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Improving Fidelity of Implementation of Universal Prevention Initiatives in Rural K-12 Schools Through External Supports: Testing Mediational Impacts on School Team Functioning, Organizational Readiness, and Change Commitment

NCJ Number
Implementation Science Volume: 18 Issue: (Suppl 3) Dated: October 2023 Pages: S138
Date Published
October 2023

This research presents Positive Behavioral Interventions and Supports (PBIS) as a multi-tiered framework for the prevention and management of K-12 student behavior issues.


Positive Behavioral Interventions and Supports (PBIS) is a multi-tiered framework for prevention and management of student behavior issues. Implementation uses a school-level team with 5-8 staff. An external support system may facilitate more-active school-level teams and, subsequently, improve fidelity of implementation. The authors are conducting a Type 3 hybrid trial based on the Interactive Systems Framework, with an external support system providing technical assistance, coaching, and other implementation strategies, during phases of the Quality Implementation Framework (capacity building; creating structures; active implementation). In this parallel two-arm design, 20 schools were randomized to training-only control, and 20 were randomized to receive support during three school years (2019-20 to 2021-22). The primary outcome is fidelity, with a hypothesized mediational mechanism of action whereby supports improve school team functioning—measured with items from the Promoting School University Partnerships to Enhance Resilience (PROSPER) trial—and readiness, measured by the Organizational Readiness for Implementing Change (ORIC) scale. Analyses examined school team surveys, and the well-established PBIS Tiered Fidelity Inventory (TFI). In 2020, team members at intervention schools reported higher scores for positive team culture, clear goals, and productive team meetings (ps<.05). Perceptions of organizational readiness and change commitment increased more at intervention schools relative to control (ps<.05). Multi-level structural equation models assessed relationships between condition, team survey constructs, and fidelity in 2020. The intervention had direct effects on team culture, which was significantly associated with subsequent fidelity (ps<.05), although the full indirect 2-1-2 path was marginally significant (p=.11). Similar results were noted for team perceptions of organizational readiness with significant direct condition effects on readiness, and readiness predicting TFI. External support may improve team function and organizational readiness, subsequently benefitting fidelity. Discussion will explore how implementation strategies—provided through external support systems—may improve scaling of effective prevention initiatives in schools. (Author Abstract Provided)

Date Published: October 1, 2023