Coaching and Asynchronous Remote Training for Evidence-Based Practices (CARE)



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The CARE (Coaching and Asynchronous Remote Training for Evidence-Based Practices) study is a partnership between CHOP, Devereux Center for Effective Schools, and schools serving rural communities throughout the state of Pennsylvania.

The study employs a pragmatic design comprised of a mixed-methods approach for the development of the training platform and a pilot randomized controlled trial to test the effectiveness of the platform with behavioral health services in schools serving rural communities.

Rural areas have fewer, and less well-trained, health care providers than non-rural areas. Schools have become more involved in the delivery of mental health services and hold great potential for increasing access to children and adolescents. Innovations in training and service delivery are needed to improve mental health care quality and availability in rural schools. Evidence-based practices (EBPs) can be incorporated into school-wide multi-tiered systems that are currently used to improve school climate and safety. School-wide Positive Behavioral Interventions and Supports (PBIS), a service-delivery strategy based on the public health model is one example. Investigators will use an iterative process (Rapid Prototyping) to develop and evaluate the appropriateness, feasibility, acceptability, and preliminary efficacy of a remote training strategy that provides resources to support use of Tier 2 EBPs in schools serving rural communities.

An increasing number of schools in rural settings are employing the multi-tier positive behavioral interventions and supports (PBIS) framework to improve school climate. A key challenge is that school personnel need technical assistance (training plus ongoing consultation) in order to implement EBPs with fidelity; however, providing ongoing on-site support is not feasible or sustainable in the majority of rural schools, due to their remote physical location. For this reason, telehealth technology has been recommended for the training of school staff in underserved rural communities.

This R18 grant for the CARE (Coaching and Asynchronous Remote Training for Evidence-Based Practices) study is being funded by the Agency for Healthcare and Research and Quality and is actively recruiting participants.

Participants will be school personnel with and without prior mental health training and students in grades four to eight in schools serving rural areas who are deemed at risk for externalizing and internalizing mental health disorders.

Study Highlights

The aims of the CARE (Coaching and Asynchronous Remote Training for Evidence-Based Practices) study are to:

  • Obtain input from school stakeholders about barriers and facilitators in remote online training by employing a community-based participatory research approach.
  • Use the iterative rapid prototyping approach to develop an asynchronous and synchronous remote training strategy (RTS) based on preliminary studies and Aim 1 data
  • To conduct a pilot randomized controlled trial comparing three training strategies: Control Condition (CC), Remote Video (RV), and Remote Video plus Coaching (RV+).

The study will employ a pragmatic design comprised of a mixed-method approach for aims 1 and 2, and a pilot randomized controlled trial for aim 3. Aims 1 and 2 will be completed during years one and two and aim 3 during years three through five of the study.

Study outcomes include perceived feasibility, appropriateness, and acceptability of the training platform, and content and process fidelity of interventions with students, and student mental health and academic engagement.

The CARE study is currently recruiting and its remote training platform has been developed.