Resources and school culture are associated with readiness for implementation of universal prevention programs in rural schools Lindsey Turner, PhD Hannah Calvert, PhD Katie Bubak-Azevedo, EdD Carl Siebert, PhD
Rural America Population density by census tract, American Community Survey 2013-17
Idaho: A Small, Mostly Rural State
Also a Mountainous State
700 Schools; 443 in Rural Areas
Rural ≠ Rural A New Portrait of Rural America https://www.americancommunities.org/chapter/overview-2/
Scenes of Rural Idaho: Our Schools
Rural Disparities Higher: Unemployment Deaths from injuries Morbidity/mortality Lower: Healthcare access (coverage and availability of providers) Educational attainment Household incomes School capacity to implement EBPs • location (i.e., geographic isolation, professional shortages) • limited infrastructure and logistics (i.e., transportation challenges and resource constraints) • perceptions (i.e., traditional rural values and distrust of outsiders; skepticism of services to be provided) • student characteristics
Cluster-randomized Type 3 hybrid effectiveness-implementation trial The EBP Schoolwide Positive Behavioral Interventions & Supports (SWPBIS) The Intervention: Idaho Rural Implementation Model (I-RIM) • Technical assistance, on-site and virtual/remote • Capacity-building for school personnel (coaching skills) • Regional and statewide networking • Online learning modules and resources
RK-12 40 rural schools (20 I-RIM intervention; 20 control) Spring 2019- 2020- 2019 2020 2021 Data sources (mixed methods): Implementation fidelity (SET, TFI) Climate (students, staff, parents) Additional surveys, interviews Student behavior (office disciplinary referrals) Student academic scores
The Baseline Team Survey Collected in February 2019, prior to intervention Each school’s PBIS team • ~5 school staff members • Must include principal • Designated “PBIS implementation coach” Responses from 168 of 204 team members (82%) Mean = 4.2 respondents per school ( SD = 1.1, range from 2-6) Roles 80% had worked in 40 principals education for >5 years 107 teachers (general + specialists) 16 counselors 5 other staff
Organizational Readiness Change Efficacy (Team) I feel confident that our team can get staff at this school invested in implementing SWPBIS. I am confident that our team can handle the challenges that might arise in implementing SWPBIS. Our team is confident that we can coordinate tasks so that implementation goes smoothly. I am confident that our team can manage the politics of implementing SWPBIS. Change Commitment (Team and Staff) Staff (including teachers) at this school are committed to implementing SWPBIS. Staff (including teachers) at this school will do what it takes to implement SWPBIS. Staff (including teachers) at this school want to implement SWPBIS. Our team is motivated to implement SWPBIS. Our team is determined to implement SWPBIS. Shea, Jacobs, Esserman, Bruce & Weiner (2014). Organizational Readiness for Implementing Change: psychometric assessment of a new measure. Implementation Science, 9.
Organizational Readiness: Average Scores, by Item Change Efficacy (Team) 4.6 I feel confident that our team can get staff at this school invested in implementing SWPBIS. 4.8 I am confident that our team can handle the challenges that might arise in implementing SWPBIS. 4.7 Our team is confident that we can coordinate tasks so that implementation goes smoothly. 4.6 I am confident that our team can manage the politics of implementing SWPBIS. Change Commitment (Team and Staff) 3.8 Staff (including teachers) at this school are committed to implementing SWPBIS. 3.8 Staff (including teachers) at this school will do what it takes to implement SWPBIS. 3.8 Staff (including teachers) at this school want to implement SWPBIS. 5.0 Our team is motivated to implement SWPBIS. 4.9 Our team is determined to implement SWPBIS. 1 2 3 4 5 6 M = 4.8 (95% CI, 4.7 to 4.9) 1 = strongly disagree to 6 = strongly agree Bars show 95% confidence interval around the mean Shea, Jacobs, Esserman, Bruce & Weiner (2014). Organizational Readiness for Implementing Change: psychometric assessment of a new measure. Implementation Science, 9.
