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Research practice partnerships (RPP) between schools and researchers present a promising approach to co-creating scalable professional development for trauma-informed schools. This study used an RPP to develop an implementation model for a trauma-informed professional development program across 15 schools in a major urban school district. The primary study goal was to describe the RPP’s co-design processes used to develop and mount a large-scale professional development program with accompanying implementation supports. A secondary goal was to provide representative case examples of feedback loops for real-time improvements to the implementation strategies. A rapid mixed methods approach drawing on the principles of developmental evaluation was used to collect implementation process data including RPP team meeting notes and documents, informal discussions, training and survey completion reports, attendance, and implementation workshop exit tickets. These data were triangulated to conduct preliminary analyses which were then presented to RPP team members for collaborative review. Results highlighted seven co-designed elements of the TISE implementation support system—engaging and supporting school leadership, implementation teams, live and asynchronous training, ongoing consultation, delivering practical resources, relationship building, and continuous improvement. Exemplar feedback loops highlighted immediate improvements to implementation resources via exit tickets and enhanced strategies for building long-term school-level team effectiveness and engagement via attendance tracking.

Context: In response to national efforts to improve quality of care, policymakers and health care leaders have increasingly turned to quality improvement collaboratives (QICs) as an efficient approach to improving provider practices and patient outcomes through the dissemination of evidence-based practices. This article presents findings from a systematic review of the literature on QICs, focusing on the identification of common components of QICs in health care and exploring, when possible, relations between QIC components and outcomes at the patient or provider level. Methods: A systematic search of five major health care databases generated 294 unique articles, twenty-four of which met our criteria for inclusion in our final analysis. These articles pertained to either randomized controlled trials or quasi-experimental studies with comparison groups, and they reported the findings from twenty different studies of QICs in health care. We coded the articles to identify the components reported for each collaborative. Findings: We found fourteen crosscutting components as common ingredients in health care QICs (e.g., in-person learning sessions, phone meetings, data reporting, leadership involvement, and training in QI methods). The collaboratives reported included, on average, six to seven of these components. The most common were in-person learning sessions, plan-do-study-act (PDSA) cycles, multidisciplinary QI teams, and data collection for QI. The outcomes data from these studies indicate the greatest impact of QICs at the provider level; patient-level findings were less robust. Conclusions: Reporting on specific components of the collaborative was imprecise across articles, rendering it impossible to identify active QIC ingredients linked to improved care. Although QICs appear to have some promise in improving the process of care, there is great need for further controlled research examining the core components of these collaboratives related to patient- and provider-level outcomes.

This narrative review aims to identify caregiver factors that influence children’s trauma treatment process and outcomes and to explore areas for future research. It reviews 29 studies published between 1996 and 2018 identified based on a search of the PsycINFO database and reference review and organizes identified caregiver factors into factors that influence treatment engagement, treatment process, and treatment outcomes in a conceptual model. The results suggest caregiver motivation and caregivers’ influences on the child’s symptom presentation may impact initial treatment engagement. Treatment process appears to be impacted by caregiver demographics; caregiver trauma exposure; caregiver functioning; caregiver participation in treatment; and the therapeutic relationship. Treatment outcomes appear to be impacted by caregiver support of the child during treatment and caregiver functioning. Caregiver factors, as measured in the extant literature base, generally seem to have the potential to positively impact children’s trauma treatment. Exceptions to this are when caregivers experience challenges supporting their child or their child’s treatment. Additionally, several limitations are noted in the current literature. Namely, there is a lack of consistent operationalization of caregiver factors and types of caregiver participation, and the role of culture and diversity variables in caregivers' engagement in children’s trauma treatment is understudied.

