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Project RISE (Resources and Internal Supports for Evidence-based Practices)
A major goal of our research with Project RISE is to identify strategies that would help sustain gains that occur as a result of the initial implementation of evidence-based practices (EBPs). Schools are a key setting for the delivery of children's mental health services. School-wide positive behavioral interventions and supports (PBIS), a service delivery strategy based on the public health model, is a useful vehicle for implementing mental health EBPs.
Within PBIS, schools implement universal (Tier 1) interventions to improve school climate and can employ targeted (Tier 2) group interventions for children with or at risk for mental health disorders. School personnel, regardless of prior mental health training, can effectively implement Tier 2 interventions when provided adequate support; however, dedicating resources for ongoing external support for implementers is not always feasible. An efficient, cost-effective and sustainable model of training and consultation is needed to achieve the potential benefits of targeted mental health interventions in schools.
Funded by the National Institutes of Mental Health and in collaboration with Devereux's Center for Effective Schools, the University of Pennsylvania, and the School District of Philadelphia, Project RISE aims to compare fidelity, cost effectiveness, and student outcomes of Tier 2 mental health interventions across two sustainment models. Over the course of five years, 12 Philadelphia schools will participate for three years in one of two treatment conditions. In year one, all schools will receive the same level of support from CHOP. In year two, schools will receive either diminished or no support from CHOP. In year three, all schools will independently implement Tier 2 services with no support from CHOP. Schools will participate in the project in three waves of four schools.
Recruitment is currently underway and the projected enrollment total is 360 students in grades four through eight, and 145 School District of Philadelphia employees.
Project RISE (Resource and Internal Supports for Evidence-Based Practices) is a partnership between CHOP, University of Pennsylvania, Devereux Center for Effective Schools, and the School District of Philadelphia. RISE aims to create internal capacity within the School District of Philadelphia to implement and sustain the use of mental health evidence-based practices (EBPs) with fidelity and clinical effectiveness.
- The study uses a two-arm, randomized controlled trial with a Type 2 Hybrid cluster randomized design: (a) Preparing for Sustainment, a consultation strategy implemented by school district coaches who receive support from external consultants, and (b) Sustainment as Usual, a consultation strategy implemented by school district coaches alone.
- Participants will be 60 implementers and 360 students at risk for externalizing and anxiety disorders. The Interactive Systems Framework for Dissemination and Implementation guides the training and support procedures for implementers.
- The EBPs employed in the study are: Coping Power Program for externalizing disorders, CBT for Anxiety Treatment in Schools for anxiety disorders, and Check-in/Check-out for externalizing and internalizing disorders.
- The implementers of the EBPs are Master's-level professionals with some prior mental health training (e.g., school counselors), and other school personnel (e.g., teachers) without prior mental health training.
- The research team expects this study will result in a feasible, effective, and cost-effective strategy for sustaining mental health EBPs that is embedded within a multi-tiered system of support. Results would likely generalize to other large, urban districts, and have an impact on population-level child mental health.