Factors that Influenced Adoption of a School-Based Trauma-Informed Universal Mental Health Intervention
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Factors that Influenced Adoption of a School-Based Trauma-Informed Universal Mental Health Intervention Kimberly T. Arnold 1 & Keshia M. Pollack Porter 2 & Shannon Frattaroli 2 & Rachel E. Durham 3 & Kristin Mmari 4 & Laura K. Clary 5 & Tamar Mendelson 4,5
# Society for Prevention Research 2020
Abstract We know little about why school administrators choose to adopt preventive mental health interventions within the context of school-based prevention trials. This study used a qualitative multiple-case study design to identify factors that influenced the adoption of a trauma-informed universal intervention by urban public school administrators during an efficacy trial. Semistructured interviews were conducted with 15 school administrators who adopted a trauma-informed mindfulness intervention called RAP (Relax, be Aware, and do a Personal Rating) Club as part of their participation in a school-based trial with eighth graders. Findings indicated that administrators adopted RAP Club to provide support for students affected by trauma and prevent students from engaging in unhealthy coping behaviors. Examples of contextual factors that contributed to adoption included a lack of trauma-informed mental health programs within schools, inadequate district funding for preventive school mental health services, and the perceived benefits of engaging in a university-community partnership. The study’s findings suggest strategies to increase school program adoption in the context of research and, more broadly, for implementation science. Keywords Program adoption . Trauma . Urban schools . Mental health intervention . Adolescents
Public schools are the main provider of mental health services for youth in the United States (U.S.). Public schools play a key role in increasing access to these services for children of color and children from low-income families, who are less likely to have access to mental health services and are also at greater risk of trauma exposure than children who are White and/or from higher-income families (Cummings et al. 2010; Eiraldi et al. 2015; Larson et al. 2017; Slopen et al. 2016). A growing
* Kimberly T. Arnold [email protected] 1
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., 3rd Floor, Philadelphia, PA 19104, USA
2
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
3
School of Education, Notre Dame of Maryland University, Baltimore, MD, USA
4
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
5
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
literature indicates that school-based mental health interventions can prevent and reduce emotional and behavioral problems for youth (e.g., Fazel et al. 2014; Murphy et al. 2017). Few of these interventions, however, have been successfully adopted or implemented in schools serving low-income children (Eiraldi et al
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