Training & Support for School Staff on Student Mental Health Issues

(E-IMPACTS Trial)

Recruiting at 2 trial locations

Overseen By Faith A Zabek, Ph.D.

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Virginia

Disqualifiers: Previous EIS use, <70% response rate

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

21350 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assess how different types of training and support affect school staff's ability to address middle school students' mental and behavioral health needs. Researchers will compare two groups: one receiving standard training and the other receiving additional support through collaborative learning and coaching sessions (EIS + ECHO). Schools seeking to improve their mental health support systems, particularly those in rural or suburban areas, are well-suited for this trial. Schools already using the Early Identification System (EIS) are ineligible.

As an unphased trial, this study provides schools with a unique opportunity to enhance their mental health support strategies through innovative training and support methods.

Do I need to stop my current medications to participate in the trial?

The trial does not specify whether participants need to stop taking their current medications.

What prior data suggests that this training and support method is safe for school staff and students?

Research shows that the ECHO model, part of the EIS + ECHO treatment, is effective and easy to use. This model connects experts with school staff through video sessions, helping them learn and apply new strategies. Studies have shown that ECHO improves skills without major safety concerns.

The Early Identification System (EIS) detects early signs of mental health issues in students and connects to interventions for various mental health risk areas. No evidence of safety issues has emerged when using EIS in schools.

In summary, both EIS and ECHO treatments appear safe for school staff, with no major adverse events reported. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial involving EIS + ECHO because it offers a new approach to supporting school staff with student mental health issues. Unlike traditional training methods, this trial integrates monthly collaborative learning sessions (ECHO) with existing implementation supports (EIS), fostering a more interactive and ongoing learning environment. This combination not only reinforces evidence-based practices but also provides follow-up support, encouraging consistent application of strategies. By focusing on enhanced implementation support, this approach has the potential to greatly improve the effectiveness of mental health interventions in schools.

What evidence suggests that this trial's treatments could be effective for improving school staff's response to student mental health issues?

Research shows that the ECHO model, part of the EIS + ECHO treatment arm in this trial, uses online learning and mentoring to enhance mental health services in schools. Studies have found that this model boosts staff confidence and knowledge about mental health practices. The ECHO model connects school staff with mental health experts through video sessions, helping them learn to better support students' mental and behavioral health needs. Meanwhile, the EIS Only treatment arm provides technical support for using the Early Identification System, which helps identify students who may need mental health support. Both approaches in this trial aim to improve how school staff understand and respond to student mental health issues. ^{1 2 3 6 7}

Who Is on the Research Team?

Michael D Lyons, Ph.D.

Principal Investigator

University of Virginia

Are You a Good Fit for This Trial?

This trial is for middle school students and staff in public schools that include grades 6-8, located in rural areas, towns, and small suburbs or cities. Schools planning to implement the Early Identification System (EIS) for mental health can participate unless they've used EIS before or had less than a 70% response rate on pre-intervention implementation.

Inclusion Criteria

Located in rural areas, towns, & suburbs / cities (NCES locales)

Public middle schools (must include grades 6-8) planning to implement the EIS

I am a student or staff member at the school.

Exclusion Criteria

Previous use of EIS (i.e., use of all screening data and intervention hub)

My response to the initial treatment was below 70%.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation Support

Schools receive either standard implementation support (EIS Only) or enhanced support (EIS + ECHO) involving professional learning communities and coaching.

9 months

Monthly online sessions

Follow-up

Participants are monitored for changes in staff burnout, knowledge, and student outcomes.

3 months

What Are the Treatments Tested in This Trial?

Interventions

• EIS + ECHO
• EIS Only

Trial Overview The study tests how different training supports affect school staff's ability to address middle schoolers' mental health needs using EIS. One group receives standard training while another gets additional support through professional learning communities and coaching.

How Is the Trial Designed?

Group I: EIS + ECHO Experimental Treatment 1 Intervention

EIS + ECHO (experimental) condition involves all of the activities included in the "EIS Only" condition and will include enhanced implementation supports. Enhanced implementation supports involve 1) monthly collaborative learning ECHO sessions for school student support team staff to support implementation of EIS and evidence-based mental and behavioral health practices and 2) individual school teams will also receive follow-up supports to promote the implementation strategies presented during ECHO sessions.

Group II: EIS Only Active Control 1 Intervention

EIS Only (active comparator) condition schools involve technical assistance to support the implementation EIS.

Who Is Running the Clinical Trial?

University of Virginia

Lead Sponsor

Trials

802

Recruited

1,342,000+

University of Missouri-Columbia

Collaborator

Trials

387

Recruited

629,000+

University of South Carolina

Collaborator

Trials

233

Recruited

122,000+

Published Research Related to This Trial

A demonstration study involving 95 clinicians in a school behavioral health network showed that implementing standardized assessments (SA) significantly improved clinician attitudes towards their clinical utility and treatment planning after training (p < .001).

Clinicians reported a notable increase in the use of SA for new clients during intakes over time, with 71.4% of expected SA data submitted, indicating successful integration of these assessments into practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploration, Preparation, and Implementation of Standardized Assessment in a Multi-agency School Behavioral Health Network. Connors, E., Lawson, G., Wheatley-Rowe, D., et al.[2023]

The initiative aims to address mental health issues in schools following crises, recognizing that schools are effective environments for helping students recover from trauma.

By supporting students after traumatic events, the initiative seeks to prevent negative impacts on academic performance, such as lower reading achievement and grade point averages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing schools' capacities to respond to community crisis: the Tennessee initiative. Love, RA., Cobb, N.[2018]

The myHealthE (MHE) system successfully automates the collection and reporting of Patient-Reported Outcome Measures (PROMs) for Child and Adolescent Mental Health Services, demonstrating feasibility and acceptability within NHS clinical services.

