducing drinking and alcohol - harms in Australia, but cross-cultural adaptation is required before replication. This study aimed at assessing the feasibility of SHAHRP in Brazil focused on implementation and acceptability. A mixed-methodsdesign was used: quantitative for implementing the program and evaluation and qualitative for acceptability. The quantitative design was a pilot of a randomized controlled trial. Private schools were randomly divided into four intervention (n=160) and four control (n=188) schools. Student’s mean age was 12.7 years. The fidelity of implementation and likely outcome measures were assessed. Qualitative data on acceptability were provided by students and teachers. The percentage of implementation varied from 62.5% to 87.5%. Behaviours such as alcohol-harms requires a larger cohort and longer follow-up to be adequately evaluated. The risk reduction approach and activities had good acceptability from students and teachers. Quantitative and qualitative outcomes on knowledge and decision-making indicated possible improvement in SHAHRP schools. The program is feasible and well accepted in a Brazilian setting, opening the way for a more comprehensive evaluation and dissemination.

Perceived sustainability of the school-based social and behavior change communication (SBCC) approach on malaria prevention in rural Ethiopia: stakeholders’ perspectives

Background Evidence on what makes the school-engaged social and behavior change communication (SBCC) interventions on malaria prevention more sustainable are limited in literature partly due to its recent emergence. Enrolling the key stakeholders, this study explored the perceived sustainability of the SBCC interventions on malaria prevention through primary school communities in rural Ethiopia. Methods The SBCC interventions were implemented from 2017 to 2019 in 75 primary schools and villages in rural Jimma to promote malaria preventive practices. As a part of program evaluation, this study employed a mixed-method to collect qualitative and quantitative data from 205 stakeholders following the end of the program. Data were collected using interview guides and structured questionnaires. The SPSS version 26 and Atlas ti7.1 software were used to analyze the data. Multivariable linear regression modeling was used to identify predictors of the perceived sustainability of the program (SOP). Results The mean score of SOP was 25.93 (SD = 4.32; range 6–30). Multivariable linear regression modeling showed that the perceived risk to malaria (β = 0.150; P = 0.029), self-efficacy (β = 0.192; P = 0.003), and perceived fidelity of implementation (β = 0.292; P = 0.000) and degree of adoption (β = 0.286; P = 0.000) were positively predicted the perceived SOP. The qualitative result identified various barriers and opportunities to sustaining the program that summarized under three themes which include perceptions about the quality of program delivery (e.g inadequate involvement of stakeholders and staffs, concerns over short project life, immature sustainability efforts), school settings (e.g schools’ malaria priority, schools’ climate and quality of coaching) and the outer settings (e.g existing structures in the health and education systems). Conclusion The study identified key predictive variables such as stakeholders’ perceived risk to malaria, self-efficacy, perceived fidelity of implementation and degree of adoption that could help to improve the sustainment of the school-based SBCC approach on malaria prevention and control. Further longitudinal study should be conducted to examine the rate of decline in program components over time and how improved sustainability would contribute to the effectiveness on malaria preventive behaviors among students.

The Self-Determined Learning Model of Instruction: Promoting Implementation Fidelity

There has been an increased focus on the tenets of implementation science in special education research, namely on the degree to which interventions are implemented as intended (i.e., fidelity of implementation) and factors that influence fidelity of implementation. For complex interventions, such as the Self-Determined Learning Model of Instruction (SDLMI), there is an ongoing need to refine conceptualizations of fidelity of implementation and the factors that influence it in inclusive educational contexts. Therefore, the purpose of this paper is two-fold: (1) to describe a framework for conceptualizing fidelity of implementation factors that influence fidelity when evaluating a complex intervention like the SDLMI and (2) to present initial content validity and internal consistency of a new measure designed to assess specific aspects of fidelity of implementation of the SDLMI in inclusive, general education classrooms. Implications and future directions for research in implementation science, special education, and self-determination interventions are described.