The Utility of Measuring Intentions to Use Best Practices: A Longitudinal Study Among Teachers Supporting Students With Autism

Fishman, Jessica; Beidas, Rinad S.; Reisinger, Erica M.; Mandell, David S.

doi:10.1111/josh.12618

Cited by 50 publications

(79 citation statements)

References 20 publications

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“…It is not clear how EI clinicians working in a service system that is planning a wide-scale implementation will incorporate the program into their existing practice. Previous studies have found significant variation in educators' motivation to adopt new evidence-based practices within large-scale rollouts such as this one [18]. Associated barriers to implementing evidence-based practices are exacerbated in large under-resourced service settings, like the early intervention system in Philadelphia [29,30].…”

Section: Introductionmentioning

confidence: 92%

“…1) [15][16][17]. Previous work finds substantial variability in teachers' and clinicians' intentions to implement a new practice, and that intentions to implement a new practice are associated with its later implementation [16,18]. Understanding EI clinicians' intentions to implement parent coaching and whether these intentions are driven by attitudes, norms, and self-efficacy can lead to tailored implementation strategies that target specific mechanisms to increase use of parent coaching.…”

Section: Introductionmentioning

confidence: 99%

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Parent empowerment and coaching in early intervention: study protocol for a feasibility study

Pellecchia

Beidas

Mandell

et al. 2020

Pilot Feasibility Stud

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Background: Parent-mediated early interventions (EI) for children with autism spectrum disorder (ASD) can result in significant improvements in children's cognitive ability, social functioning, behavior, and adaptive skills, as well as improvements in parental self-efficacy and treatment engagement. The common component to efficacious parentmediated early interventions for ASD is clinician use of parent coaching and occurs when a clinician actively teaches the parent techniques to improve their child's functioning. Available evidence suggests that communitybased EI clinicians rarely coach parents when working with families of these children, although specific barriers to coaching are unknown. This consistent finding points to the need to develop strategies to improve the use of parent coaching in community EI programs. The purpose of this community-partnered study is to iteratively develop and pilot test a toolkit of implementation strategies designed to increase EI clinicians' use of parent coaching. Methods: This study has four related phases. Phase 1: examine how EI clinicians trained in Project ImPACT, an evidence-based parent-mediated intervention, coach parents of children with ASD. Phase 2: identify barriers and facilitators to clinician implementation of parent coaching by administering validated questionnaires to, and conducting semi-structured interviews with, clinicians, parents, and agency leaders. Phase 3: partner with a community advisory board to iteratively develop a toolkit of implementation strategies that addresses identified barriers and capitalizes on facilitators to improve clinician implementation of evidence-based parent coaching. Phase 4: pilot test the feasibility and effectiveness of the implementation strategy toolkit in improving EI clinicians' use of parent coaching with nine EI clinicians and parent-child dyads using a multiple-baseline-across-participants single-case design. Discussion: Completion of these activities will lead to an in-depth understanding of EI clinicians' implementation of parent coaching in usual practice following training in an evidence-based parent-mediated intervention, barriers to their implementation of parent coaching, a toolkit of implementation strategies developed through an iterative community-partnered process, and preliminary evidence regarding the potential for this toolkit to improve EI clinicians' implementation of parent coaching. These pilot data will offer important direction for a larger evaluation of strategies to improve the use of parent coaching for young children with ASD.

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Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Parent empowerment and coaching in early intervention: study protocol for a feasibility study

Pellecchia

Beidas

Mandell

et al. 2020

Pilot Feasibility Stud

Self Cite

View full text Add to dashboard Cite

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“…Nevertheless, school mental health services are frequently not based on evidence for effectiveness [32][33][34][35]. Recent evidence shows that school mental health professionals' intentions to use EBP are strongly associated with subsequent use [36] and that implementation may be driven as much or more by individual-level determinants (e.g., attitudes) than by organizational processes [11]. BASIS employs strategies targeting each TPB component: (1) Strategic education about EBP and intervention fidelity to improve attitudes toward EBP, (2) Social influence techniques to alter perceptions of subjective norms, and (3) Motivational Interviewing techniques to enhance perceived behavioral control.…”

Section: Beliefs and Attitudes For Successful Implementation In Schoomentioning

confidence: 99%

The influence of a blended, theoretically-informed pre-implementation strategy on school-based clinician implementation of an evidence-based trauma intervention