The paper outlines a framework for developing and implementing digital health innovations, addressing logistical and governance challenges, which can guide future researchers in creating interoperable systems within NHS infrastructure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Moving from development to implementation of digital innovations within the NHS: myHealthE, a remote monitoring system for tracking patient outcomes in child and adolescent mental health services. Morris, AC., Ibrahim, Z., Moghraby, OS., et al.[2023]

In a study involving 169 school professionals across 94 high schools in Michigan, the adaptive implementation strategy that included Replicating Effective Programs (REP) and added Facilitation for slower-responding schools led to the highest average delivery of cognitive behavioral therapy (CBT) sessions (154.1 sessions).

Contrary to expectations, the combination of REP, Coaching, and Facilitation did not significantly increase the number of CBT sessions delivered compared to REP alone, indicating that not all implementation strategies may enhance service delivery equally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan. Smith, SN., Almirall, D., Choi, SY., et al.[2022]

The transition to online training during COVID-19 allowed the Northwest Mental Health Technology Transfer Center to reach a broader and more diverse audience, enhancing support for school mental health practices.

Participants, including families and caregivers, reported positive gains in knowledge and behaviors after attending virtual youth suicide prevention training, indicating that online formats can effectively support mental health initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What Happens When Training Goes Virtual? Adapting Training and Technical Assistance for the School Mental Health Workforce in Response to COVID-19. Olson, JR., Lucy, M., Kellogg, MA., et al.[2023]

The ECHO telementoring model significantly increased school staff engagement and satisfaction with online mental health training, with effect sizes of 0.58 and 0.82, respectively, among participants who attended ECHO sessions.

While ECHO improved engagement and satisfaction, it did not lead to a significant increase in knowledge about evidence-based mental health practices compared to those who only accessed online modules, indicating the need for further research to assess its overall effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting School Mental Health Providers: Evidence from a Short-Term Telementoring Model. Lyons, MD., Taylor, JV., Zeanah, KL., et al.[2023]

The implementation of a computerized assessment system in a pediatric psychiatric clinic led to a dramatic increase in the completion rates of standardized assessments for new patients (from 0% to 90%) and return visits (from 0% to 80%) within one year.

Provider and patient satisfaction improved significantly, with 94% of providers reporting enhanced visit efficiency and patients rating their satisfaction with the assessment process at 4.1 out of 5, indicating a positive reception of the new system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing Outcome-based Care in Pediatric Psychiatry: Early Results and Overcoming Barriers. Krishna, R., Valleru, J., Smith, W.[2022]

A study involving 41 school counselors across 23 schools used the Voice Diagnostic Interview Schedule for Children IV (DISC-IV) to assess 530 students, revealing that 72% were at risk for mental health issues, with many having never received treatment before.

The assessment identified critical issues such as suicidal symptoms and social phobia, and 82% of parents of at-risk children agreed to follow-up evaluations, demonstrating the effectiveness of using an evidence-based tool for early identification of mental health problems in school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Establishing ongoing, early identification programs for mental health problems in our schools: a feasibility study. Nemeroff, R., Levitt, JM., Faul, L., et al.[2021]

The pilot projects demonstrated that partnerships between school staff and mental health professionals can effectively improve access to mental health support for students, with over 1200 activities reported by InReach workers in schools over 3 years.

Participants in the School Mental Health Toolbox training found the skills useful, particularly in promoting better sleep and relaxation techniques, indicating that training school staff can enhance their ability to support student mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Partnerships at the Interface of Education and Mental Health Services: The Utilisation and Acceptability of the Provision of Specialist Liaison and Teacher Skills Training. Fazel, M., Soneson, E., Sellars, E., et al.[2023]

The TRAILS program successfully trained 86 community clinicians in Michigan to become coaches in cognitive behavioral therapy (CBT), significantly improving their knowledge and application of CBT strategies.

This coaching model, which includes in vivo support and personalized consultation, effectively addresses the shortage of mental health providers for youth by enhancing the implementation of evidence-based practices in schools.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a statewide network of coaches to support youth access to evidence-based practices. Meyer, AE., Rodriguez-Quintana, N., Miner, K., et al.[2023]

Citations

1. cdc.gov cdc.gov/lab-quality/php/echo/index.html

Project Extension for Community Healthcare Outcomes The ECHO (Extension for Community Healthcare Outcomes) Project was designed to educate and train laboratory and healthcare professionals on ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38330317/

Applying the extension for community healthcare outcomes ... The ECHO model uses online learning and telementoring to improve school mental health services. It showed improvements in self-efficacy and knowledge, and ...

3. uth.edu uth.edu/echo/

Project Echo Project ECHO (Extension for Community Healthcare Outcomes) creates forums for specialists to share knowledge and bridge the gap between the care provided in ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4873719/

Project ECHO (Extension for Community Healthcare ... ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning.

5. systematicreviewsjournal.biomedcentral.com systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-021-01832-0

Effectiveness and experiences of the Extension for Community ... The Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education is an innovative guided-practice model aiming at amplifying ...

6. moprevention.org moprevention.org/wp-content/uploads/2021/01/Coalition-growth-SPR.final_.pdf

Running Head: FIDELITY AND STUDENT OUTCOMES Mental Health Prevention and Intervention Model and Student Outcomes ... districts plus one parochial school ... Early Identification System- Student Report (EIS-SR) ...

7. ruralsmh.com ruralsmh.com/intervention-hub/

Early Identification System (EIS) Intervention Hub The EIS intervention hub connects to interventions across 7 risk areas known to be related to later mental health problems.