Incorporating Community Perspectives to Inform the Scaling-Out of an Evidence-Based Executive Functioning Intervention from Schools to Community Mental Health Settings.

Abstract

There is an urgent need for targeted efforts to better translate effective, evidence-based interventions (EBIs) to community settings. EBI adaptations or modifications that respond to community members' needs and recommendations are critical to improve fit and use in publicly funded children's mental health services. The current mixed-methods study utilized caregiver and mental health therapist perspectives regarding the perceived fit and necessary adaptations to a school-based, transdiagnostic intervention targeting executive functioning for implementation in children's mental health settings. We gathered community perspectives through surveys (n = 43) and four focus groups with mental health therapists (total n = 14, mean participants per focus group = 3.5, range 2-5) and semi-structured interviews with caregivers (n = 17). Results indicated the perceived relevance of an EBI targeting executive functioning in mental health services. Key adaptation recommendations included: a) modifying and simplifying intervention materials, b) incorporating educational material regarding executive function, c) a stronger emphasis on caregiver involvement, and d) adjusting the intervention format and length to improve fit with the mental health services context. Findings suggest community-partnered processes are necessary to adapt EBIs as well as to improve fit and translation between school and mental health settings. We also review resulting adaptations as well as next steps and future recommendations.