Effectiveness of Multi-Level Implementation Strategies on Caregiver-Identified "Top Problems:" Secondary Outcomes of a Hybrid Trial of Two Autism Interventions.
Meeting the needs of autistic children requires the effective implementation of evidence-based interventions (EBIs). The TEAMS project tested the effectiveness of leader-level and provider-level implementation strategies to support the implementation of two autism-focused EBIs. The leader-level strategy was found effective in improving observed provider fidelity and standardized caregiver-reported child outcomes. This study extends the primary trial findings by assessing individualized child outcomes.
The current study examines the individual and combined effects of the TEAMS implementation strategies - TEAMS Leadership Institute (TLI) and TEAMS Individualized Provider Strategy (TIPS) - on caregiver-identified Top Problems.
Data were extracted from the TEAMS project, a hybrid type 3 implementation-effectiveness trial testing the effects of implementation strategies when paired with AIM HI (An Individualized Mental Health Intervention for Autism) in mental health programs (Study 1) and CPRT (Classroom Pivotal Response Teaching) in classrooms (Study 2). Programs/districts were randomized to TLI and/or TIPS. Data from 353 caregivers of autistic children (M age = 7.89 years, SD = 2.92, 80.1% male, 44.2% Latinx) were analyzed. Clinical outcomes were measured using the Top Problems Assessment at intake and after 6 months.
Controlling for study intervention (AIM HI or CPRT), a significant TLI x Time interaction (B = -0.95, p = .021) indicated greater reductions in Top Problem intensity in the TLI (vs. no-TLI) condition. No significant effects were found for TIPS or TIPSxTLI.
Findings support the effectiveness of leader-focused implementation strategies in improving the outcomes valued most by families.
The current study examines the individual and combined effects of the TEAMS implementation strategies - TEAMS Leadership Institute (TLI) and TEAMS Individualized Provider Strategy (TIPS) - on caregiver-identified Top Problems.
Data were extracted from the TEAMS project, a hybrid type 3 implementation-effectiveness trial testing the effects of implementation strategies when paired with AIM HI (An Individualized Mental Health Intervention for Autism) in mental health programs (Study 1) and CPRT (Classroom Pivotal Response Teaching) in classrooms (Study 2). Programs/districts were randomized to TLI and/or TIPS. Data from 353 caregivers of autistic children (M age = 7.89 years, SD = 2.92, 80.1% male, 44.2% Latinx) were analyzed. Clinical outcomes were measured using the Top Problems Assessment at intake and after 6 months.
Controlling for study intervention (AIM HI or CPRT), a significant TLI x Time interaction (B = -0.95, p = .021) indicated greater reductions in Top Problem intensity in the TLI (vs. no-TLI) condition. No significant effects were found for TIPS or TIPSxTLI.
Findings support the effectiveness of leader-focused implementation strategies in improving the outcomes valued most by families.
Authors
Benjamin Benjamin, Stahmer Stahmer, Johnson Johnson, Lau Lau, Roesch Roesch, Hernandez Hernandez, Brookman-Frazee Brookman-Frazee
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