3 - (SYM 64) Supporting Evidence-based Intervention in the Classroom: A Pilot RCT

Classroom behavioral interventions are well-established to support students with attention-deficit hyperactivity disorder (ADHD; Evans et al., 2018). However, they can be difficult for teachers to use with consistent fidelity, which points to the need for implementation strategies to support their use. Given time and resource constraints inherent in schools, it is particularly important to identify implementation strategies that are feasible, flexible, and sustainable within this setting. There is also growing recognition that implementation strategies developed, selected, and refined in partnership with end users will have a higher chance of success (Lyon & Bruns, 2019; Pellecchia et al., 2018). Educators possess valuable practice-based expertise that is essential for developing implementation strategies that are contextually appropriate and feasible. Involving educators as partners is particularly important for ensuring that strategies are feasible and sustainable given policy, funding, and staffing considerations (Aarons et al., 2011).

This presentation will describe a multi-stage effort to develop and test implementation strategies to support teachers’ use of behavioral classroom interventions to support students with ADHD. The multi-stage project comprised: 1) mixed-method assessment of barriers and facilitators to teachers’ intervention use; 2) an iterative development process conducted in partnership with teachers and other school partners; and 3) an RCT pilot study, evaluating teacher implementation and student outcomes. This presentation will provide an overview of the approaches we used to learn from educators’ expertise across project stages.

We also will share results from the pilot RCT, which is underway and will be complete by June 2024. During the first year of the pilot trial (2022-2023 school year), we recruited and randomized teachers and students largely from minoritized backgrounds (57% Black, 21% Hispanic/Latino) in 11 classrooms. All classrooms randomized to receive the implementation strategy received the full dose of the strategy, as measured by consultant meetings attended. Evidence from our iterative development and ongoing pilot RCT indicate that the implementation strategy is highly acceptable and feasible (mean score of 4.74 [SD = .38] on a quantitative measure of acceptability on a 1-5 scale). We will discuss lessons learned related to the bidirectional relationship between research and practice in real-world settings.