Moving Toward Scale up: Refinement of Approach and Supports for Implementation with Fidelity

Following two RCTs of ParentCorps, we refined our approach to training and developed tools for “end users” (i.e., principal, school-based mental health professionals [MHPs], teachers, parent support specialists). Our approach is intended to promote knowledge, motivation and capacity for sustained behavior change through sequenced group and individualized experiences, with a “spirit” of explicitly valuing collaboration and supporting autonomy. All materials reflect this spirit and the consistency of manuals and materials across the three components eases delivery and bolsters fidelity. In addition, two tools aim to support sustainable implementation with fidelity: 1) the Quality Implementation Decision Support (QIDS or “KIDS”) system includes data input by all users and provides principals with easy to understand graphic representations of fidelity data for decision making (e.g., offering the Program for Parents at a different time or in a different language if participation is limited); and 2) iParentCorps provides all school users with open access to ParentCorps 101 e-learning, a library of resources, and opportunities for facilitated discussions with ParentCorps Coaches and social networking with other users.

The implementation model (illustrated in the Figure) was applied and evaluated in 6 NYC public elementary schools. This study considered four indicators of fidelity via QIDS: 1) delivery of the specified number of days/sessions; 2) participation; 3) adherence to core content; and 4) facilitator competence. As in the trials, the three intervention components were delivered in all 6 schools. All 14 sessions of the Program for Students were implemented in all 17 pre-k classrooms; adherence to core content was high (> 90%). Eleven 14-session cycles of the Program for Parents were implemented by MHPs, with participation by 190 families (~60% of the targeted population); adherence to core content was high (> 90%); and weekly ratings by participants indicate that facilitators were competent and engaging. All indicators of fidelity were comparable to the efficacy trials which were co-facilitated by university-based MHPs. Finally, at the end of the 14-month capacity building phase, principals endorsed high levels of satisfaction (e.g., “Staff received enough support to effectively implement the program”; “ParentCorps has helped improve relationships between parents and teachers”) and commitment to sustainability (e.g., allocation of school funds).

Results suggest that the model is sufficient to achieve fidelity at the same levels found in the efficacy trials. Future work will consider factors theorized to influence fidelity based on Damschroder’s Consolidated Framework for Implementation Research (e.g., alignment with organizational values).