Survey Items: Characteristics of Individuals & Intervention (CFIR) Knowledge (Conceptual + Practical), α = .83 I know a fair amount about the theory and principles behind SWPBIS I know what Tier 1 behavioral interventions look like in general education I know how to monitor student behavior I know how to display data for analyses I know how to make decisions based on behavior data (disciplinary referrals) I know a fair amount about how to implement SWPBIS Intervention Value, α = .96 I believe SWPBIS can support successful learning outcomes for our students I believe SWPBIS is an effective strategy for improving school safety outcomes I believe SWPBIS can help to improve school climate I believe SWPBIS can support successful learning outcomes for our students Intervention Characteristics (custom-developed items) I believe SWPBIS has advantages over other programs (relative advantage) SWPBIS seems like it is complicated (complexity) Fan, Zhang, Cook, Yang (2018). Exploring the factor structure of the RTI Readiness and Implementation Survey, J Appl School Psych, 34(4); 360-387.
Survey Items: Inner Context (CFIR) System Support, α = .82 • My school's vision and goal for student behavior are shared and owned by stakeholders (staff and students) • The rationale for using positive behavior support systems in our school is clear • Implementing positive behavior support systems is a priority for our district leadership • Implementing positive behavior support systems is a priority for our school leadership • Implementing positive behavior support systems is a priority for our school staff Sufficient Time , α = .83 • I have sufficient time for completing behavior management documentation or paperwork • I have sufficient time to attend PBIS leadership team meetings • I have sufficient time to implement positive behavior support systems Resources ( r = .77) • I have access to resources which I can use for progress-monitoring student behavior progress • I have access to resources which I can use for implementing behavior interventions Fan, Zhang, Cook, Yang (2018). Exploring the factor structure of the RTI Readiness and Implementation Survey, J Appl School Psych, 34(4); 360-387.
Survey Items: Inner Context (CFIR) System Barriers My school's behavior management process is bureaucratic and overly complex (paperwork) and merely benefits administration (e.g., for compliance purposes) Teachers in my school feel disempowered by behavior management processes (being over-supervised or scrutinized for accountability purposes) School Culture for EBPs Using evidence-based practices to support students is consistent with the culture of our school
Average Scores for Constructs 4.2 Knowledge (conceptual/practical) 5.0 Intervention, value 3.7 Intervention, complexity 4.6 Intervention, relative advantage 4.4 System support 3.0 Barriers, bureaucratic/complex processes 3.1 Barriers, over-scrutinized 3.7 Sufficient time Sufficient resources for progress monitoring 3.9 4.9 Culture for EBP 1 2 3 4 5 6 1 = strongly disagree to 6 = strongly agree
Analytic Approach • Linear regression models to examine relationships with readiness • Clustered within school • Bivariate, then a full model Associations of each construct with Organizational Readiness (bivariate) Knowledge (conceptual/practical) .11*** Intervention, value .52*** -.12* Intervention, complexity Intervention, relative advantage .35*** System support .58*** Barriers, bureaucratic/complex processes -.16*** Barriers, over-scrutinized -.04 Sufficient time .33*** .20** Sufficient resources Culture for EBP .24*** * p < .05, ** p < .01, *** p < .001
Multivariate Results R 2 = .579 Coeff p 95% CI -.031 .544 -.132, .071 Knowledge (conceptual/practical) Intervention, value .207 .017 .039, .375 Intervention, complexity -.006 .875 -.082, .070 Intervention, relative advantage .010 .873 -.116, .136 System support .403 <.001 .290, .516 Barriers, bureaucratic/complex processes -.091 .004 -.150, -.031 Sufficient time .114 .055 -.003, .230 Sufficient resources .008 .879 -.097, .113 Culture for EBP .080 .177 -.038, .199 System Support, 5 items, α = .82 3 of those items: Implementation is a priority for district leadership / school leadership / school staff (very similar to “Change Commitment” in Organizational Readiness)
Multivariate Results R 2 = .465 Coeff p 95% CI -.097 .099 -.214, .019 Knowledge (conceptual/practical) Intervention, value .273 .005 .089, .458 Intervention, complexity -.008 .839 -.069, .085 Intervention, relative advantage .083 .260 -.064, .230 System support Barriers, bureaucratic/complex processes -.093 .007 -.160, -.027 Sufficient time .233 <.001 -.116, .350 Sufficient resources .075 .202 -.042, .191 Culture for EBP .157 .017 -.029, .285
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