Exploring Effectiveness and Mechanism of Change of an Implementation Strategy on Guideline Implementation in Schools

Lydia Kwak

Status: Completed

Conditions: Mental Disorder; Stress

Treatments: Behavioral: Workshops; Behavioral: Implementation team; Behavioral: Educational meeting; Behavioral: Internal facilitator; Behavioral: Plan-Do-Study-Act improvement cycles

Study type: Interventional

Funder types: Other

Identifiers

NCT05019937

2020-01214 (Other Grant/Funding Number)

Details and patient eligibility

About

This project is a two-armed randomized-controlled trial exploring the effectiveness and mechanisms of change of two different implementation strategies for implementing the Guideline for the prevention of mental ill-health at the workplace. The project will be conducted among public primary and secondary schools belonging to four municipalities in Sweden. Data will be collected with mixed-methods at baseline and different time-points of follow-up.

Full description

There is an urgent need for more knowledge on effective implementation strategies, as two-thirds of implementation efforts fail to achieve the intended change, and half have no effect on outcomes of interest. These implementation failures are partly due to the limited understanding of how implementation strategies work-the mechanisms of change through which implementation strategies affect implementation. This project will fill this research-gap by exploring mechanism of change during a cluster randomized controlled trial that compares the effectiveness of two implementation strategies for implementing the Guideline for the prevention of mental ill-health at the workplace in schools. Schools are chosen as the setting for implementation given the high prevalence of mental ill-health among teachers. Moreover, schools lack a structured approach to the prevention of mental ill-health. The aim of the project is to investigate how implementation strategies affect the defined mechanisms and guideline implementation. Mechanisms that will be tested include hypothesized mediators originating from the individual behavior change theory COM-B. The project will be conducted in public primary and secondary schools in four municipalities in Sweden. Data will be collected with mixed-methods from school-management and personnel at baseline, and different time-points during follow-up.

Enrollment: 2,276 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All personnel employed by the school

Exclusion criteria

• Personnel not employed by the school (e.g. cleaning- and canteen-personnel)

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

2,276 participants in 2 patient groups

Multifaceted implementation strategy

Experimental group

Description:

Schools randomized to this arm will be exposed to a multifaceted implementation strategy, which contains five implementation components

Treatment:

Behavioral: Plan-Do-Study-Act improvement cycles

Behavioral: Internal facilitator

Behavioral: Educational meeting

Behavioral: Implementation team

Behavioral: Workshops

Single implementation strategy

Active Comparator group

Description:

Schools randomized to this arm will be exposed to a single implementation strategy, which contains one implementation component

Treatment:

Behavioral: Educational meeting