Lyon¹,

Cook²,

Duong³

et al. 2019

Preprint

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BackgroundIndividual-level implementation determinants, such as clinician attitudes, commonly influence the successful adoption of evidence-based practices, but few explicit strategies have been tested with regard to their ability to impact these key mechanisms of change. This paper reports on an initial test of a blended, theoretically informed pre-implementation strategy designed to target malleable individual-level determinants of behavior change. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a brief and pragmatic pre-implementation strategy that uses strategic education, social influence techniques, and group-based motivational interviewing to target implementation attitudes, perceived social norms, perceived behavioral control, and behavioral intentions to implement among mental health clinicians working in the education sector.MethodsAs part of a pilot trial, 25 school mental health clinicians were randomized to BASIS (n = 12) or an attention control placebo (n = 13), with both conditions receiving training and consultation in an evidence-based intervention for youth experiencing trauma (the Cognitive Behavioral Intervention for Trauma in Schools). Theorized mechanisms of change (attitudes, perceived social norms, perceived behavioral control, and behavioral intentions) were assessed at baseline, post-training, and 4-month follow-up. Clinician participation in post-training consultation and intervention adoption were also tracked.ResultsA series of regression models and independent sample t tests indicated that BASIS had significant, medium to large effects on the majority of its proximal mechanisms from baseline to post-training. BASIS was also associated with a greater latency between initial training in the intervention and discontinuation of participation in post-training consultation, with clinicians in the BASIS condition persisting in consultation for an average of 134 days versus 32 days for controls, but this difference was not statistically significant. At 4-month follow-up, most differences in the theorized mechanisms had attenuated, and approximately the same small number of BASIS clinicians adopted the trauma intervention as controls.ConclusionFindings suggest that the brief BASIS pre-implementation strategy had a significant influence on its proximal mechanisms of change, but that these changes did not persist over time or translate into adoption of the trauma intervention. Implications for theory refinement, revisions to the BASIS protocol, and next steps for research surrounding individual-level implementation strategies are discussed.Methods. As part of a pilot trial, 25 school mental health clinicians were randomized to BASIS (n = 12) or an attention control placebo (n = 13), with both conditions receiving training and consultation in an evidence-based intervention for youth experiencing trauma. Theorized mechanisms of change (attitudes, perceived social norms, perceived behavioral control, and behavioral intentions) were assessed at baseline, post-training, and four-month follow-up. Clinician participation in post-training consultation and intervention adoption were also tracked. Results. A series of regression models and independent sample t-tests indicated that BASIS had significant, medium to large effects on the majority of its proximal mechanisms from baseline to post-training. BASIS was also associated with a greater latency between initial training in the intervention and discontinuation of participation in post-training consultation, with clinicians in the BASIS condition persisting in consultation for an average of 134 days versus 32 days for controls, but this difference was not statistically significant. At four-month follow-up, most differences in the theorized mechanisms had attenuated, and approximately the same small number of BASIS clinicians adopted the trauma intervention as controls. Conclusion. Findings suggest that the brief BASIS pre-implementation strategy had a significant influence on its proximal mechanisms of change, but that these changes did not persist over time or translate into adoption of the trauma intervention. Implications for theory refinement, revisions to the BASIS protocol, and next steps for research surrounding individual-level implementation strategies are discussed.

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“…This model has been used to understand and predict many health-related behaviors [ 9 ], and interventions aimed at improvements in health-related intentions have been associated with behavior change [ 10 ]. However, the TPB has only recently been examined in relation to the implementation of EBPs for children with ASD in community settings [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Fishman and colleagues demonstrated public school teachers who reported strong intentions to use visual schedules, an EBP for children with ASD, were significantly more likely to be observed using them with their students than teachers who reported weaker intentions, providing support for the role of intentions in predicting behavior [ 11 ]. Further, teachers reported significant variability in their intentions to use four different EBPs following training.…”

Section: Introductionmentioning

confidence: 99%

Community providers’ intentions to use a parent-mediated intervention for children with ASD following training: an application of the theory of planned behavior

et al. 2018

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ObjectivesThe theory of planned behavior (TPB) suggests that attitudes, subjective norms, and perceived behavioral control influence intentions to perform a behavior, and that intentions predict behavior. The present studies examined whether the TPB is applicable to community providers’ use of a parent-mediated intervention for children with autism spectrum disorder (ASD) following introductory training and whether TPB constructs can be modified with training.ResultsStudy 1 demonstrated that community providers’ intentions to use the intervention post-training predicted their use of the intervention 6 months later [X2(1) = 8.03, p = .005]. Study 2 found that provider education (β = .23, t = 2.27, p = .025), attitudes (β = .21, t = 2.09, p = .039), and perceived behavioral control (β = .21, t = 2.15, p = .035) were all unique predictors of intentions. There was a significant increase in providers’ ratings of subjective norms (Z = − 2.46, p = .014) and perceived behavioral control (Z = − 7.36, p < .001) from pre- to post-training. Attitudes towards parent-mediated interventions were highly favorable pre-training and did not significantly increase. Results expand on previous findings and demonstrate the applicability of attitudes and perceived behavioral control in understanding community providers’ use of evidence-based practices for children with ASD.

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The Utility of Measuring Intentions to Use Best Practices: A Longitudinal Study Among Teachers Supporting Students With Autism

Cited by 50 publications

References 20 publications

Parent empowerment and coaching in early intervention: study protocol for a feasibility study

Parent empowerment and coaching in early intervention: study protocol for a feasibility study

The influence of a blended, theoretically-informed pre-implementation strategy on school-based clinician implementation of an evidence-based trauma intervention

Community providers’ intentions to use a parent-mediated intervention for children with ASD following training: an application of the theory of planned behavior

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