BackgroundMiddle managers are in a unique position to promote the implementation of evidence-based practices (EBPs) in healthcare organizations, yet knowledge of middle managers’ role in implementation and determinants (e.g., individual-, organizational-, and system-level factors) which influence their role remains fractured, spanning decades and disciplines. To synthesize understanding, we undertook a systematic review of studies of middle managers’ role in healthcare EBP implementation and determinants of that role.MethodsWe searched MEDLINE/PubMed and Business Source Complete (Ebsco) for literature on middle managers’ role in healthcare EBP implementation and its determinants. We abstracted data from records that met inclusion criteria (i.e., written in English, peer-reviewed, and reporting either a protocol or results of an empirical study) into a matrix for analysis. We summarized categorical variables using descriptive statistics. To analyze qualitative data, we used a priori codes and then allowed additional themes to emerge.ResultsOne hundred five records, spanning across several countries and healthcare settings and relating to a range of EBPs, met our inclusion criteria. Studies of middle managers’ role in healthcare EBP implementation and its determinants substantially increased from 1996 to 2015. Results from included studies suggest that middle managers shape implementation climate in addition to fulfilling the four roles hypothesized in extant theory of middle managers’ role in implementation. However, extant studies offered little understanding of determinants of middle managers’ role.ConclusionsOur findings suggest that middle managers may play an important role in facilitating EBP implementation. Included studies offered little understanding regarding the relative importance of various roles, potential moderators of the relationship between middle managers’ roles and EBP implementation, or determinants of middle managers’ role in EBP implementation. Future studies should seek to understand determinants and moderators of middle managers’ role. Clearer understanding may facilitate the translation of evidence into practice.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0843-5) contains supplementary material, which is available to authorized users.

Maximizing academic engagement and student learning demands that teachers effectively and positively manage student behavior within the classroom. Proactive classroom management (PCM) has been advocated as a preventionoriented and intentional approach to promoting high levels of academic engagement as incompatible to classroom problem behaviors (Rathvon, 2008). PCM involves a variety of classroom management techniques and is distinguishable from other classroom management models by three primary characteristics. First, PCM seeks to optimize academic engagement as a means of preventing inappropriate behaviors that interfere with learning (Gettinger, 1988). Second, PCM integrates instruction and management into a comprehensive classroom system, rather than treating them as separate domains (Rathvon, 2008). In other words, teachers deliver and maintain the flow of academic instruction within the context of ongoing PCM strategies. Third, PCM focuses on group rather than individual aspects of student behavior (Gettinger, 1988). Prior research highlights several effective PCM strategies (Simonsen, Fairbanks, Briesch, Myers, & Sugai, 2008). However, few experimental studies have examined teacher-student interactions as a classwide PCM strategy, and more precisely, whether increasing ratios of positive-to-negative interactions can reduce problem behaviors and promote better academic engagement. One of the most readily available and dispensable resources teachers can deliver to proactively manage desirable classroom behavior is their own attention through positive interactions with students. There are abundant opportunities provided on a daily basis to strategically and positively interact with students to recognize them for their behavior and performance, as well as engage in positive conversations that enable students to feel like a respected and valued member of the classroom. Although teacher behavior and attention can be 679137P BIXXX10.

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BackgroundThe Evidence-Based Practice Attitude Scale (EBPAS) is a widely used tool, but it has not been adapted and validated for use in schools, the most common setting where youth access behavioral health services. This study examined the factor structure, psychometric properties, and criterion-related validity of the school-adapted EBPAS in a sample of school-based behavioral health consultants.MethodA research team comprised of experts in implementation of evidence-based practices in schools along with the original developer adapted the EBPAS for the school setting. The adapted instrument was administered to a representative sample (n = 196) of school-based behavioral health consultants to assess the reliability and structural validity via a series of confirmatory factor analyses.ResultsThe original EBPAS factor structure was confirmed, with the final model supporting four first-order factors that load onto a second-order factor capturing general attitudes toward evidence-based practice. Correlations among the subscales indicated both unique and shared variance. Correlations between EBPAS scores and consultant variables demonstrated differential criterion-related validity, with the total score and the Requirements and Openness subscales demonstrating the strongest correlations.ConclusionsThe adapted EBPAS performed well when administered to behavioral health consultants operating in the educator sector, supporting the relevance of assessing attitudes in school settings. Potential directions for future research and applications of the EBPAS in schools and other service sectors are discussed.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0804-z) contains supplementary material, which is available to authorized users.

Externalizing behaviors undermine learning environments, yet many teachers report receiving inadequate preservice training to manage these behaviors in the classroom (Christofferson & Sullivan, 2015). Disruptive, aggressive, and noncompliant behaviors constitute the majority of externalizing problems that negatively affect classroom learning environments (E. Little, 2003; E. Little & Hudson, 1998). These problem behaviors interfere with instructional delivery, contribute to an unproductive learning atmosphere, and compromise students' ability to stay focused and learn (Walker, Ramsey, & Gresham, 2004). Students who exhibit classroom problem behaviors are likely to experience negative short-and long-term outcomes, including poor grades, absenteeism, exclusionary discipline, conduct problems, school dropout, and incarceration (e.g.,

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