Mental health care preferences are examined among 1,893 low-income immigrant and U.S.-born women with an acknowledged emotional problem (mean age = 29.1, SD = 89.6). Ethnicity, depression, somatization, and stigma are examined as they relate to mental health care preferences (medication, individual and group counseling, faith, family/friends). Seventy-eight percent of participants counseling would be helpful; 55%; group counseling; and 32% medication. Faith was cited by 81%; family and friends were endorsed by 65%. Minorities had lower odds than Whites of endorsing medication (Black immigrants: OR = 0.27, p  < 0.001, U.S.-born Blacks: OR = 0.30, p  < 0.001, immigrant Latinas: OR = 0.50, p  < 0.01). Most minorities also had higher odds of endorsing faith compared to Whites (Black immigrants: OR = 3.62, p  < 0.001; U.S.-born Blacks, OR = 3.85, p  < 0.001; immigrant Latinas: OR = 9.76, p  < 0.001). Being depressed was positively associated with endorsing medication (OR = 1.93, p  < 0.001), individual counseling (OR = 2.66, p  < 0.001), and group counseling (OR = 1.35, p  < 0.01). Somatization was positively associated with endorsing medication (OR = 1.29, p  < 0.05) and faith (OR = 1.37, p  < 0.05). Stigma-concerns reduced the odds of endorsing group counseling (OR = 0.58, p  < 0.001). Finally, being in mental health treatment was related to increased odds of endorsing medication (OR = 3.88, p  < 0.001) and individual counseling (OR = 2.29, p  = 0.001).

There is great interest in the dissemination and implementation of evidence-based treatments and practices for children across schools and community mental health settings. A growing body of literature suggests that the use of one-time workshops as a training tool is ineffective in influencing therapist behavior and patient outcomes and that ongoing expert consultation and coaching is critical to actual uptake and quality implementation. Yet, we have very limited understanding of how expert consultation fits into the larger implementation support system, or the most effective consultation strategies. This commentary reviews the literature on consultation in child mental health, and proposes a set of core consultation functions, processes, and outcomes that should be further studied in the implementation of evidence-based practices for children.

This article describes implementation experiences \"scaling up\" the Cognitive Behavioral Intervention for Trauma in Schools (CBITS)-an intervention developed using a community partnered research framework. Case studies from two sites that have successfully implemented CBITS are used to examine macro- and school-level implementation processes and strategies used to address implementation issues and create a successful implementation support system. Key elements of the implementation support system include pre-implementation work, ongoing clinical and logistical implementation supports, promotion of fidelity to the intervention's core components, tailored implementation to fit the service context, and a value on monitoring child outcomes.

Urban Latino youth are exposed to high rates of violence, which increases risk for diverse forms of psychopathology. The current study aims to increase specificity in predicting responses by testing the hypothesis that youths’ reinforcement sensitivity—behavioral inhibition (BIS) and behavioral approach (BAS)—is associated with specific clinical outcomes and increases risk for the development of such problems following exposure to violence. Utilizing a short-term longitudinal design, Latino youth ( N  = 168) provided reports of BIS/BAS and emotional/behavioral problems at Time 1, exposure to violence between Time 1 and Time 2, and clinical symptoms at Time 2. Results suggested that reinforcement sensitivity moderated the relation between violence exposure and psychopathology, such that increasing levels of BIS were associated with elevated risk for internalizing and posttraumatic stress symptoms following exposure to violence whereas BAS increased risk for externalizing problems. The importance of building on existing knowledge to understand minority youth psychopathology is discussed.

Measurement feedback systems (MFSs) have been proposed as a means of improving practice. The present study examined the implementation of a MFS, the Contextualized Feedback System (CFS), in two community-based clinic sites. Significant implementation differences across sites provided a basis for examining factors that influenced clinician uptake of CFS. Following the theoretical implementation framework of Aarons et al. (Adm Policy Mental Health Mental Health Serv Res 38(1):4–23, 2011 ), we coded qualitative data collected from eighteen clinicians (13 from Clinic U and 5 from Clinic R) who participated in semi-structured interviews about their experience with CFS implementation. Results suggest that clinicians at both clinics perceived more barriers than facilitators to CFS implementation. Interestingly, clinicians at the higher implementing clinic reported a higher proportion of barriers to facilitators (3:1 vs. 2:1); however, these clinicians also reported a significantly higher level of organizational and leadership supports for CFS implementation. Implications of these findings are discussed.